Dr. Naglie received his medical degree from McGill University, specialty training in Geriatric Medicine at the University of Toronto, and graduate training in Clinical Epidemiology at McMaster University. He is a Professor in the Department of Medicine and Institute of Health Policy, Management and Evaluation at the University of Toronto and holds the Hunt Family Chair in Geriatric Medicine. He is the Vice President of Medical Services and Chief of Staff, and Chief of the Department of Medicine at Baycrest Health Sciences and is a Scientist at Baycrest’s Rotman Research Institute and at the Toronto Rehabilitation Institute-University Health Network. His research focuses on outcomes evaluation and quality of life in cognitively impaired and frail older adults. Dr. Naglie is a member of Candrive, a national team of researchers interested in driving safety in older adults, and he has a particular interest in driving issues in persons with cognitive impairment. He is Co-Lead with Dr. Mark Rapoport of the Driving and Dementia Research Team for the Canadian Consortium on Neurodegeneration in Aging, which is supported by CIHR and many partners and is the Canadian component of the CIHR Dementia Research Strategy.
An intervention framework and toolkit to ease the decision-making and transition to non-driving for persons with dementia and their caregivers
Introduction: Driving is a marker of independence and an important aspect of quality of life for older adults. Decision-making about driving and the experience of transitioning to non-driving is laden with ethical, safety, psychosocial and health implications, posing significant challenges for persons with dementia, their family caregivers and healthcare providers. Our previous research identified a lack of established intervention approaches to driving cessation, as well as major gaps in the knowledge, accessibility and utility of resources and tools available to support the driving cessation process for individuals with dementia and their caregivers.
Objectives: To design an evidence-based, multi-component intervention framework and toolkit to help facilitate and support drivers with dementia and their family caregivers in the decision-making process and transition to life without driving while maintaining their social and emotional well-being.
Methods: We used a range of knowledge creation and synthesis activities to inform the development of the framework, including literature reviews and qualitative methods to explore the perspectives of key stakeholders (e.g., family caregivers, healthcare/service providers). Tools and resources (e.g., guidelines, videos, assessment tools) that address driving cessation were collected, reviewed and organized according to the components of the intervention framework.
Results: Based on these research activities we developed the Driving Cessation in Dementia Framework and Toolkit (DCD-FT), which supports decision-making about driving cessation and the transition to non-driving for persons with dementia and their family caregivers. It is comprised of a rigorously reviewed and curated collection of materials and resources organized to align with the seven components of the driving cessation intervention framework that we developed. The components address both the practical and emotion oriented aspects of driving cessation and include: information/awareness; communication; mobility/community access; relationships/role transitions; crisis/conflict; loss/grief; and identity/meaning.
Conclusion: By providing a novel and comprehensive resource to support persons with dementia, their family caregivers and healthcare providers during the driving cessation process, the Driving Cessation in Dementia Framework and Toolkit can help older people with dementia retain their mobility, social connectivity and quality of life. Next steps include revising the DCD-FT based on stakeholder input and then evaluating its implementation in community settings.