Developing an evidenced-based role for the social worker in addressing driving competency in clients with dementia

The goal of this action research (AR) project was to develop an evidenced-based role for social workers in driving competency intervention in clients with dementia. Initially a seven-member focus group identified driving-related needs. Next, an online survey was distributed to social workers in a northeast state to identify practices of assessing the driving ability of clients with dementia. Of the 96 responders, 53 worked with people who have dementia. Results were analyzed using qualitative and quantitative methods. Finally, eight community professionals were interviewed and provided insight into relevant policy development. Needs identified by focus group members included places they or their loved ones drive to: purchase goods; obtain services; socialize; drive dependents; work; and for "joy rides". Findings from survey responders and interviews with community professionals identified barriers preventing driving cessation discussions including: lack of affordable and reliable transportation; lack of support from families or healthcare professionals; and client resistance. Online responders and community professionals believed a guide addressing driving cessation would be helpful. Community professionals offered recommendations including: early intervention; building trusting relationships; using multidisciplinary approaches to problem solve; community networking; building similar advocacy bases; creating a special needs registry; obtaining DMV support to increase communication to law enforcement; increasing DMV referrals; and empowering clients. A brief guide was created from the data collected. This guide may be developed into a protocol to deliver and manage clinical care of clients with dementia in advance of and during the time they no longer have capacity to safely drive.