Article

Position Statement of the American Association for Geriatric Psychiatry Regarding Principles of Care for Patients With Dementia Resulting From Alzheimer Disease

American Journal of Geriatric Psychiatry (Impact Factor: 4.24). 08/2006; 14(7):561-72. DOI: 10.1097/01.JGP.0000221334.65330.55
Source: PubMed

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    • "In contrast, when a person with dementia presents with only 'mild' effects on routine activities and cognitive function, fitness to drive should be determined on a caseby-case basis (Carmody et al. 2012). The importance of addressing fitness to drive for those with dementia has been defined in position statements published in Canada, USA, Australian and New Zealand (Lyketsos et al. 2006, Hogan et al. 2008). Hogan et al. (2008) outlined approaches to managing driving retirement in the Canadian Medical Association Journal including the family doctor's responsibility to monitor and counsel patients with progressive dementia who will eventually need to cease driving. "

    Full-text · Dataset · Jan 2016
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    • "In contrast, when a person with dementia presents with only 'mild' effects on routine activities and cognitive function, fitness to drive should be determined on a caseby-case basis (Carmody et al. 2012). The importance of addressing fitness to drive for those with dementia has been defined in position statements published in Canada, USA, Australian and New Zealand (Lyketsos et al. 2006, Hogan et al. 2008). Hogan et al. (2008) outlined approaches to managing driving retirement in the Canadian Medical Association Journal including the family doctor's responsibility to monitor and counsel patients with progressive dementia who will eventually need to cease driving. "
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    ABSTRACT: To synthesise primary research exploring decision making practices used to determine the time to retire from driving for individuals living with a dementia. Driving requires complex cognitive and physical skills potentially compromised due to the progressive nature of dementia. Whilst on-road assessments are considered reliable indicators of driving capacity by clinicians, drivers with dementia disagree. Integrative literature review informed by Whittemore & Knafl (2005). Electronic database search of Medline, CINAHL, Web of Science, Google Scholar 1997-2012; and incremental hand search. Primary studies published in peer reviewed journals were appraised against quality assessment criteria using CASP methodological assessment tools. A total of 43 studies were retained for synthesis. Key findings were abstracted and a themes matrix was generated to identify patterns of meaning. Six themes emerged: (i) dementia may compromise the complex task of driving; (ii) defining onset and severity of dementia is problematic; (iii) symptom progression impacts on driving skills; (iv) assessment of fitness to drive remains subjective; (v) some drivers are reluctant to accept negative assessment outcomes; and (vi) the search for effective strategies to enhance acceptance of driver retirement continues. This integrative literature review identified a large body of knowledge exploring the issues of driving cessation for drivers with dementia. However a challenge remains for practitioners, drivers and their family carers regarding how best to address this highly emotive issue. Findings could inform a structured approach to address this sensitive topic in a timely manner. © 2015 John Wiley & Sons Ltd.
    Full-text · Article · Jul 2015 · Journal of Advanced Nursing
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    • "ForAustralianmedicalpractitionersthereisnolegalobligationtoreportapatient'sdiagnosisof dementia(Carmodyetal.2013).Mandatoryreportingobligationsforimpairedphysicalorcognitive fitnesstodriveareonlylegislatedinSouthAustraliaandtheNorthernTerritory(Brownetal.2005, AustralianandNewZealandSocietyforGeriatricMedicine2009,Carmodyetal.2014).Whena clinicianassessesanindividualasdemonstratingsymptomsofdementiathatsignificantlyaffectdaily livingactivities,itisdeterminingfitnesstodrivingismorestraightforward.Incontrast,whenaperson withdementiapresentswithonly'mild'effectsonroutineactivitiesandcognitivefunction,fitnessto driveshouldbedeterminedonacase-by-casebasis(Carmodyetal.2012).Theimportanceof addressingfitnesstodriveforthosewithdementiahasbeendefinedinpositionstatementspublished inCanada,USA,AustralianandNewZealand(Hoganetal.2008,Lyketsos,etal.2006).Hoganetal. (2008)outlinedapproachestomanagingdrivingretirementinCanadianMedicalAssociationJournal includingthefamilydoctor'sresponsibilitytomonitorandcounselpatientswithprogressivedementia whowilleventuallyneedtoceasedriving.ConcurringwiththeAustralianandNewZealandSocietyfor GeriatricMedicine(2009)positionstatement,Hoganetal.alsorecommendedthat:(i)fitnesstodrive fordriverswithmilddementiacannotbesolelydeterminedusingabriefcognitivetest;and(ii) cliniciansshouldrelyonanoff-roadandonroadassessment. "

    Full-text · Article · Jan 2015
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