By Linda Belardi.
People with dementia are failing to meet the Victorian requirement to report their diagnosis to the state road authority due to a lack of awareness of the new law, a survey by Alzheimer’s Australia Victoria has found.
Under the Victorian legislation introduced last year, it is the responsibility of drivers to notify VicRoads of a dementia diagnosis, but in a survey of the changes, more than one third of family carers said they were unaware of the requirement.
In response, Alzheimer’s Australia Vic has called for a sustained education campaign by VicRoads to reduce any misunderstanding of the new fitness to drive standards.
Anecdotal evidence also suggests that a small number of people may be avoiding getting a diagnosis of dementia in order to remain driving.
Under the new standards, a driver with dementia is not allowed to hold an unrestricted licence.
With a conditional licence a person is required to undertake a regular medical review at least once a year, which may include a driving test with a specialist occupational therapist. However, Alzheimer’s Australia Vic said many people with dementia are struggling to meet the costs of the on-road driving test required under the legislation.
Whilst most people surveyed (41 per cent) pay between $100 and $300 for an on-road driving test, 5 per cent – usually rural residents – are paying over $700.
Coupled with the expense of the doctor’s examination, the cost of the driver assessment is a significant burden for a pensioner, particularly if an annual retest is required, the peak body said.
“There is a need to make the testing equitable and accessible,” said the ‘Dementia and Driving in Victoria’ report released today, and based on a survey of 139 family carers and 19 people with dementia.
Alzheimer’s Australia Vic is concerned that some people with dementia have lost their ability to drive simply because they can not afford the test. To help people wear this cost, the consumer peak body has called on the Victorian government to subsidise the cost of the testing.
Over half of family carers surveyed said they would like to see a rebate be made available through Medicare, and 33 per cent would like to see the Victorian government partly subsidise the cost.
Due to long waiting times, Alzheimer’s Australia Vic has also recommended a statewide assessment of the supply of occupational therapists available to undertake the testing, particularly in regional areas.
A review of driver compliance may also be required, as anecdotal evidence suggests that people with progressive cognitive conditions may forget or misunderstand that they are no longer fit to drive, said the report.
However, with only 11 per cent of people surveyed with dementia continuing to drive with a conditional licence, greater investment in alternative transport is urgent, said the peak body.
This could be addressed through a state-funded community transport system to meet the needs of people requiring door-to-door travel, but cannot afford taxis.
“The community transport sector needs to be incorporated into state government transport policy including an adequate and sustainable funding commitment,” the report said.
Respondents also reported that half price taxi fares using Victoria’s Multi-purpose Taxi program were difficult to obtain, and a simplification of the approval process for people with cognitive impairment was required. At the moment, the scheme is weighted toward physical disabilities and low-income earners, the paper said.
The report recommended expanding HACC and packaged services to include more transport assistance to attend appointments, particularly where there is no family to assist the person with dementia.
An adequately resourced volunteer drivers program, with drivers trained in understanding people with dementia and other disabilities, should also be investigated.
In the area of research, the peak body called for further investigation into the crash involvement of people with dementia and the number of people with undiagnosed dementia driving on Australian roads.
Although there is evidence that dementia increases crash risk, it is also internationally accepted that not all people with dementia experience a decrease in their driving skills, particularly in the early stages of the condition.
In response to consumer feedback and with the assistance of the RACV Community Partnership Project, Alzheimer’s Australia Vic will develop key resources on dementia and driving and deliver programs over two years in every Victorian region.
The discussion paper was officially released at the Alzheimer’s Australia Vic Parliamentary Friends of Dementia meeting today at Parliament House.
Dementia and Driving in Victoria Discussion Paper is available at http://www.fightdementia.org.au/victoria/publications-from-alzheimers-australia-vic.aspx
Key survey findings:
Over 70 per cent of family carers would prefer their GP to inform their loved one with dementia to stop driving.
33 per cent of family carers reported that the impact of stopping driving on the person with dementia was greater than they had expected.
Only 12 per cent of respondents said they were using public transport or volunteer transport.
Memory loss and cognitive decline may result in disorientation on familiar routes; poor judgement and slowed reaction times; loss of attention and difficulty processing multiple stimuli.