Peterson Colleen M, Ingvalson Stephanie, Birkeland Robyn W, Louwagie Katie W, Scott Theresa L, Pachana Nancy A, Liddle Jacki, Gustafsson Louise, Gaugler Joseph E
University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, Michigan, USA.
School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Innov Aging. 2024 Mar 1;8(3):igae022. doi: 10.1093/geroni/igae022. eCollection 2024.
Driving retirement can be a necessary but challenging and emotionally complex transition, especially for people living with dementia. This pilot study evaluated the utility of CarFreeMe™-Dementia (CFM™-D), a telehealth intervention providing tailored education and social support to those living with dementia and their care partners, as they prepare for or adjust to driving retirement. Delivered by empathetic health professionals, CFM™-D is a person-centric, flexible program tailored to address challenges specific to the participants' driving retirement stage and individualized contexts.
A single-arm, mixed-methods design was used to follow participants over a 6-month period. Participants received CFM™-D, a 7-8-module semistructured intervention, including education and planning support for driving retirement (impact of dementia, transportation options) and emotional adjustment (grief and loss, stress management). Surveys evaluated the perceived utility of intervention components as well as changes in well-being and readiness for driving retirement over time. An open-ended survey item and semistructured interviews provided additional feedback and a contextual understanding of the empirical data.
A total of 50 families enrolled (17 care partners, 16 retiring/retired drivers with memory loss, and 17 care partner-retiring/retired driver dyads). Nearly all participants would recommend the intervention. Care partners reported significantly reduced ( < .05) isolation and relationship strain, and retiring drivers reported significant reductions in depressive symptoms. Driving retirement preparedness scores improved. Driving retirement phase, enrolling as a dyad, and retiring driver cognitive/functional impairment were associated with these outcomes. Participants also engaged in more driving retirement activities outside of the intervention (e.g., talking with health professionals).
CFM™-D is a useful intervention for retiring drivers with dementia and their family members, with preliminary data suggesting it supports improved well-being and driving retirement preparedness. A randomized controlled trial is needed to determine the efficacy of the CFM™-D intervention and future translation needs.
停止驾车可能是必要之举，但却是一个充满挑战且情感复杂的转变过程，对于患有痴呆症的人来说尤其如此。这项试点研究评估了“无车生活——痴呆症版”（CFM™-D）的效用，这是一种远程医疗干预措施，为患有痴呆症的人和他们的护理伙伴在准备或适应停止驾车期间提供量身定制的教育和社会支持。CFM™-D由富有同理心的健康专业人员提供，是一个以人为本、灵活的项目，旨在应对参与者停止驾车阶段及个性化背景下的特定挑战。
采用单组、混合方法设计，对参与者进行为期6个月的跟踪。参与者接受CFM™-D，这是一个包含7 - 8个模块的半结构化干预措施，包括针对停止驾车的教育和规划支持（痴呆症的影响、交通选择）以及情感调整（悲伤与失落、压力管理）。调查评估了干预组成部分的感知效用以及随着时间推移幸福感和停止驾车准备情况的变化。一个开放式调查项目和半结构化访谈提供了更多反馈以及对实证数据的背景理解。
共有50个家庭参与（17名护理伙伴、16名有记忆丧失问题的即将退休/已退休驾驶员，以及17对护理伙伴 - 即将退休/已退休驾驶员组合）。几乎所有参与者都推荐该干预措施。护理伙伴报告称孤独感和关系紧张程度显著降低（P < 0.05），即将退休的驾驶员报告抑郁症状显著减轻。停止驾车准备得分有所提高。停止驾车阶段、以组合形式参与以及即将退休驾驶员的认知/功能障碍与这些结果相关。参与者在干预之外也更多地参与停止驾车相关活动（例如与健康专业人员交谈）。
CFM™-D对于患有痴呆症的即将退休驾驶员及其家庭成员是一种有用的干预措施，初步数据表明它有助于改善幸福感和停止驾车准备情况。需要进行一项随机对照试验来确定CFM™-D干预措施的疗效以及未来的转化需求。
