Implications for Program and Policy

A goal for all people, including people with dementia, is to maintain their community mobility. A starting point for thinking about policy related to community mobility and dementia is to consider the policy framework for older adults crafted by the United States Department of Transportation (2003). That framework includes:

  • New roadway designs that better accommodate the needs and limitations of older drivers and pedestrians, along with land use that minimizes auto dependence and facilitates aging in place.
  • Vehicle safety systems designed to protect fragile older occupants, better understanding of the interaction between older drivers and vehicle systems, and use of new technologies to meet the needs of older drivers and passengers.
  • Better understanding of factors that place older drivers at increased risk; more effective procedures for identifying, assessing, training, rehabilitating, and regulating functionally limited drivers; better understanding of how to enable people with functional disabilities to walk safely (see Dunbar, 2000).
  • Public transportation systems that facilitate wider use by older people, including one-call-does-it-all mobility managers; evaluation and promulgation of best practices; elimination of programmatic barriers to coordinated delivery of transportation services; and intercity travel that is more elder-friendly.
  • Formation of State and local action plans to develop safe transportation for an aging populace.
  • A comprehensive campaign to educate older people and their caregivers on how to identify unsafe older drivers; information for community service groups to equip them to address the safe-transportation needs of older people.
  • Research on the effects that loss of mobility can have on the quality of life of older people, on the potential for related health-care costs, and on ways to reduce the transportation problems of older people through technological and other solutions.

Action steps are delineated for each of these items in the US DOT (2003) report and in Eberhard (2004). However, steps related specifically to people with dementia have not yet been identified. That is clearly an area where leadership is needed among Alzheimer’s professionals, advocates and other concerned citizens. The first step is to acknowledge that while a diagnosis of dementia does not mean that the individual must immediately stop driving, it does mean that the person will need to stop driving before long, and that plans should be in place when that time comes.