title: [How to handle the dilemma of driving for patients with Alzheimer's disease? A survey of advices provided by French caregivers guides].
abstract: For many old people, driving takes an important place in the daily living activities and contributes to carry on their autonomy and self-esteem. However, many studies showed a link between car accidents and Alzheimer's disease, even in the early stages of dementia, and people caring for these patients inevitably ask the question: "Is my patient with Alzheimer's disease still able to drive his car?" Guides devoted to caregivers can play an important role to improve the knowledge of Alzheimer's disease and to afford advices for patients managing. To assess how these guides handle the question of patients driving, we made a survey of the 46 French caregiver guides (re)published between 1988 and 2013. The question of driving is raised with more or less details in 31 guides. All state that driving should be discontinued but that the consequences of this decision on the patient autonomy should be taken into account. A few guides provide clues to assess driving competence for the patients, and many propose advices to support the implementation of the driving discontinuity decision, such as to discuss with the patient to persuade him to stop driving, to ask for assistance by the family physician, to hide the car's keys or to disconnect its battery... In France, physicians are not allowed to prohibit driving or to report dangerous driving to authorities. Ultimately, the caregivers remain faced with the ethical dilemma to choose between safety and the patient's autonomy preservation. Therefore the responsibility for the patient to persist or give up driving only falls to them.
authors.affiliation: Laboratoire Interpsy, EA 4432, Université de Lorraine, Nancy, France.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Mietkiewicz
authors.affiliation: Laboratoire Interpsy, EA 4432, Université de Lorraine, Nancy, France.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Ostrowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D001334:Automobile Driving / Q000523:psychology*; D017028:Caregivers; D005260:Female; D005602:France; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Alzheimer disease; driving; guides; informal caregivers