Summary :
Specialized Alzheimer Teams (ESA in France) provide support to people living at home with Alzheimer’s disease or related disorders (ADRD). The occupational therapist’s role within these teams is to assess autonomy in Activities of Daily Living (ADL), to define personalized support goals, and then to guide Gerontology Care Assistants (ASG in France) in implementing home-based sessions (presenting the issues and pathologies encountered, suggesting interventions, and reassessing goals). Driving is one of these ADLs. In France, drivers with certain medical conditions must undergo a medical check-up. A legal text published in March 2022 specifies the conditions for driving for people with ADRD. Not all individuals supported by ESAs are aware of this legislation, and to our knowledge, there is no existing tool to address this subject during ESA follow-up. In light of this, we examined how to support ESA patients in driving cessation while preserving their participation in daily activities, leisure, and social life. Driving is a complex and multidimensional activity (complexity of the task itself, perceptions associated with car ownership, and the consequences of cessation); it is a subject addressed by occupational therapists during their interventions (driving assessment, supporting changes in habits). Due to the lack of available tools to discuss this topic with beneficiaries, we developed a kit within the Mâcon ESA (Saone-et-Loire), which was subsequently tested by several teams in the same department. Feedback from this experience highlights the benefits of using this tool: 9 out of 26 beneficiaries stopped driving and implemented transportation
alternatives; 17 beneficiaries continued to drive, and two-thirds of them have modified their habits by reducing driving frequency and/or adopting alternative solutions. Regarding limitations, these include difficulties accessing to driving alternatives, a lack of caregiver support, refusal by the individual, challenges in understanding instructions when cognitive impairment is advanced, as well as reluctance from Gerontology Care Assistants (ASG) to use the kit. Finally, avenues for improving this tool have been explored.
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Article rédigé par :
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Manon Tissier
Ergothérapeute DE
manon_tissier@hotmail.fr