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Purpose: This phenomenological study explored older people's experience of driver licence cancellation. Methods: Qualitative data were derived from interviews with four men and one woman, aged between 68 and 87 years (mean age = 78.6 years). Results: Driver licence cancellation was a deeply traumatic and shocking experience. Driving had been a normal and accepted part of life, and cancellation of their driver licences meant the loss of their independence. They lost their means of identification, and they were confronted with future losses and the deep sadness associated with these. Conclusions: There is a need for sensitive health-care practices that consider the devastating consequences of licence cancellation, and support older people through the difficulties associated with adjusting to life without a driver licence.

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Background and Aims:Determining if a person with dementia should be referred for a driver assessment, at what stage of the illness and how often to repeat this are difficult decisions for health professionals. The aims of this study were to develop criteria for driver assessment referral and to explore the value of routine reassessment for drivers with dementia. Methods and Results: Twenty participants with a diagnosis of dementia were recruited from a memory clinic and underwent a standard occupational therapy driver assessment and reassessment 6 months later. Fifteen failed the initial assessment but 10 went on to pass local area assessments. Some participants in the early stages of the disease failed. Five of the nine participants suitable for reassessment at 6 months also failed. Conclusion:The results confirmed that routine referral following the diagnosis of dementia is appropriate. Change in performance was noted at reassessment, confirming that 6 months between assessments is an appropriate timeframe.

Background: People with Alzheimer's disease may be required to undertake clinical and on-road assessments to determine fitness to drive. The manner in which on-road assessments are conducted with drivers who do and do not have navigational problems may affect the outcome. Objectives: Investigate the effect of 1) navigational difficulties, 2) location of assessment (un/familiar area) and assessment order, and 3) undertaking a second assessment (practice), on passing an on-road driving assessment. Methods: Forty-three drivers undertook an Occupational Therapy-Driver Assessment Off Road Assessment (OT-DORA) Battery which included the Drive Home Maze Test (DHMT). Participants with/without a history of navigational problems were randomly allocated into three groups: 1) Unfamiliar/then familiar area assessment; 2) Unfamiliar/unfamiliar; 3) familiar/unfamiliar. An on-road assessment protocol was used including over 100 expected behaviors at nominated points along the directed route. For familiar area assessments, the driver self-navigated from their home to shops and services. A pass/fail decision was made for each assessment. Results: A generalized linear mixed effects model showed neither location, nor practice affected passing the on-road assessment. Participants with navigational problems were six times less likely to pass regardless of route familiarity and direction method, and the DHMT was a significant negative predictor of passing. Conclusion: Drivers with Alzheimer's disease who have navigational problems and are slow to complete the DHMT are unlikely to pass an on-road assessment. However, navigation and maze completion skills may be a proxy for an underlying cognitive skill underpinning driving performance.