A profile of community navigation in adults with chronic cognitive impairments

Abstract

The results of both studies were consistent and indicated that community access is severely restricted for individuals with CI. The majority of trips that were taken tended to be routine and assisted. The variety of travel was limited; participants ventured to the same set places with the same people. Participants described barriers accounting for these problems and suggested a number of strategies to minimize problems.

Validation of the Activities of Community Transportation model for individuals with cognitive impairments

“…However, the data from the paratransit dispatch centre may also not fully represent the complete spectrum of transportation challenges since data were recorded by dispatchers receiving information from drivers in the field. For example, previous research has documented that individuals with cognitive impairments also demonstrate challenges with navigating to and within their destination [10,11], but these data were not available in the current study.…”

“…It was challenging to collect sufficient data for trip observations specifically for TBI survivors who present with navigation challenges because they either did not use public transportation or did not frequently venture outside their residences. Sohlberg et al [10] previously demonstrated that these individuals are primarily 'home-bound' despite adequate physical ability and availability of an accessible and reliable bus route at their door-step. Anxiety, fear of getting lost or leaving an established 'comfort zone', financial restrictions, reduced initiation or spontaneity, and lack of opportunity precluded many of these individuals from venturing out.…”

“…Individuals who are unable to drive typically either rely on care providers for rides or use public transportation [10]. Dependence on care providers for transportation may add to burden of care [4] and reduce self-determination among adults with cognitive impairments [6].…”

“…However, learning to access and use public transportation systems efficiently provides significant challenges to many individuals with cognitive impairments [11]. Availability and accessibility of public transportation systems appear insufficient to compensate for driving cessation as many individuals do not feel confident in their ability to use public transportation [8][9][10]. Travellers with a variety of impairments may need specific training to access and use public transportation effectively and confidently [12].…”

Family members’ needs and experiences related to driving disruption following acquired brain injury

“…However, the barriers and challenges of using alternative transport have been reported in several studies (Risser, Iwarsson, & Ståhl, 2012;Rosenkvist, Risser, Iwarsson, Wendel, & Ståhl, 2009;Sohlberg, Todis, Fickas, Hung, & Lemoncello, 2005). Transportation services, which include public transport and specialised services for persons with disability, have been perceived as unreliable, unpredictable and difficult to access (Ing, Vento, Nakagawa, & Linton, 2014;Rudman, Hebert, & Reid, 2006).…”