Date of Graduation

5-2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Public Policy (PhD)

Degree Level

Graduate

Department

Political Science

Advisor

Leah J. Henry

Committee Member

Brinck Kerr

Second Committee Member

Alishia Ferguson

Third Committee Member

John Gaber

Keywords

Aging, Alzeimer's disease, Dementia, Driving, Geriatrics, Gerontology

Abstract

Background: States have various policies regarding a physician's ability or responsibility to report at-risk drivers with dementia to the Department of Motor Vehicles (DMV). Some states have mandatory reporting policies, others have optional reporting policies and some have no policy regarding this issue. Arkansas has no reporting policy regarding drivers with dementia to the DMV. Therefore, physicians in Arkansas face the risk of liability if they report a patient against their will to the DMV in good faith. Neurologists and geriatricians are often in a position to diagnose and treat individuals with dementia. Research Questions: The following three research questions were developed in an effort to identify how the problem of drivers with dementia is defined among these two types of specialists in Arkansas: (1) What knowledge do Arkansas neurologists and geriatricians have of state policy regarding reporting of at-risk drivers with dementia to the DMV; (2) What are Arkansas neurologists' and geriatricians' opinions regarding various policy options for reporting of such drivers to the DMV; and (3) What are the reporting practices of Arkansas neurologists and geriatricians of drivers with dementia to the DMV? Methods: A survey was distributed to Arkansas neurologists and geriatricians to explore the reporting practices, knowledge and opinion of policy regarding drivers with dementia among these practitioners. Results: There was considerable uncertainty among respondents, regarding the process of assessing and reporting at-risk drivers with dementia in Arkansas. Support for optional reporting policy was very strong. Mandatory reporting policy was less favored by those surveyed. Respondents reported that conversations with patients and family members regarding the cessation of driving is often contentious and ongoing. Conclusions: Findings have implications for both policy and practice. It is recommended that the Arkansas legislature develop and adopt an optional reporting policy. There is also a need for physician education regarding state reporting policy, as well as training in the assessment of fitness to drive for patients with dementia.

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