The Hartford Financial Services Group, Inc., in collaboration with the MIT Age Lab and Connecticut Community Care, Inc., conducted in-depth interviews with caregivers and people with dementia to learn how families perceive and manage driving and transportation issues when a person has dementia. The study was initiated because most information about dementia warns against driving, but does not describe how individuals and caregivers can determine when to stop.

The goal was to develop a thorough guide to help families maximize the independence of the person with dementia while at the same time minimize the risk of driving accidents. This guide provides practical tools for every stage of the process, from monitoring behavior to limiting and ultimately stopping driving. The information is based on the experiences of family caregivers and people with dementia, as well as suggestions from experts in medicine, gerontology and transportation.

Research Methodology

Phase I

In 1999, The Hartford Corporate Gerontology Group, the MIT AgeLab, Connecticut Community Care, Inc., and independent researchers Donna P. Couper, Ph.D., and Cheryl M. Whitman, MSN, CMC, conducted a series of interviews with individuals with Alzheimer's and those who cared for them.

The study involved in-depth, semi-structured interviews with 45 caregivers and nine persons with dementia. Interviews were conducted by the research team in Connecticut between October and December 1999.

The primary sample of caregivers included 24 adult children, 14 spouses, 3 grandchildren, 2 nieces and 1 daughter-in-law.

These persons with dementia were from the families of the 45 caregivers. To be eligible for the study, they had to have a probable diagnosis of Alzheimer's Disease or related disorder. In most cases, the person with dementia was either still driving or had stopped driving within the prior two years.

The results from this study formed the basis for the booklet At the Crossroads: A Guide to Alzheimer's Disease, Dementia and Driving.

Expert reviewers of the booklet included: Katrinka Smith Sloan (Director, Applied Gerontology Group, AARP); Richard A. Marottoli, M.D., MPH (Associate Professor of Medicine, VA Connecticut and Yale University School of Medicine; Chair, Committee on the Safe Mobility of Older Persons, Transportation Research Board); Harry E. Morgan, M.D. (The Center for Geriatric and Family Psychiatry, Inc., Glastonbury, CT; Advisory Board member, Northern Connecticut Chapter of the Alzheimer's Association); and Sue A. Smolski, A.P.R.N. (The Center for Geriatric and Family Psychiatry, Inc., Glastonbury, CT).

Phase II

Beginning in fall 2005, The Hartford's Corporate Gerontology Group partnered with the MIT AgeLab and the Boston University School of Medicine's Alzheimer's Disease Clinical and Research Program to conduct a study to examine whether the materials from At the Crossroads presented in an educational seminar format helped caregivers to cope better with issues they faced around dementia and driving. More than 80 caregivers in central and eastern Massachusetts took part in the study. The results suggest that those who participated in the educational sessions:

• felt more certain that they would be able to handle driving-related issues;
• felt better prepared to address the issue with their loved one;
• were more likely to have made a plan to talk to their relative about limiting or stopping driving;
• and were more likely to have talked to their relative about his or her driving.

Materials adapted from these educational sessions have been incorporated into this web site and the At the Crossroads booklet to provide caregivers with additional support and tools. (The revised booklet is now called At the Crossroads: Family Conversations about Alzheimer's Disease, Dementia and Driving.)

The Hartford/MIT AgeLab Partnership