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6Dementia and Driving Checklist 1. Questions to Ask the Patient and Family Patient Yes No Have you noticed any change or decreased confidence in your driving skills Have you had any accidents (or

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How to fill out dementia and driving checklist

01

To fill out the dementia and driving checklist, follow these steps:

02

Begin by gathering all the necessary information, such as the driver's personal details, medical history, and any previous driving incidents.

03

Review the checklist thoroughly to understand the different sections and requirements.

04

Start by entering the driver's basic information, including their name, contact details, and driver's license number.

05

Move on to documenting the driver's medical conditions, including any diagnosed dementia or related cognitive impairments.

06

Provide a detailed description of the driver's dementia diagnosis, including the date of diagnosis and any relevant medical reports or assessments.

07

Ensure to include information about any medications the driver is currently taking, especially those that may impact their driving abilities.

08

Document any recent driving incidents or accidents the driver has been involved in, including dates, locations, and details about the incidents.

09

Include information about any restrictions or recommendations given by healthcare professionals regarding the driver's ability to drive safely.

10

Review the completed checklist to ensure all the necessary information has been accurately provided.

11

Submit the filled-out checklist to the appropriate authority or organization responsible for evaluating the driver's eligibility to continue driving.

12

Note: It is recommended to consult with healthcare professionals or experts specialized in dementia and driving assessments for guidance throughout the process.

Who needs dementia and driving checklist?

01

The dementia and driving checklist is needed by individuals who have been diagnosed with dementia or related cognitive impairments and still wish to continue driving. This checklist serves as a comprehensive evaluation tool to assess the individual's ability to continue driving safely considering their medical condition and any potential risks.

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