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Driving: A new self-management tool (in addition to a 'stroke…
Driving: A new self-management tool
(in addition to a 'stroke passport')
ACUTE PHASE
Assessment of the importance of returning to driving to the patient (using an outcome measure like the COPM)
If pt has visual or cognitive changes/ if return to driving marked as important to patient, assess stage of change and acceptance of losing driving role - using self assessment tool based on ROSPA
Identify significant roles and functions driving fulfills for the patient
Identify alternatives to driving and record
Identify stage of change (? any ambivalence/ resistance?)
target the intervention based on stage of change seen
provide relevant information leaflets with support (stroke association/ enable me)
Full Therapy and Medical discharge summary put into - for pt to take with them with DRIVING PASSPORT if appropriate
clear pt recorded SMART goals and rehab plan
full cognitive and visual screen information to go with patient
Introduce a stroke passport (as seen in Somerset and Wales) - covers all areas of health literacy, mentions generic driving advice
based on concepts of building self efficacy, shared decision making, goal planning
involve and educate family/ supportive others throughout process
COMMUNITY PHASE
The community MDT to continue to work on 'driving passport using a self management approach
regular feedback on achievements and existing impairments using same paperwork as other therapists
ensure alternative modes of transport are signposted
continue writing pt focused goals and review regularly
link with community support eg stroke support groups
work on rehab strategies - eye search, cognitive rehab, virtual reality, functional rehab
celebrate all the successes that pt has achieved since stroke
signpost towards on road driving assessment
POST ACUTE PHASE
REVIEW BY ACUTE STAGE
provision of 'driving passport' to consultant/ or GP at 6 week post stroke review
creates a clear pathway for pt
pt has been informed and involved in shared decision making regularly throughout the stroke pathway
there are no surprises for the pt if the consultant/ gp decides to inform DVLA they are not safe to drive
Pt can celebrate all ways rehab goals has been achieved using stroke passport
improves communication between services
Next in-patient team is taking on the task of working on 'driving passport' based on a self management approach
peer support (narratives)
use of elearning (enable me)
rospa videos
guest speakers
visual hazard perception
continue assessments (cognitive/ visual/ functional)
feeding back successes and impairments to patient