Family and caregivers often wonder if a person with dementia should continue driving as soon as they learn of the diagnosis. But, the inability to drive safely does not always follow a diagnosis of dementia.
However, dementia is progressive, which means symptoms will get worse over time. These problems can be with memory, visuospatial abilities, and other cognitive abilities. Because of this, a person’s ability to operate a motor vehicle declines, and, ultimately, the individual must be prepared to give up driving.
Most people take driving for granted. Freedom, adaptability, and autonomy are what we get from driving. While we all may have to give up the keys eventually, diseases like dementia can necessitate the choice to quit driving being made much sooner.
Sometimes it may feel like second nature to get behind the wheel. But, it’s a difficult task that requires planning, coordination, problem solving, and quick reflexes to name few. Dementia can impair one’s ability to remember and focus. It can affect vision & judgment.
At times, even after receiving a dementia diagnosis, a person can continue to operate a motor vehicle safely and responsibly. However, they will eventually have to give up driving because of the condition’s effect on their cognitive and physical abilities.
Many people find it incredibly hard trying to forego their driving privileges. The resulting feelings of loss and grief can linger for a long time. Because of the dangers, some people decide to cut down on or completely eliminate their own personal driving.
Some people may be unable to judge when it is no longer safe for them to drive, yet they may insist on continuing to do so. When a person’s symptoms represent a danger to others on the road, family members, caregivers, and healthcare professionals may need to step in.
6 Signs That People With Dementia Should Stop Driving
Determining when someone is too impaired by dementia to drive safely is challenging because the disease’s course differs from person to person.
The first step would always be contacting the physician for addressing any concerns and for further education specific to your needs. Caretakers and people living with dementia can use the information in this fact sheet below as a roadmap when making decisions about driving restrictions and cessation. Any safety concern that is listed below should always be discussed with the doctor.
1. Getting Tickets or Having Accidents
The National Highway Traffic Safety Administration (NHTSA) reports that drivers aged 85 and up had the highest collision rate per mile traveled. This alarming number highlights that senior drivers, especially those with impaired cognitive abilities are in heightened danger in the event of a car accident.
Regrettably, mishaps are often the precursor of worse things to come. You may want to intervene if your close relative has a history of traffic infractions, including accidents, tickets, and mysterious automobile damage upon their return home.
Accidents, while unfortunate, can make it simpler to intervene, as they serve as wake-up calls for people who may not have realized their symptoms had developed to such an extreme state.
Whether or not your loved one admits to the change and its ramifications, the fact that they are trying to cover up the evidence of their recent car damage & accidents may be a clear indicator.
2. Confusion in Observing Traffic Signs
Dementia, according to the Alzheimer’s Society, impairs not only memory but also visuospatial abilities and the ability to plan ahead, all of which are crucial for safe driving.
Age-related declines in vision and hearing may further complicate the already challenging task of generating reliable split-second judgments.
Your loved one may be losing the capabilities necessary to maintain their driver’s license if they suddenly lose their ability to remember traffic rules or correctly interpret traffic signals and signs.
Warning signals include:
- Not stopping when signs or lights say to.
- Failing to move over to the right lane at the appropriate time.
- Misinterpreting traffic and road signs.
3. Avoiding Driving With Others
The best way to gauge a relative’s driving abilities is to ride with them. You can observe their response time, speed, and compliance with traffic regulations if you join them on shopping trips or let them drive.
If they refuse to let you ride, it could be because they are aware that their driving expertise is declining. Thus, they don’t want you to criticize them, worry about them, or even be in trouble.
It’s more plausible if they still drive for others but refuse to include their loved ones in their trips.
Refusing passengers could also indicate that even brief interruptions (such as a passenger’s voice or activity) are too much to bear. As dementia progresses, signs such as slower than normal reaction times become much more noticeable to outside observers.
This further contributes to the patient’s tendency to become easily distracted. How we approach the person living with dementia is also crucial when it comes to bringing up driving related concerns.
4. Unable to Locate Familiar Routes
People with dementia can display symptoms like disorientation. If they have been wandering or turning up in odd places while driving, their cognitive impairment is likely putting other drivers in danger.
Your loved one’s safety on the road is jeopardized if they have even occasional episodes of disorientation, which could cause them to become lost or leave without warning.
The Alzheimer’s Association Policy Division and the National Highway Traffic Safety Administration conducted a detailed analysis of dementia and driving. They found that being disoriented and having access to a vehicle is potentially lethal.
Keep this grave danger in mind, and intervene if a loved one wanders off in a place they know well.
5. Road Rage And Aggression
Aggression is a major contributor to road rage, another major threat to traffic safety. If your loved one with dementia is experiencing mood swings, or behavioral episodes, pay close attention to how they feel about drivers on the road, how they feel after driving, and what they have to say about their experiences on the road.
If these mood swings are contributing to any further aggression, speak with the physician.
6. Failing Independent Driving Evaluation
In the end, an impartial examination of a person’s driving skills is the most reliable option. Therefore, regular road testing is an important element of the treatment process for people with dementia. It allows for the tracking of decreasing skills, and the determination of when driving should be stopped.
Even if your loved one refuses to take road tests, you may still be able to file a report or request an evaluation with the DMV in your state.
Road tests are a practical approach to safeguard your loved one and others on the road from their inevitable decline in driving ability as dementia progresses.
In addition, they provide a neutral, evidence-based assessment in place of your biased thoughts and feelings. If your loved one has been reluctant to your earlier efforts, a test might take the pressure off. It provides an objective means for them to demonstrate or face their driving skills. A physician may also recommend a driving test be performed by a specialist like an Occupational Therapist, who is able to perform driving related evaluations (ask the doctor if they would recommend this & see if this is available in your area).
Last Resort to Prevent a Person With Dementia From Driving
Here are some preventative measures to use as a last option if the person with dementia in question refuses to give up driving:
- Limit who can use car keys. Hide your keys. Provide non-functional keys if the individual with dementia insists on keeping a set of keys.
- Stop the car and turn the engine off. For example, you could disconnect the battery to disable the car’s starter. Or you might have a “kill switch” installed that needs to be activated before the vehicle starts.
- Get rid of the car. You should sell the car if you can manage without it.
Alternatives to Driving
A person’s freedom to move and engage in activities shouldn’t be avoided because of a lack of access to regular transportation. Popular means of transport include:
1. Ask Friends And Family
Friends, relatives, and neighbors may offer to drive the person to events and doctor’s visits. Compile a list of people willing to drive them, along with their contact information and the times they are free to do so.
2. Community Transport
Taking the bus or subway instead of driving could be safer for people with mild dementia. People who are already well-versed in utilizing the local public transit system will benefit the most from this. There’s always an option for a family member or friend to join.
Middle to Late-stage dementia patients may have trouble understanding schedules and directions.
3. Taxis/Ride Shares
There are options like taxi’s or ride shares that allow for transportation to/from places. If the person is safe to be out alone after taking a taxi or a ride share to get them there, this could be a possible option. There are also companies out there that will provide the transportation to/from and stay with the person the entire time. There’s one in Austin called https://www.elderwheels.care/.
You can try to create a payment account with the cab driver if you don’t want the person with dementia to deal with cash.
4. Transportation Services For Seniors And Those With Special Needs
There are also transportation services for seniors and those with special needs you can look into, You can try to google organizations for the names of services offering accessible transportation.
For some people with dementia, the choice to quit driving is not a voluntary one. The doctor’s decision to keep someone from driving may be final.
They may not pass the driving exam the first time around. For example, there may have been a family quarrel about driving that led to family members preventing the person from driving or taking away the car keys.
The inability to drive is a source of frustration or sadness for some people with dementia. They’re upset because they can’t do what they want and feel like they’re losing control of their own lives.
Always speak to a doctor first when driving or tasks related to driving become a concern. They can help provide the best individualized advice for your situation.