Driving and Dementia: when is it no longer safe

My loved one was recently diagnosed with dementia. Is driving even an option?

A dementia diagnosis does not necessarily mean that a person is incapable of driving and should have their license suspended. Some people in the early stages of dementia can continue to drive safely depending on when they are diagnosed and how quickly the disease is progressing. However, eventually it will no longer be safe to drive and it is important to prepare your loved one for this inevitability. The skills most impacted by dementia include divided attention, visual-spatial abilities and speed of response. Driving requires quick reactions, the ability to focus on several things at once, good judgement and remembering the rules of the road. The risk of having an accident doubles every five years from the onset of dementia.

The best thing to do is talk to your loved one’s doctor about the progression of the disease and how it will impact their driving. Tell the doctor if you have any concerns. He/she will evaluate your their cognition and the impact of any other existing conditions such as vision or hearing loss, cardiac problems or neurological disorders. Your doctor may also be able to refer your husband for a special driving evaluation where available. The Canadian Medical Association recommends a reassessment of driving safety every 6 to 9 months. Physicians in most provinces are responsible for identifying potential medical risks that could affect a person’s fitness to drive and notifying the responsible authorities.

What are the warning signs that driving is no longer safe?

As the disease progresses, your loved one’s cognitive function, memory and visual-spatial orientation will decrease and may lead to:

• Using improper speed or stopping in traffic for no apparent reason
• Being confused when to stop or change lanes
• Getting lost on familiar roads
• Driving in the wrong direction
• Using improper signalling
• Ignoring traffic lights and signs – thinking ‘green’ means stop and ‘red’ means go
• Relying on a co-driver or refusing passengers like family and friends
• Becoming nervous or irritated about driving
• Not being able to make sound judgments on the road – avoiding near misses, not braking in time, driving too fast in inclement weather
• Deteriorating eye, hand, leg coordination and reflexes
• Receiving an increased number of traffic violations or police warnings
• Misjudging widths and distances, resulting in an unusual number of small dents or scrapes on the vehicle

How can I help prepare my loved one for the day he can no longer drive?

Everyone should be prepared that at some stage of your life, regardless of cognitive loss, you may no longer be able to drive. The thought of losing this form of independence may make you angry or depressed, especially if you have a progressive disease like dementia. It is important to be sensitive to your loved one’s emotions and to communicate with them over time to get them used to the idea and to offer transportation alternatives that may still give him some control over their life. Look at bus schedules together, research community organizations that offer rides, set up an account with a taxi or ridesharing service, and approach family and friends who can help out.

Discuss the fact that staying off the road is for their safety as well as the safety of other drivers and pedestrians who could be hurt in an accident. Some people with dementia may actually be relieved to relinquish the car keys if they are feeling confused or worried while driving, but they will still need your support to help them cope with this loss of mobility.

What if my loved one refuses to stop driving?

When safety is a factor and your loved one should no longer be driving, you can ask their doctor or another healthcare professional to discuss the issue with the two of you. Physician advice is one of the most frequently cited reasons a patient with dementia stops driving.

If that doesn’t solve the issue, you could:

• Ask the doctor to write a prescription that says: “Do not drive.” A person with dementia may take an official prescription seriously.
• Take away the car keys
• Remove the car battery
• Move the car out of sight

Talking to healthcare professionals or families in similar situations can help. You can also contact your local Alzheimer Society. If you need extra help, we are here for you. Our caregivers are trained and certified to care for individuals with dementia.