Our Tips On Keeping Someone With Dementia From Driving
Of course, the level of dementia determines what techniques you could use and what may work each individual is unique therefore, each individual requires their own set of unique solutions.
The problem that I saw as an occupational therapist was that many people who were dealing with someone with dementia tried to reason with that person.
But, the issue there is that its not prudent to think that you can reason with someone whose thinking pattern has become faulty.
What Im trying to say here is that there usually is no way to reason with someone who has dementia or Alzheimers disease.
So, that means that other tactics are needed , but its for a good reason. You want to help that person be as safe as possible for their own sake and for the sake of others on the road.
Mild Alzheimers Sufferers Driving Declined Most Rapidly
The researchers found that decline in driving abilities was slowest in those without dementia diagnoses. The decline was quicker in very mild Alzheimers patients and even quicker in mild Alzheimers cases. Two years after the beginning of the test, almost all drivers with Alzheimers were in the unsafe category. The researchers noted that most people who receive a diagnosis of Alzheimers stop driving within three years, presumably because they or caregivers notice a decline in driving skills. It appears, from the research, that this self-restricting or restriction by caregivers should probably come a year earlier.
In defiance of the statistics, some people with dementia and mild Alzheimers were still safe drivers. Therefore, blanket restrictions on all people with dementia are inappropriate. The six-month monitoring recommendations of the AAN seem consistent with these findings: that individuals within a diagnosis group differ in driving abilities.
Warning Signs Of Driving Problems
The guidelines say these are some of the warning signs caregivers should watch for:
- Accidents. Research shows that people who have had a crash in the past five years are more likely to have another accident, compared to people with mild dementia alone.
- Moving violations. One study showed that people over 70 who had two or more tickets in the past three years were more likely to have a crash than any other age group, including teenage boys, who recently held that spot.
- Driving less. “The magic number seems to be 60 miles a week. Driving less than that is associated with unsafe driving,” although where you live and how frequently you typically drive factor in, Iverson says.
- Avoiding certain driving situations, such as driving at night or in the rain.
- Road rage. Research shows that aggressive or impulsive personality traits can be useful in identifying unsafe drivers, Iverson says.
Becoming lost on a familiar route may also be a warning sign, says David Knopman, MD, a spokesman for AAN who was not involved in writing the guidelines.
Getting lost once may mean nothing, he says. “But if a person arrives two hours late repeatedly with no good explanation or there are unexpected dents in the car, there may a problem, says Knopman, a neurologist at the Mayo Clinic in Rochester, Minn.
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Should Someone With Dementia Be Driving
Alzheimers disease and other types of dementia often present slowly over time in seniors. This can make it very difficult for even close family members and friends to notice that something is amiss in the early stages. Unfortunately, the insidious nature of these progressive conditions often leaves seniors extremely vulnerable during the time between the onset of symptoms and official diagnosis.
In addition to causing changes in ones ability to perform daily activities like cooking, paying bills, bathing and managing medications, dementia can also seriously affect a seniors ability to drive. Not only does their unsafe driving endanger their own health, but it also poses a hazard to the surrounding community.
Discuss Your Concerns About Their Driving
If someone you know may or does have dementia, but continues to drive, discuss your concerns about their driving with them. Its important to raise the issue early, while theyre still able to make decisions about their driving future, such as selling their vehicle. Sometimes people with dementia will recognise their own limits and accept that theyre putting themselves and others at risk. Give the person a chance to make the decision to stop driving.
They may be reluctant to stop driving, possibly because they cant understand fully that they have had a loss of skills. The problem must not be ignored, even if theyre only travelling to the shops and back. You may need the family to help ensure the person doesnt drive.
Its often useful to involve the persons health practitioner, who can assess their fitness to drive and, if necessary, take appropriate action if they dont agree to stop driving. The health practitioner could be their usual doctor , a registered nurse or nurse practitioner, or a specialist if appropriate.
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Can You Legally Drive With Alzheimers Or Dementia
This question immediately comes to the minds of family members, but the questions raised are broader than simply, does my state have a law against driving with dementia / Alzheimers?. As relevant are the following questions:
-Do I need to report someone with dementia to the department of motor vehicles ? If so, how soon?-Will our doctor report the individual to our state DMV?-Do I need to notify my car insurance that a driver in my house has dementia?-Will our insurance provider refuse to cover us or raise our rates?
Laws and rules about driving with a diagnosis of Alzheimers vary by state and are often unclear. For example, in California doctors are required to notify the Department of Motor Vehicles if a person has been diagnosed with dementia, and the DMV then issues a request for driver reexamination,. This is a driving test that can result in driving restrictions during certain times of day, or even the full loss of driving privileges. How quickly the reporting and re-examination happen is very vague, as is enforcement. Another example is Texas, where there are no laws about reporting a diagnosis to driving authorities, but anyone can report a potentially unsafe driver to the state DMV. Accordingly, a doctor, a neighbor or even a family member may choose to do so. Then the driver will have to pass a doctors evaluation to stay behind the wheel.
Can A Person With Dementia Continue To Legally Drive
Here in the USA, each state has different legal rules when it comes to driving and specific illnesses, including dementia.
In other parts of the world, they are not as lenient.
In the UK, you must inform the DVLA that you suffer from dementia. If you do not and are found out, you will be fined. If you are in an accident, you can be prosecuted.
In Australia, drivers are also required to advise their licensing authorities of their diagnosis as well.
It is surprising, at least to me, that there are not stricter rules concerning this issue but then again there have not been as many studies on the topic as I believe there should be.
In one study by Dr Laura B. Brown and Dr. Brian R. Ott, they found that
there is probably a 2- to 8-fold greater risk of crashes for elderly drivers with mild to moderate dementia compared to those not demented.
I dont think this should come as a shock to anyone after all considering the symptoms that are normally found in persons with dementia, its very easy to see how these symptoms can impede the driving tasks of anyone with that disease.
So again, I do urge you to have your driving skills evaluated either through a rehabilitation program or the DMV .
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Confusion Over Colors Words Or Road Rules
Geri Taylors accident wasnt the first sign of trouble. Months before she realized she should stop driving, she straddled two highway lanes because she suddenly thought she needed to follow the dotted lines instead of driving between them. According to the Alzheimers Society, dementia affects many of the mental abilities needed for safe driving, including visuospatial skills and memory. It doesnt help that vision and hearing may decline throughout the aging process, making it even more difficult to make accurate split-second interpretations.
If your loved one suddenly forgets traffic rules or misunderstands traffic signals and signs, they may be losing the abilities that licensed drivers are required to have. Look for red flags like running stop signs and red lights, stopping at green lights, failing to stay in the right lane or misreading traffic and street signs.
One Seat Is Not Like The Others
Believe it or not, the seat they sit in makes a significant difference.
It turns out that the ideal seat for someone with dementia is the middle seat in the back. This will help to prevent them from trying to open car doors as the vehicle moves. It might also minimize anxiety. Plus, it prevents them from rolling down windows and throwing things out. They will also get a better 180 degree view as well.
Use child safety locks for doors and windows in case they attempt to change seats while you are driving. Also, bring cushions, pillows or comfy travel seats to make the trip more pleasant for them physically.
Never let a person with dementia sit in the front. This is to prevent their urge to grab the wheel as you drive. And, it will prevent items that drop or get thrown from being trapped under pedals.
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Other Health Conditions That Affect Driving
Many people with dementia have other health conditions that may also affect their driving.
Problems with vision and hearing are common in older people, as is arthritis. If this affects a persons neck, it may reduce their head-turning ability. This can make manoeuvres like pulling out into moving traffic much harder.
Some older people also have weaker muscles which can make physical tasks like steering or braking difficult.
Certain medications may also affect a persons driving such as drugs taken to help a person to sleep or some drugs for depression. If the person needs to inform their driver licensing agency about taking these medications, the doctor will advise them of this.
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Refusing To Drive With Others
Riding with your relative is the easiest way to assess their driving skills. Accompany them on errand runs or offer to let them drive, and notice their reaction times, speed, and adherence to traffic rules. If they wont let you get in the passengers seat, it could mean their driving skills are already getting worse, and they dont want you to judge, worry, or even be in danger. Thats especially likely if they still give rides to other people, but wont let close family members or friends tag along.
Refusing passengers may also be a sign that minor distractions are enough to make focusing impossible. Distractibility gets worse as dementia progresses, and symptoms like slowed-down response times are a lot more obvious to objective observers. Insist on spending some time as their co-pilot, and get acquainted with their current abilities as a driver.
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How To Stop A Person With Dementia From Driving
Car keys are a symbol of independence for American adults, which usually makes taking them away a daunting task for family caregivers. As our loved ones age, we must be hypervigilant about looking for signs that their mental and physical abilities are changing. This is an extremely delicate subject for most seniors, but under no circumstances should you allow someone to drive if there is any sign of impairment.
Many AgingCare members post in the Caregiver Forum asking for advice on how to stop a person with dementia from driving. Ultimately, preventing a loved one from getting behind the wheel may require taking away their car keys, revoking their drivers license and/or automobile insurance, and possibly even disabling or removing their car.
The extent to which you must go to keep a senior from driving depends entirely on their stubbornness, lucidity and desire to get behind the wheel. Which, again, may be deceiving as these things fluctuate. The extent to which you can legally go to keep them safe also varies. For example, you cannot legally sell a loved ones car unless you have a valid power of attorney for finances that permits you to handle such affairs.
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The Importance Of A Travel Partner
If you are traveling more than several hours, have a driving partner.
This person can also help to take turns staying with your parent when you need gas or a few minutes of quiet.
If your parent has advanced dementia, a travel buddy can also provide you with peace of mind and assistance. This person will particularly come in handy if your parent requires assistance to shower, dress and go to the bathroom.
Have the driving partner to sit in the back with your parent. There they can help more easily and keep your parent engaged. And, your travel partner can help ensure heating and air conditioning temperatures are appropriate to reduce agitation.
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More Tips For Surviving Your Road Trip
Here are some more tips to make your trip less stressful:
- Take plenty of their favorite snacks and water to prevent dehydration and irritation from hunger. But, balance hydration needs with bathroom breaks.
- Bring plenty of familiar items from home such as a favorite blanket, cards, books and pictures to reduce stress.
- Play familiar music to keep the mood positive.
- Pack plenty of clothes for all weather conditions with extra outfits for potential spills or accidents. But, also try to pack light to make overnight stops easier to maneuver. Or, you could pack a separate bag for the stops along the way.
- Dont forget about a safe-return bracelet with their name and your phone number in case you would get separated.
Signs That Dementia Is Affecting Driving Ability
- vision can they see things coming straight at them or from the sides, do they respond appropriately to stop and traffic signs and signals?
- hearing can they hear the sound of approaching cars, car horns and sirens, and do they pay attention to these when in the car?
- reaction timecan they turn, stop or speed up their car quickly?
- problem solving do they become upset and confused when more than one thing happens at the same time?
- coordination have they become clumsy and started to walk differently, because their coordination is affected?
- alertness are they aware of, and understand, what is happening around them?
- left and rightcan they tell the difference?
- memory and confusion do they become lost or confused on familiar routes?
- stop and go do they understand the difference between stop and go coloured traffic lights?
- route finding can they read a road map and follow detour routes?
- steering are they able to stay in the correct lane and veer, change lanes or merge when required?
- mood has their mood changed when driving? Some previously calm drivers may become aggressive or angry.
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Role Of Caretakers And Family
Because Alzheimers cannot be cured and is degenerative, management of patients is essential. Alzheimer’s disease is known for placing a great burden on caregivers/family the pressures can be wide-ranging, involving social, psychological, physical, and economic elements of the caregiver’s life.
No two families dealing with dementia will resolve transportation issues in exactly the same way. Roles and relationships within families can affect decisions about when and how a person should stop driving.
Caregivers can reduce stress and increase their chances of success by relying on others for emotional support, transportation assistance, financial assistance or to meet other needs. Caregivers need to remember that family members tend to follow long-established patterns for making decisions. It is unrealistic to think that patterns will change when handling a difficult issue like driving safety.
Disagreements in families are often the result when individuals do not have the same opportunities to assess driving abilities. Having factual information about driving behaviour does not guarantee families will reach a consensus on when to limit driving. However, frequent, open communication about specific, observed behaviours and concerns may help to lessen differences.
Everyone involved in caring for the person with dementia can help by focusing on the key issues – the self-respect of the person with dementia and the safety of everyone on the road.
Risky Driving Behaviours Caused By Dementia
If you’ve been driving for many years, driving may feel mostly automatic. However, as dementia progresses, it will change your abilities, such as your level of concentration, judgement, orientation, perception and physical ability â all important and necessary skills for driving.
As a result, regardless of your driving skill and experience before you started having symptoms, your dementia will eventually put you at a higher risk for the following driving behaviours:
- Slow response times,
- Taking too much time to reach a destination or not reaching the destination at all,
- Driving too slowly or too fast,
- Driving through stop signs or red traffic lights,
- Stopping at green traffic lights,
- Having difficulty merging with traffic,
- Making left hand turns in the face of oncoming traffic and pedestrians crossing the intersection.
These behaviours can increase your risk of a collision, which can cause serious injury and death for you and other people.
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