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.
When Should Dementia Patients Stop Driving
American Academy of Neurology Offers Guidelines for Taking Away the Car Keys
April 13, 2010 — If a family member with Alzheimer’s disease or other dementia is racking up traffic tickets, getting in repeated fender benders, or exhibiting road rage, it may be time to think about taking away the car keys.
About 4 million Americans have some type of dementia and nearly all will eventually have to give up driving, says Donald J. Iverson, MD, of the Humboldt Neurological Medical Group, Inc., in Eureka, Calif.
Itâs one of the most wrenching decisions a family has to make, forcing the patient to face a loss of autonomy, Iverson tells WebMD. And there’s no hard rule or simple test to tell when a person is poised to become a danger, he says.
In an effort to offer some guidance to patients and their families, Iverson and other experts convened by the American Academy of Neurology recently combed through 6,000 studies and articles to arrive at new guidelines on dementia and driving.
The recommendations were released here at the AAN’s annual meeting and simultaneously published online by the journal Neurology.
Transitioning To Living Without Driving
To help you plan ahead for the time when you must stop driving, consider the following strategies:
- Consider alternative forms of transportation. These can be public transit, taxis, services provided by community organizations, and transportation organized by family members and friends.
- Use these alternative forms of transportation while it is still safe for you to drive. This will help you get used to new routines that you will transition to after you hang up the car keys for good. As well, this may help you accept the difficult decision to stop driving when it eventually comes.
- Look into companies that offer home delivery services. These can be pharmacy or grocery home delivery services.
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Progression And Reviewing Support
Vascular dementia could get worse over time, so its important to help your loved ones with such illness by reviewing care plans, mobility device options, and other types of support as soon as you can. You can do this together by using some tools to aid communication.
Finding out what they enjoy, what they wish they were able to do, and where they feel they might need help is useful, as well as your own observations. Watching your relative move around the house can help you see areas that are becoming more difficult to navigate so you can see where mobility aids can make life easier for them.
Driving Is Something Most People Take For Granted
It gives us freedom, flexibility and independence. While we will all need to step out from behind the wheel one day, conditions such as dementia can mean that the decision to stop driving needs to be planned for and made much earlier than expected.
Driving can seem like an automatic activity. However, it is a complicated task that requires complex thought processes, manual skills and fast reaction times. Dementia can cause loss of memory, limited concentration, and vision and insight problems. This affects a persons judgement and ability to drive safely.
A diagnosis of dementia does not always mean that a person has to give up driving straight away. Because the condition involves a gradual decline in cognitive and physical ability however, they will need to stop driving at some point.
The experience of giving up driving can be very difficult for many people, and the sense of grief and loss can be ongoing.
For quality of life and wellbeing, its vital to think about and plan ways that a person living with dementia and their families and carers can keep mobile, active and socially connected in the transition to non-driving.
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How Is Vascular Dementia Diagnosed
In addition to a complete medical history and physical exam, your healthcare provider may order some of the following:
- Computed tomography . This imaging test uses X-rays and a computer to make horizontal, or axial images of the brain. CT scans are more detailed than general X-rays.
- FDG-PET scan. This is a PET scan of the brain that uses a special tracer to light up regions of the brain.
- Electroencephalogram . This test measures electrical activity in the brain
- Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of the brain.
- Neuropsychological assessments. These tests can help sort out vascular dementia from other types of dementia and Alzheimer’s.
- Neuropsychiatric evaluation. This may be done to rule out a psychiatric condition that may resemble dementia.
Stage : Initial Mild Stage
Initial mild stage is also one of the vascular dementia that people should know and try to reduce its signs and symptoms for good.
This is known as the starting of this kind of disorder. During this stage, he or she will become more forgetful than ever before.
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They will have difficulty in remembering what they were talking about and what they need to do. Besides, they will find it hard to concentrate at work, thus decreasing work performance. People can get lost more often and feel difficult to find the right words.
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This stage of vascular dementia often begins to show signs and symptoms, about 5-7 years before the prediction of the presence of this disorder. Also, there is no diagnosis of vascular dementia.
This is in brief one of the vascular dementia stages, so people should not look down, yet work with their doctors and familiars in order to manage their conditions.
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Dementia And Driving Don’t Mix
In addition to a love of the open road, Wes and Walter share something else: Both men have dementia, and both have frightened their family and friends with their on-the-road escapades.
According to the Alzheimer’s Association, approximately 4 million people in the U.S. have Alzheimer’s disease, and it is estimated that the number could increase to 14 million by 2050, making the prospect of sharing a lane with an Alzheimer’s afflicted driver not such a remote possibility.
The risk that these drivers pose to themselves and others is serious enough that the American Academy of Neurology is now telling physicians when to take away a patient’s driving privileges. In the new guidelines, issued in the June 27 journal Neurology, the academy says that a person with Alzheimer’s disease and moderate dementia has a “substantially increased accident rate” and should not drive.
Neurologists consider a person with moderate dementia to be one who has some difficulty remembering recent events, such that the difficulty interferes with everyday activities. For example, this person might no longer be able to balance a checkbook or may stop a hobby such as woodworking. The person can take care of normal activities such as showering but may need some prompting to initiate the task.
For the first three months after the diagnosis, he continued to drive — but not alone. “I pretty much insisted on being with him,” Allen says.
How Does Dementia Affect Driving Ability
Dementia can make driving unsafe because it can affect someones ability to coordinate multiple tasks, judge distances and speed, stay alert, process information, remember directions and cope with stressful situations.
Being diagnosed with dementia does not mean the person has to stop driving straight away. But as the disease progresses, they will eventually need to stop driving.
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When Should You Call Your Doctor
911 or other emergency services immediately if signs of a stroke or transient ischemic attack develop suddenly. These may include:
- Numbness, weakness, or inability to move the face, arm, or leg, especially on one side of the body.
- Vision problems in one or both eyes, such as dimness, blurring, double vision, loss of vision, or a sensation that a shade is being pulled down over your eyes.
- Confusion, or trouble speaking or understanding.
- Trouble walking, dizziness, or loss of balance or coordination.
- Severe headache with no known cause.
if a person suddenly becomes confused or emotionally upset or doesn’t seem to know who or where he or she is. These are signs of delirium, which can be caused by a reaction to medicines or a new or worsening medical condition.
Call a doctor if you or a person you are close to has new and troubling memory loss that is more than an occasional bout of forgetfulness. This may be an early sign of dementia.
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.
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Vascular Dementia Signs And Symptoms
Vascular dementia affects different people in different ways and the speed of the progression also varies from person to person. Some symptoms may be similar to those of other types of dementia and usually reflect increasing difficulty to perform everyday activities like eating, dressing, or shopping.
Behavioral and physical symptoms can come on dramatically or very gradually, although it appears that a prolonged period of TIAsthe mini-strokes discussed aboveleads to a gradual decline in memory, whereas a bigger stroke can produce profound symptoms immediately. Regardless of the rate of appearance, vascular dementia typically progresses in a stepwise fashion, where lapses in memory and reasoning abilities are followed by periods of stability, only to give way to further decline.
|Common Signs and Symptoms of Vascular Dementia|
|Mental and Emotional Signs and Symptoms|
What Is Vascular Dementia
Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It’s caused when decreased blood flow damages brain tissue. Blood flow to brain tissue may be reduced by a partial blockage or completely blocked by a blood clot.
Symptoms of vascular dementia may develop gradually, or may become apparent after a stroke or major surgery, such as heart bypass surgery or abdominal surgery.
Dementia and other related diseases and conditions are hard to tell apart because they share similar signs and symptoms. Although vascular dementia is caused by problems with blood flow to the brain, this blood flow problem can develop in different ways. Examples of vascular dementia include:
- Mixed dementia. This type occurs when symptoms of both vascular dementia and Alzheimer’s exist.
- Multi-infarct dementia. This occurs after repeated small, often “silent,” blockages affect blood flow to a certain part of the brain. The changes that occur after each blockage may not be apparent, but over time, the combined effect starts to cause symptoms of impairment. Multi-infarct dementia is also called vascular cognitive impairment.
Researchers think that vascular dementia will become more common in the next few decades because:
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Stage : Mid Stage Semi Severe Vascular Dementia
Another one on the list of the vascular dementia stages that I would like to reveal in this article today and want you and my other readers to know if you are considering whether they get this disorder or not.
Loss of mobility: Many people gradually lose the ability of walking and performing everyday tasks. One of the first signs is that they walk unsteadily. They can also seem slower, bump into things and fall objects. Some people even become confined to a chair or bed. People who are caring for people with vascular dementia should ask for an advice from a community nurse or a therapist to aid mobility.
Memory loss: This symptom is very severe in the stages of vascular dementia. Patients may not be able to recognize other people who are close to them and even their own reflection. Also, they may not be able to find their way home around familiar surroundings or identify objects they use every day. However, occasionally, they may experience sudden flashes of recognition. They may believe that they are in a time from their past and may look for something or somebody from that time. For those around them, it may be helpful to try talking with them about the past. Even when they have severe memory loss, they still can appreciate or respond to music, touch and scent. Thus, continue to talk to them, even when they cannot respond.
Arrange For An Independent Driving Evaluation
The safest option for assessing a personâs driving skills is to arrange for an independent driving evaluation. Prior to the evaluation, inform the examiners that the person being evaluated has dementia. Evaluations are sometimes available through driver rehabilitation programs or State Departments of Motor Vehicles .
Although laws vary from state to state, some states require physicians to notify the DMV of any patient diagnosed with dementia. The person with dementia may then be required to report to the DMV for a behind-the-wheel driver re-examination. In some states, individuals diagnosed with moderate or severe dementia may have their licenses automatically revoked. To find out about driving and dementia laws, you can call the Department of Motor Vehicles for the state in which the individual resides.
Because symptoms of dementia are likely to worsen over time, individuals who pass a driving evaluation should continue to be re-evaluated every six months. Individuals who do not pass must discontinue driving immediately.
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Warning Signs Your Loved One Should Not Be Driving
Getting angry on the road is typical for many drivers, but if your loved one is becoming especially frustrated or confused while driving, this is a good indicator that its time to take the keys away. Other signs to look out for:
Missing or disregarding traffic signs and signals. Veering outside the lane. Decreased use of appropriate driving etiquette. Forgets the destination or gets lost on familiar roads. Increasing dependence on navigation aids in their home area. Difficulty determining the brake pedal from the gas pedal. New dings, dents, or scratches in the paint of the car.
People in the middle to late stages of dementia should not be driving, because the danger to themselves and others is too great. Its too easy to, for instance, lose focus and run a red light. The sad fact is that everyone with dementia will have to stop driving at some point, probably within three years, and its up to the people around them to determine when that point is. Consulting with the doctor or having the local Department of Motor Vehicles administer a driving test are ways to get a concrete answer, rather than leaving it up to your own feel.
Having The Conversation About Not Driving With Dementia
This can be difficult, especially if the person with dementia has been a figure of authority, like your mother or father. Losing the ability to drive can be emotional, so be prepared with hard, non-emotional evidence to make your case. Treat your preparation like youre getting ready for trial: accumulate evidence to make a strong case.
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Signs That Dementia May Be Affecting A Persons Driving
Changes in driving behaviour may have been occurring for some time without being noticed. Consider the following driving warning signs:
- Vision Can they see things coming straight at them and from the sides? Can they see and respond appropriately to traffic signs and signals?
- Hearing Can they hear the sound of approaching cars, car horns and sirens and respond appropriately? Do they pay attention to these when in the car?
- Reaction time Can 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 Is their coordination affected? Do they get the brake and accelerator pedals mixed up?
- Alertness Are they aware and understand what is happening around them?
- Can they tell the difference between left and right?
- Do they become confused on familiar routes? Do they get lost or take a long time on familiar journeys?
- Do they understand the difference between Stop and Go coloured lights?
- Are they able to stay in the correct lane?
- Can they read a road map and follow detour routes?
- Has their mood changed when driving? Some previously calm drivers may become angry or aggressive.
- Are there new bumps and scratches on the car?