Caregivers And Doctors Take Charge
So is there anything a person with dementia can do to improve his or her driving skills?
Not really, Iverson says. One study showed that people over 85 who took an in-person test to renew their driving license slightly lowered their risk of being in a deadly crash. But otherwise there was no evidence supporting strategies such as driver training or licensing restrictions, Iverson says.
The bottom line, he says, is that even as dementia worsens, most patients are going to deny that they pose a hazard on the road. That places doctors and caregivers in charge.
Don’t bring up giving up the car keys when a person is just recovering from the blow of being diagnosed with dementia, Iverson says.
“But over time, caregivers and doctors should begin the discussion,” he says. “It’s a process. And, it’s not easy.”
Doctors, patients, and caregivers must also know their state laws, because some states require that doctors report any medical conditions that may affect a patient’s ability to drive safely.
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.
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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What To Do If Travel Isnt Possible For Your Senior With Dementia
Sometimes travel will be too overwhelming or exhausting for seniors with dementia. If thats the case for your older adult, its best not to push them beyond their limits.
If your older adult cant travel, technology can help them enjoy a significant event or visit with relatives. For example, if theres a family wedding, arrange video chats so they can view the ceremony and talk with relatives. That way they still get to participate in the celebration.
Another thing to remember is that this doesnt mean you cant travel. To allow you to go on a trip and take a much-needed break, consider asking family to take over, hiring in-home caregivers, or arranging a short respite stay in an assisted living community that meets their needs.
How Do I Know If There Is A Problem
Be on the lookout for the warning signs of dementia. These include not being able to remember recent events, repeating statements or questions, not knowing the date or time, and having trouble doing normal things like cooking or making a telephone call.
Look for a change in the persons driving skills. Do you feel safe riding with this person? Would you let him or her drive young children? Does he or she drive too fast or too slow, change lanes without looking, or fail to yield the right of way to other drivers? Does he or she have trouble making left turns at traffic lights, get upset or confused in heavy traffic, or have trouble following directions? Do other drivers honk their horns or get mad at this person? Does the persons car have scrapes or dents?
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Dont Forget To Pack Your Patience
Traveling with a parent with dementia will be challenging at times. Your patience will be tested. So, have a strategy in place up front to manage your stress.
The important thing is to make the trip as enjoyable as possible for all of you.
If you need a mental break from the action, play some road games to keep everyone entertained. Bring games they can play such as electronic bingo. Play 20 questions with topics they are familiar with such as guessing former celebrities.
What Can I Do If I Think Someone Has A Problem
If you think that a friend or family member might have dementia, talk to his or her doctor. The doctor will check this person for dementia and other problems that can affect driving skills. The doctor might want to do medical tests or have the person take a driving test.
Right now, there is no perfect way to test for safe driving in people with dementia. If a person is judged to be unsafe, he or she must stop driving. It is important to help this person find other ways to get around. Older people can become depressed when they stop driving. Doctors and social workers can help.
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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.
Skills Needed To Drive Safely
These are the skills a person must have to drive safely:
- good vision in front and out of the corners of the eyes
- quick reactions to be able to brake or turn to avoid crashes
- good coordination between eyes, hands and legs
- the ability to make decisions quickly
- the ability to make judgements about whats happening on the road.
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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?
Measures To Stop The Alzheimers Patient From Driving
Families struggle with the decision to limit or stop the family member from driving and the sense of dependence may prevent people with dementia from giving up the car keys. Unfortunately, no examination or single indicator exists to determine when a person with dementia poses a danger to himself or others. Families must determine when a person’s attention span, distance perception or ability to process information makes it difficult for him or her to respond safely in driving situations.
Finding Dementia Sufferers Who Get Lost While Driving
May 15, 2013
Various methods may help boost success in finding drivers with Alzheimers disease or other forms of dementia who get lost, a new study suggests. They include prompt notification of law enforcement officers, detailed descriptions of the missing person and not just their car, and preventive measures to keep people with dementia from getting lost in the first place.
It is common for someone with Alzheimers to become lost while driving. Quickly finding the missing person is critical, since it is estimated that half of those who are not found in the first 24 hours will suffer serious injury or death.
In recent years, Silver Alert programs have been adopted by many states to locate missing seniors. The programs, modeled on the Amber Alert system to find lost or abducted children, involve alerts sent out to local law enforcement and media outlets that provide a detailed description of the missing person as well as the kind of car they may be driving and the license plate number. Billboards on highways and TV and radio spots alert the public to those details.
Silver Alerts help local law enforcement find elders with Alzheimers or other cognitive impairment and return them home safely. For families and caregivers of loved ones assisted by the Silver Alert, it also increases awareness of the possibility of future problems or the need for additional assistance.
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.
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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.
How Do We Stop The Person With Alzheimers From Driving
It is important to consider the persons feelings and perceived loss of independence when explaining why he or she can no longer drive. Helping the person with dementia make the decision to stop driving – before you have to force the person to stop – can help maintain a positive sense of self-esteem.
The most effective approach to limit or stop driving involves progressive steps and a combination of strategies that fit the family’s circumstances, resources and relationships. For people in the early stages of dementia, driving is best reduced over time rather than all at once.
You can ask your doctor to advise the person with dementia not to drive. Involving your doctor in a family discussion on driving is probably more effective than trying by yourself to persuade the person not to drive. Ask the doctor to write a letter stating that the person with Alzheimers must not drive or a prescription that says, No driving.
Explain your concerns about his or her unsafe driving with the person, giving specific examples, and ask the person to voluntarily stop driving. The following steps might assist in explaining the need to stop driving:
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Starting A Conversation About Driving
It can be hard to talk about driving with someone who has dementia, as they might see it as their right or as something they can do automatically. They might see their inability to drive as a very big loss and a decrease in their independence.
- Discuss their driving habits, so you can find other transport options to keep them active and socially connected.
- Arrange for more home visits so they do not need to drive.
- Be positive that their roles in life for example, as a grandparent or partner will continue without driving.
- Explain how dementia affects them while their driving record may be safe, this will not always be the case.
- Talk finances no more paying for registration, insurance and petrol.
- Encourage regular visits to their doctor and other health professionals to check medication, eyes, diet and general health, to help maintain some independence.
When Should A Person With Dementia Stop Driving
Neurologists can make a more personalized recommendation regarding someone driving with dementia with help from a new AAN guideline.
A new guideline by the American Academy of Neurology helps neurologists determine when people with and other dementias should stop driving. It’s an update of the AAN’s 2000 guideline, which concluded that “patients with mild categorically should not drive,” says Donald J. Iverson, M.D., lead guideline author and a neurologist with the Humboldt Neurological Medical Group, Inc., in Eureka, CA. “The update softens the message to ‘should strongly consider discontinuing driving,'” Dr. Iverson explains. The guideline is published in the April 20, 2010 issue of Neurology .
Clinical trial evidence illustrates that patients’ driving skills deteriorate with increasing dementia severity, according to the guideline. Yet studies also show that as many as 76 percent of dementia patients pass an on-road driving test, making a recommendation that patients with dementia absolutely should not drive under any conditions too restrictive, says Dr. Iverson: ” wanted to preserve the patient’s autonomy to some extent. Giving up driving is associated with depression and increased awareness of mortality. We wanted to limit that as much as possible.”
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The guideline also suggests follow-up evaluations every six months may be useful to determine whether driving risk has increased.
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Driving Safety And Alzheimer’s Disease
Good drivers are alert, think clearly, and make good decisions. When people with Alzheimer’s disease are not able to do these things, they should stop driving. But some people may not want to stop driving or even think there is a problem.