Understanding Dementia & Driving
The Hartford Center for Mature Market Excellence® partnered with the MIT AgeLab to conduct research to bring clarity to the very serious and emotional issue of dementia and driving and to help drivers and their families plan a successful transition from driver to passenger.
More than 5 million people in the U.S. are afflicted with dementia, with Alzheimer’s disease being the most common form. Deciding when to limit or stop driving can be a confusing issue for individuals diagnosed with dementia and their caregivers. Earlier diagnosis and better medications may allow people to drive longer, further complicating the decision on dementia and driving. However, as the disease progresses driving skills will diminish, and the person with dementia must stop driving. Most information about dementia warns against driving, but does not describe when or how to stop.
Ways To Stop An Elderly Person From Driving
1. Anonymously report them to the DMVThe Department of Motor Vehicles allows people to report unsafe drivers, often anonymously. You dont have to be a doctor, anyone can file a report.
The benefit is that your older adult wont blame you for taking their license away. Instead, theyll be angry with the DMV.
Each states DMV has different procedures. Typically when someone is reported as an unsafe driver, theyre called in for a drivers license retest regardless of when their license expires. Contact your local DMV to find out what is needed in your state to request a retest.
If you dont feel comfortable filing a DMV report, speak confidentially with their doctor and share your concerns. Ask the doctor to write a letter that you can take to the DMV.
2. Use Alzheimers or dementia forgetfulness to your advantageAlzheimers or dementia can cause seniors to become irrational and stubborn about driving.
In these situations, an effective strategy is to remove the car and any reminders of driving. At the same time, creatively distract them from the topic until they forget about driving altogether.
This approach spares them from angry confrontations or getting depressed about not being allowed to drive.
3. Have a relative or close friend borrow the carIf your older adults car isnt in the garage, they wont be able to drive it. To keep them from getting suspicious, you could arrange for a relative or close friend to borrow the car.
Getting Lost In Familiar Places
Disorientation is one of the most common symptoms of dementia. Getting lost or showing up in strange places is a clear sign that this cognitive impairment is making it unsafe to drive alone. If your loved one experiences any bouts of disorientation at all, theres a risk that these could occur while driving, leaving them vulnerable to getting lost or leaving inexplicably.
According to a comprehensive review of dementia and driving by the Alzheimers Association Policy Division and NHTSA, disorientation and access to car keys are a dangerous combination. Be especially aware of this particular risk, and take action if your loved one gets lost in familiar places.
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What Can Affect An Older Persons Ability To Drive
Some health issues can affect an older persons reaction time, reflexes and other aspects of driving, such as:
- Medication: some medications can slow down reaction time or cause sleepiness.
- Eyesight or vision problems: poor eyesight can affect the ability to see clearly front-on or from the sides.
- Hearing loss: they may not be able to hear a car horn or siren.
- Mobility problems or pain: they may have difficulty or be slower pulling the handbrake, using the footbrake or moving their heads to check their side vision.
- Memory problems: they may get lost, confused or disorientated if they are in an unfamiliar area.
If the change in someones driving ability is linked to a health condition, there could be a solution that would allow them to continue driving safely. Encourage the person to speak to their GP or pharmacist about any health problems or medications that may be affecting their ability to drive safely.
The Role Of Health Practitioners
Health practitioners may refer a person suspected of having dementia to an occupational therapist for an assessment of their driving. This isnt the same as a driving test its a more comprehensive assessment.
Health practitioners also have a legal obligation to advise the Transport Agency if they believe that a person unfit to drive is likely to carry on driving.
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When Should A Senior Stop Driving
One of the harshest realities associated with aging is the loss of mobility and agency. It can be particularly difficult to assess and address when you may be a threat to yourself and others by handling certain matters on your own.
One such activity that is common among those who take care an aging loved one is driving.
Many of us spend a vast majority of our lives behind the wheel of vehicles, as we commute to work, run errands for our families, embark out on a night of entertainment or even long distance travel. However, there may come a time in which we must consider, not only our safety, but the safety of our passengers and other motorists.
It can be hard to convince a loved one that it is time to surrender their drivers license. But walking into a conversation about aging drivers equipped with a balance approach of valuable information, compassion and solutions may help the senior in your life understand the right decision to make.
Having The Conversation About Stopping Driving
Whenever it happens, the decision to stop driving won’t be easy âand neither will the conversation that leads to that decision:
- After all, you’re losing the privilege to drive due to changes in your abilities that you can’t stop âbecause of this, it’s totally normal to feel angry, sad, frustrated or hopeless.
- As well, it may add a strain on the relationship between you and your friends and family . They will likely notice changes in your abilities before you do, and may be the first to discuss whether you should stop driving.
- On the other hand, they may be hesitant to bring up the conversation about your driving ability, whether it’s out of a desire to see you live independently or to avoid conflict in your relationship with each other.
Although losing the privilege of driving can be difficult, it’s important to remember that it can be equally, if not more devastating, to be involved in a motor vehicle collision. A collision can result in serious disability or death for you or in trauma and death of others.
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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.
What Is The Maximum Age Limit For A Driving License
Believe it or not, there is no maximum age limit for a driving license. As long as you can pass your states requirements for renewing your drivers license and of course also pass the vision test you can get licensed to continue driving at any age.
Know that each state in the USA has a different set of requirements as you can see in the table that I mentioned earlier in this article.
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Talking With A Person With Dementia About Driving
- Discuss the persons driving when everyone is calm.
- Have the discussion when there have been changes in medications or health status, rather than a driving incident.
- Have short and frequent conversations, which are better for most people with dementia than a long one-off discussion.
- Concentrate on the persons strengths and the positive aspects of other options.
- Acknowledge that giving up driving is hard to do.
- Normalise the situation by pointing out that everyone will have to stop driving at some point.
- Focus on the nature of the disease many people with dementia have very safe past driving records, but this has no bearing on their safety as a driver with dementia in the future.
- Focus on the financial benefits of selling the car.
- Be respectful and try to understand how the person with dementia will be feeling.
- Offer to support the driver by driving them to appointments, social gatherings, shops and services.
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.
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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.
As the caregiver, you must talk with the person about the need to stop driving. Do this in a caring way. Understand how unhappy the person may be to admit that he or she has reached this new stage.
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.
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Most Common Form Of Dementia Is Alzheimer’s Disease
The most common form of dementia is Alzheimers disease. Alzheimers is a disorder affecting the function of the brain. A person can appear fully alert and awake, but their memory and judgement are impaired. With Alzheimers, recent memory goes first. People tend to forget events rather than details. Rather than Who did I sit next to at the wedding?, a person with Alzheimers will ask What wedding?
No single feature distinguishes Alzheimers disease the total picture determines whether or not a person has Alzheimers.
Driving With Dementia: 6 Dangerous Signs Its Time To Step In
Are you worried that your parent or grandparent is unsafe behind the wheel? Dementia affects everyone differently, but it often disrupts the motor skills and cognitive skills that are necessary for safe driving. While the pace and severity of the disease are unpredictable, a diagnosis is always a good reason to pay closer attention to driving with dementia. From disorientation and aggression to slow response times and poor reasoning abilities, common dementia symptoms are downright dangerous when mixed with motor vehicles. As Alzheimers disease progresses, it may fall to loved ones to recognize the warning signs and take action for people who are driving with dementia.
Of course, you dont want to make this call too early and risk alienating or limiting the independence of someone you loveor wait too long and take an even bigger risk. Thats why its so important to learn when and how to spot the telltale signs that driving is no longer safe. Here are six of the biggest indicators that your loved ones dementia is a road hazard and its time to take the keys:
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It May Affect Their Insurance Cover
Insurance companies require that any condition likely to affect a drivers ability must be disclosed or the company has the right to turn down a claim. After notification of this condition, whether the company will continue to provide insurance cover or not depends on the recommendation of the health practitioner and consultation with the insured parties. If the person with dementia is still driving, ask their insurance company if theyll be covered by insurance if they crash.
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.
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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.
A Helpful Test You Can Do
If you suspect a person may be showing signs of dementia, give them this simple test on common traffic signs.
Ask What does the sign mean? and What action should the driver take?
Suggested answers:
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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.
Managing Travel With People With Dementia
- Be prepared to be fully responsible for the person with dementia this can be taxing, so try to get plenty of rest before the trip.
- You need to keep hold of all important possessions passports, money, schedules and tickets.
- Encourage the person with dementia to wear an identification bracelet at all times. Make sure that the following information is also in their wallet or purse: name, address and phone number of your away-from-home address. Mark all clothing with their name.
- Take a list of important contacts, such as doctors and family.
- Remember to take enough medications to cover the period of travel, as well as prescriptions.
- Take a list of recent and current medications, which may be helpful if the person with dementia becomes unwell.
- If travelling by plane, consider notifying the airline that you are travelling with a person with dementia and ask staff for assistance.
- Take steps to provide a safe away-from-home environment such as locking the door and leaving the bathroom light on all night.
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