Unsafe Drivers With Dementia A Growing Concern
Alzheimer's Disease and Driving Ability
Learn how to evaluate when someone in the early stages of Alzheimer's disease needs to stop driving.
By Chris Iliades, MD
Medically Reviewed by Christine Wilmsen Craig, MD
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If you are caring for someone with early Alzheimer’s disease, you should know that all people with Alzheimer’s will eventually reach a point where they will have to stop driving because of their illness. According to the National Highway Traffic Safety Administration (NHTSA), changes in someone’s physical, emotional, and mental condition can have a profound effect on their driving abilities.
When Should Someone With Early Alzheimer’s Disease Stop Driving?
"This is a difficult decision to make and a harder one to implement," says Vaughn E. James, author ofThe Alzheimer’s Advisor: A Caregiver’s Guide to Dealing With the Tough Legal and Practical Issues(AMACOM, 2008). "This issue must be considered carefully and sensitively. Even though the patient may be upset about his or her loss of independence, safety and aversion to liability must be the priority," he says.
James recommends that caregivers look for specific clues in the behavior of a person with early Alzheimer’s that may signal it's time to take the keys. Getting easily lost, becoming angry, or appearing confused while driving are all telltale signs.
The NHTSA also suggests that caregivers look for the following warning signs that may indicate that driving has become unsafe for a person with early Alzheimer’s disease, those traveling with them, and other people on the road. Such signals include:
- Needing more help with directions
- Forgetting destinations or where the car was parked
- Having trouble making turns or being confused by traffic signals
- Receiving citations for moving violations
- Putting dents or scrapes on the car that can’t be explained
Cheryl Woodson, MD, author of the bookTo Survive Caregiving(Infinity Publishing, 2007), and founder of the Woodson Center for Adult Healthcare, in Chicago Heights, Illinois, has been a practicing geriatric specialist for more than 20 years. She emphasizes that the decision to stop a person with Alzheimer's disease from driving should be made sooner rather than later.
“People with Alzheimer’s disease cannot catalog new information, so they cannot react appropriately. If you see a ball roll into the street, you stop because you know a kid is coming after it. People with Alzheimer’s disease may not stop until they see the kid, or they may not be able to sort out whether to hit the brake or the gas,” Dr. Woodson explains.
What to Do Once the Decision Is Made
The following tips can help you manage the process of breaking the “no more driving” news to your loved one:
- Be sensitive but be firm.You'll want to "be sensitive to your loved one’s feelings about losing the ability to drive, but be firm in requesting that he or she no longer drives. You should be consistent, and should not allow the person to drive on good days but not on bad days," says James.
- Ask for help.The person with Alzheimer’s disease may respond better to an authority figure. His or her doctor can also request an evaluation by the Department of Motor Vehicles. In many areas, a driver rehabilitation specialist can help determine when driving ability is no longer safe.
- Accept responsibility.Once the decision has been made, do what you have to do. If necessary, take the keys. “If just having keys is important to the patient, you can substitute a different set of keys. If all else fails, disable the car or move it to a location where the patient cannot gain access to it,” says James.
- Make alternate plans for transportation.Losing the ability to drive is likely to make people with Alzheimer's disease feel as though they are no longer able to be an independent person. It is important to reassure them that, with the help of family, friends, and other modes of transportation, they will still be able to get around town and do the things they want to do.
The Bottom Line on Alzheimer’s Disease and Driving
A 2008 study reported in the journalNeurology, followed 84 patients with early Alzheimer’s disease with on-road driving tests every six months. The study found that patients with early Alzheimer’s disease became unsafe drivers after an average of 11 months. The researchers concluded that all patients with Alzheimer’s disease will eventually have to stop driving.
For this reason, driving skills should be reassessed at least every six months in the early stages of Alzheimer’s. Once the decision to stop driving has been made, it should be final. As the caregiver, this responsibility may fall to you. And though it can be a difficult process, just remember, it's worth it; "you may save a life, either your loved one's or someone else’s," Woodson notes.
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