Dementia and Driving

Four Basic Principles

Caregivers who have wrestled with driving and transportation issues were asked: "If you could do it over, what would you do differently? What advice would you give others who are in similar situations?" They revealed four basic principles that can help people manage driving with dementia and transportation decisions.

1. There is no easy answer; no right way
   Caregivers need to consider the personality and the abilities of the person with dementia when making decisions over the course of the disease. They must take into account the roles and relationships within the family that affect decisions and their outcomes. Each family must select strategies that will work within its unique situation.
2. Begin discussions and planning early and involve the person with dementia
   Ideally, a person with dementia should make the transition from driver to passenger over a period of time. The Agreement with My Family about Driving (link to pdf file, below) can serve as the starting point for meaningful discussions about driving. Open, early and continual communication can help the person with dementia and the family to agree on a course of action before a crisis occurs.
3. Base decisions on driving behavior observed over a period of time
   Regular monitoring and assessing of driving helps caregivers respond appropriately. A diagnosis alone may not be sufficient reason for a person to stop driving. However, when it clearly is no longer safe for a person to drive, caregivers must not delay in taking necessary steps. In hindsight, many caregivers regret permitting a loved one to drive longer than it was safe. The result was prolonged anxiety for caregivers and placing others at risk.
4. Get support when making and implementing decisions about driving
   It is not healthy for the caregiver, the person with dementia or the family as whole, when one person shoulders all of the responsibility for making and implementing decisions about driving and dementia. Caregivers can make reasonable requests of family members and those outside the family. Neighbors, friends and relatives can contribute by providing for the emotional, social and transportation needs of the person with dementia.

Doctors, occupational therapists, lawyers, care managers, financial planners and local Alzheimer's support groups offer information, guidance and perspective. People in authority outside the family can reinforce the family's efforts to ensure the safety and dignity of a person with dementia. The more people who are asked to help, the less any one person has to do and the greater the likelihood that the person with dementia will get the best support.

Tips & Tools

People diagnosed with dementia rightfully want to drive for as long as it is safe. Family members must constantly weigh the need to respect a person’s desire to drive with the need for safety. The following tips and tools can help people with dementia and their families balance safety and independence and manage difficult decisions around driving.

Tips for drivers with dementia

The following tips can help drivers with dementia ease the transition from driver to passenger:

• Confide in a friend or family member about what driving means to you. Help them understand what you have to give up when you stop driving.
• Work with your family to create a transportation plan that meets your needs.
• Consider the creating a written agreement with your family as a way to balance your independence with safety.
• Volunteer to be a passenger. Allow others to do the driving.

Tips for caregivers

The following tips can help caregivers who are struggling to decide when to limit or stop driving privileges for a person with dementia:

• Imagine for a moment your own life without driving. Allow your relative with dementia to express how he or she feels about not driving.
• Initiate conversations about driving and transportation needs early and often.
• Observe the person with mild dementia when driving.
• Keep a written record of observable driving behavior over time.
• Share observations of unsafe driving with the person with dementia, other family members and healthcare providers.
• Create opportunities for you or others to drive the person with dementia.
• Ask professionals outside the family to raise questions about driving safety.
• Get information about driving evaluation services in your state or region.

Tools that Can Help

Not Going It Alone Worksheet

Support from others can reduce stress and increase chances for success. Your circle of support can include people inside and outside the family. Use this helpful worksheet to indentify your circle of support.

View Not Going It Alone Worksheet

Agreement about Driving

The Agreement about Driving can help caregivers and persons with dementia plan ahead for the time when the person with dementia must limit or stop driving. This informal agreement does not restrict driving at the moment of signing, but designates a person to take necessary steps to ensure driving safety in the future.

View the Agreement about Driving
 

To Read More About

• Understanding Driving and Dementia.
• The Transition from Driver to Passenger.
• Positive and Productive Conversations.
• When it’s time for loved ones with dementia to stop driving and how to help them cope with driving cessation., download or order your free copy of At the Crossroads: Family Conversations about Alzheimer’s Disease, Dementia & Driving.