Alzheimer's, Dementia and Driving

Who Should Have the Conversation

Asking a person to stop driving can be a delicate, highly emotional matter. Family members delay having these conversations mainly because they want to avoid conflict and hurt feelings. Some adult children don't want to challenge a parent or may already be overloaded with other responsibilities.

It is rarely a good idea to have the conversation initiated by the person farthest away or least emotionally vested. The best choice is usually a spouse or an adult child who knows the driver's physical condition and driving abilities and has the person's best interests in mind. The Conversation Planner: How Can I Have Good Conversations About Not Driving? worksheet can help families plan progressive and productive conversations on dealing with dementia patients.

When & How to Start

If a relative's driving safety has been on family members' minds, it is time to talk about it and lay the foundation-before driving becomes a problem. Changes in medications and health status are good times for this discussion. Sometimes families wait until an accident or traffic violation happens, but then the driver may dismiss the incident as a common occurrence not related to his or her abilities.

Personalities and families vary, but it's usually better to have frequent, short conversations than a long, one-time conversation. If safety is a pressing concern, discussions need to be more direct and specific and conducted in a calm, reasonable and informative tone. It's important for family members to know that many, if not most, individuals with dementia have difficulty learning and remembering new information, even in the early stages of dementia. They may not even recall a previous conversation about driving and act as if it's the first time the topic is being raised.

Outside Support

Because the driving decision is complex and emotional – it’s a good idea to involve well-trained, objective third-parties from the start.

Healthcare Professionals

Healthcare professionals may be more likely to discuss driving issues with a patient if a caregiver has met with him or her privately and shared observations of driving behavior. This input can help because physicians do not have tests to determine definitively when a person in the early stages of dementia should not drive. And some doctors may hesitate to bring up a topic as emotionally charged as not driving for fear of jeopardizing their relationship with a patient.
Doctors may request that a patient not drive for a period of time while trying new medication that may produce drowsiness. When a physician is concerned about someone's driving safety, writing a prescription to stop driving may give added weight.

Comprehensive Driving Evaluations

Comprehensive driving evaluations are performed by occupational therapists with specialized driver evaluation training and include a clinical evaluation – which involves a variety of cognitive, visual and physical assessments – an on-the-road test, and either oral or written feedback on the results of the evaluation. Such evaluations may provide families with additional input and support.

Other Sources of Support

Lawyers, financial planners and care managers may be in a position to raise questions about driving safety. Caregivers can enlist their assistance by asking them to mention the subject as part of planning. Alzheimer's support groups offer opportunities for caregivers and persons with dementia to share concerns and explore options.

To Read More About

• Understanding Driving and Dementia.
• The Transition from Driver to Passenger.
• Sound Advice, Tips and Tools.
• 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.