Driving represents independence, competence and control. It's a way to access healthcare, buy necessities, be productive and stay connected to family, friends and the community. Concerns about driving often surface during the early stages of dementia when individuals are still independent and able to manage daily activities.

Not Like Common Changes in Later Life
This disease is not like other changes in later life that affect driving, such as eyesight problems and slow reaction times. Many older adults who don't have dementia can assess their driving without family intervention and make gradual changes to the way they drive. And most are able to continue driving safely throughout their lives.

Changes in Persons with Dementia
It's different for those with Alzheimer's Disease and other dementias. The progression of this disease is usually gradual and somewhat unpredictable. It affects cognitive functions critical to driving. Everyone with Alzheimer's Disease or other irreversible causes of dementia will eventually lose the ability to drive safely, due to problems with:

• judgment
• multi-tasking
• slowed reaction times
• impaired spatial skills
• other cognitive deficits.

With dementia, an individual's capacity to assess his or her driving abilities may also diminish. People with dementia are especially likely to minimize the complexity of driving and overestimate their abilities. They may make excuses for their high-risk driving. Some common reasons people with dementia use to justify their continued driving include:

"Just because I got lost doesn't mean I can't drive."
"I make sure I look where I'm going."
"I've driven for years without an accident."

As driving and assessment skills decline, the risk of serious loss or injury increases. Caregivers must step in and assume the responsibility for monitoring and regulating the driving of the person with dementia.