Dementia and Driving

Assessing Driving Abilities

In the early stages of dementia, many people are still socially engaged and able to manage daily activities-including safe driving. However, all people with irreversible dementia will eventually become unsafe to drive because of the degenerative, progressive nature of the brain disease. The question is: at what point is someone unable to continue to drive safely? That nagging question surfaces early.

Observe Driving Behaviors for Signals

Many caregivers report that they have allowed a family member with dementia to continue driving after they believed it was unsafe. At the other extreme, some family members overreact to common driving errors such as failure to complete a stop at a stop sign. They may blame these errors on the disease when the person may have exhibited this bad habit long before dementia. A single occurrence of poor driving usually is not cause to stop driving. It does, however, signal the need for increased monitoring.

These activities can help caregivers assess their concerns about the skills of a person who may be driving with dementia:

• Create opportunities to observe the person with mild dementia while driving.
• Keep a written record of observed driving behaviors over time. Use this warning signs list as an objective way to monitor any changes in driving skills.
• Share observations of unsafe driving with the person with dementia, other family members and healthcare providers.

While we’re hopeful that you find these guidelines helpful, the only way to truly assess whether a driver with dementia can continue to drive safely is to undergo a comprehensive evaluation by a specially-trained occupational therapist.

Reduce Driving Gradually

The most effective approach to limit or stop driving involves progressive steps and a combination of strategies that fit the family's circumstances, resources and relationships.

For people in the early stages of dementia, driving is best reduced over time rather than all at once. Families can help by finding ways to let others drive or reduce the need to drive. Caregivers and families should be sure to address the important social needs of the person with dementia that were met through driving. When possible, include the person with dementia when planning ahead to limit driving.

Some Limit Their Own Driving Early On

Fortunately, in many cases, people with dementia begin limiting where and when they drive. The following signs indicate that a person with dementia is modifying his or her driving behavior:

• Driving shorter distances.
• Driving on familiar roads.
• Avoiding difficult unprotected left-hand turns.
• Avoiding driving at night, in heavy traffic, on heavily traveled roads or during bad weather.
• Keep in mind that driving even short distances in good weather can pose a risk if driving skills are impaired. Most accidents happen close to home.

Let Others Do the Driving

Public Transportation

This option may work for people with mild dementia who live in urban areas and are already accustomed to using these methods. Public transportation is often too complicated for those with more advanced dementia.

Taxis can be a cost-effective alternative, especially when fares are compared to the expense of gas, insurance, taxes, repairs and car payments. Taxis could be used for people in middle to later stages of dementia if:

• There are no behavioral problems.
• The driver has explicit directions.
• Someone is available to meet the person at the beginning and end of the trip.

Some taxi companies will set up accounts for family caregivers so a person with dementia has easy access to transportation without worrying about payment.

Friends and Relatives

Friends, neighbors, relatives or caregivers can offer to drive the person with dementia to appointments or other social events. Other family members will be more likely to assist with the driving if caregivers make specific requests and schedule appointments at times that work for those requested to help.

Co-Piloting Is Not The Answer

Some caregivers act as co-pilots to keep a person with dementia driving longer. The co-pilot gives directions and instructions on how to drive. By chance, this strategy may work for a limited time. But in hazardous situations, there is rarely time for the passenger to foresee the danger and give instructions, and for the driver to respond quickly enough to avoid the accident. Finding opportunities for the caregiver to drive and the person with dementia to co-pilot is a safer strategy.

To Read More About

• Understanding Driving and Dementia.
• Positive and Productive Conversations.
• Sound Advice, Tips and Tools.
• Balancing the social needs, early planning to limit driving, and building social support, download or order your free copy of At the Crossroads: Family Conversations about Alzheimer’s Disease, Dementia & Driving.