When Should Dementia Patients Stop Driving

Measures To Stop The Alzheimers Patient From Driving

Families struggle with the decision to limit or stop the family member from driving and the sense of dependence may prevent people with dementia from giving up the car keys. Unfortunately, no examination or single indicator exists to determine when a person with dementia poses a danger to himself or others. Families must determine when a person’s attention span, distance perception or ability to process information makes it difficult for him or her to respond safely in driving situations.

How Does Dementia Affect Driving

A diagnosis of dementia is not in itself a reason to stop driving. One in three people with dementia still drives. The most important thing is whether the person can still drive safely. Dementia may affect their ability to do this.

Driving may feel easy and natural for people who drive often or have been driving for many years. However, it is a complex task that involves quick thinking as well as sensory and manual skills.

A safe driver must use a range of mental abilities including:

• focus and attention to switch between different driving tasks while ‘reading the road
• visuospatial skills to keep the right speed, distance and road position
• problem-solving skills to deal with any challenges on the road, such diversions or obstacles
• judgement and decision-making for example, to understand and prepare for the actions of other road users
• reaction skills to act quickly to avoid an accident
• memory for example, to remember a route.

Being patient and calm also helps people to drive more safely.

As dementia gets worse, it affects these skills even more. This means everyone with dementia will eventually be unable to drive safely. How quickly this happens varies from person to person.

Strategies For Difficult Transitions

If the person living with dementia is unwilling to give up driving, consider these last-resort preventive strategies:

• Control key access. Keep keys out of sight. If the person with dementia wants to keep a set of keys, offer keys that won’t start the vehicle.
• Disable the vehicle. Remove a battery cable to prevent the car from starting, or ask a mechanic to install a “kill switch” that must be engaged before the car will start.
• Sell the vehicle. If you can make do without the vehicle, consider selling it.

This article is written by Mayo Clinic staff. Find more health and medical information on mayoclinic.org.

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Dementia: When And How To Stop A Loved One From Driving

October 23, 2017 by Norma Loeb

Driving is a hallmark of independence that many older people hate to relinquish. For many adults, it marks the end of an era a period in which they were self-sufficient and autonomous. Its also a major milestone in a persons life as it may signify a shift in interpersonal relationships. A daughter may now become a caregiver a mother may become the one being cared for.

Making the decision to give up driving is hard for all adults. It is difficult for people to recognize when the time has come, which is why caregivers and family members must have patience and compassion for their loved one. Giving up driving is scary. It is a huge change for an older adult and its normal to feel sad, panicked, scared and even angry.

Signs You or a Loved One Should Stop Driving

Driving is usually stressful for people with dementia, so many adults with Lewy Body Dementia, Alzheimers and other forms of the disease decide to give up driving voluntarily. If youre not sure if the time has come, here are some red flags to watch for:

Having a hard time driving is a natural part of the aging process for many adults. Other factors that have nothing to do with dementia, such as vision, hearing, joint pain and slower reflexes, can also play a role.

Helping a Person with Lewy Body Dementia Surrender Their License

New Yorks Driver Re-evaluation Program

• Physicians via form DS-6
• Police officers via form DS-5
• Concerned individuals via form DS-7

Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

• Getting lost easily
• Noticeably poor performance at work
• Forgetting the names of family members and close friends
• Difficulty retaining information read in a book or passage
• Losing or misplacing important objects
• Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

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How Dementia Affects Driving Ability

Driving gives us freedom and independence, which is why it can be difficult to cope when changes in our health affect our ability to do it.

An introduction to dementia in the UK

Driving is a great way to get out and about, keep up with hobbies and stay in touch with friends and family. Thatâs why many dementia sufferers will continue to drive even though their health is declining. They might adapt their routine slightly by changing when or where they drive, rather than giving it up completely.

But not everyone can instantly recognise they have an issue with their health.

Dementia refers to a group of symptoms that affect and deteriorates brain functions – including recognition, memory, language, and planning. Symptoms of dementia gradually get worse over time, so it can be difficult to recognise the point at which it starts to affect day-to-day life.

The Alzheimerâs Society believes one in three people with dementia still drive, and that being diagnosed doesnât necessarily mean you have to give up driving straight away. However, as dementia progresses, thereâll come a point when you should no longer be behind the wheel.

When looking at the signs of dementia, itâs easy to see how driving can be affected:

• Memory loss impacting day-to-day life

• Difficulties with planning and organising

• Losing track of time or place

• Problems with vision, speaking and writing

• Misplacing objects

• Withdrawal from work or social activities

• Changes in behaviour and personality

Signs That Dementia Is Affecting Driving Ability

• vision can they see things coming straight at them or from the sides, do they respond appropriately to stop and traffic signs and signals?
• hearing can they hear the sound of approaching cars, car horns and sirens, and do they pay attention to these when in the car?
• reaction timecan they turn, stop or speed up their car quickly?
• problem solving do they become upset and confused when more than one thing happens at the same time?
• coordination have they become clumsy and started to walk differently, because their coordination is affected?
• alertness are they aware of, and understand, what is happening around them?
• left and rightcan they tell the difference?
• memory and confusion do they become lost or confused on familiar routes?
• stop and go do they understand the difference between stop and go coloured traffic lights?
• route finding can they read a road map and follow detour routes?
• steering are they able to stay in the correct lane and veer, change lanes or merge when required?
• mood has their mood changed when driving? Some previously calm drivers may become aggressive or angry.

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Why Is This Study Important

According to some current guidelines, patients with even mild AD should stop driving. However, in the current study, most patients with mild AD were able to pass the on-road driving test. They remained safe drivers for several months. This study also suggests that among patients with AD, those who are older and have less education are more likely to become unsafe drivers faster.

When Should A Person With Dementia Stop Driving

Neurologists can make a more personalized recommendation regarding someone driving with dementia with help from a new AAN guideline.

A new guideline by the American Academy of Neurology helps neurologists determine when people with and other dementias should stop driving. It’s an update of the AAN’s 2000 guideline, which concluded that “patients with mild categorically should not drive,” says Donald J. Iverson, M.D., lead guideline author and a neurologist with the Humboldt Neurological Medical Group, Inc., in Eureka, CA. “The update softens the message to ‘should strongly consider discontinuing driving,'” Dr. Iverson explains. The guideline is published in the April 20, 2010 issue of Neurology .

Clinical trial evidence illustrates that patients’ driving skills deteriorate with increasing dementia severity, according to the guideline. Yet studies also show that as many as 76 percent of dementia patients pass an on-road driving test, making a recommendation that patients with dementia absolutely should not drive under any conditions too restrictive, says Dr. Iverson: ” wanted to preserve the patient’s autonomy to some extent. Giving up driving is associated with depression and increased awareness of mortality. We wanted to limit that as much as possible.”

The guideline also suggests follow-up evaluations every six months may be useful to determine whether driving risk has increased.

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Ask A Doctor To Step In

Having an intervention could be effective as long as youre respectful and have facts to back up your request. To make the intervention go smoother, enlist the help of your loved ones primary care physician. The doctor can explain how driving puts your parents health in jeopardy. If your loved one wants to alleviate symptoms associated with dementia and slow its progression, he or she needs to be open to doing things that boost health, such as giving up driving. Although you have your parents best interests in mind, he or she may be more open to advice when it comes from a medical advisor or non-relative.

Its hard for our loved ones to give up the things that are closely tied to independence, and its difficult for an adult child to face the challenge of telling a parent that he or she can no longer drive. Caring for a senior loved one can be challenging for families who dont have expertise or professional training in home care, but this challenge doesnt have to be faced alone. Family caregivers can turn to Mesa Home Care Assistance for the help they need. We provide high-quality live-in and respite care as well as comprehensive Alzheimers, dementia, stroke, and Parkinsons care. If you need professional care for your senior loved one, Home Care Assistance is just a phone call away. Reach out to one of our Care Managers today at 699-4899.

Can A Person With Dementia Continue To Legally Drive

Here in the USA, each state has different legal rules when it comes to driving and specific illnesses, including dementia.

In other parts of the world, they are not as lenient.

In the UK, you must inform the DVLA that you suffer from dementia. If you do not and are found out, you will be fined. If you are in an accident, you can be prosecuted.

In Australia, drivers are also required to advise their licensing authorities of their diagnosis as well.

It is surprising, at least to me, that there are not stricter rules concerning this issue but then again there have not been as many studies on the topic as I believe there should be.

In one study by Dr Laura B. Brown and Dr. Brian R. Ott, they found that

there is probably a 2- to 8-fold greater risk of crashes for elderly drivers with mild to moderate dementia compared to those not demented.

US National Library of Medicine

I dont think this should come as a shock to anyone after all considering the symptoms that are normally found in persons with dementia, its very easy to see how these symptoms can impede the driving tasks of anyone with that disease.

So again, I do urge you to have your driving skills evaluated either through a rehabilitation program or the DMV .

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Driving Assessment For Patients With Dementia: A How

Evaluating driving safety in patients with mild cognitive impairment or dementia can be challenging.

This MedCase discusses driving assessment for a patient with mild dementia using the 2014 Clinical guideline on Dementia and Driving Safety1 and the Hui Process,2 a four-step approach to building relationships with Mori patients and whnau.

When to assess?

How to assess fitness to drive in patients with dementia

Initial assessment

The first assessment should use readily available information to assess driving safety. Some things to consider:

Second assessment

If patients are unwilling or unable to undergo an OT assessment, then clinicians must rely on other sources of information, such as:

Confusion Over Colors Words Or Road Rules

Geri Taylors accident wasnt the first sign of trouble. Months before she realized she should stop driving, she straddled two highway lanes because she suddenly thought she needed to follow the dotted lines instead of driving between them. According to the Alzheimers Society, dementia affects many of the mental abilities needed for safe driving, including visuospatial skills and memory. It doesnt help that vision and hearing may decline throughout the aging process, making it even more difficult to make accurate split-second interpretations.

If your loved one suddenly forgets traffic rules or misunderstands traffic signals and signs, they may be losing the abilities that licensed drivers are required to have. Look for red flags like running stop signs and red lights, stopping at green lights, failing to stay in the right lane or misreading traffic and street signs.

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A Helpful Test You Can Do

If you suspect a person may be showing signs of dementia, give them this simple test on common traffic signs.

Ask What does the sign mean? and What action should the driver take?

Suggested answers:

Maintaining Your Driving Ability

The good news is that, while your symptoms are mild, you can take steps to help you drive safely and independently for as long as possible:

• Settle into a consistent routine. Stick to the same route when you drive from place to place. Figure out when you most need to drive, and follow that plan. For example, do you drive to medical appointments, to shop, to meet with friends? Are there times when someone else can drive?
• Drive with someone that can assess your driving abilities on an ongoing basis. They can notice if there are any changes in your driving abilities and can spot risky behaviours that you may not be aware of.
• Use technology to support your capacity to drive. If you’re driving by yourself, use assistive technologies such as a GPS to help you.
• Above all, living well with dementia has been shown to slow the progression of dementia. Challenging your brain, following a good diet and staying physically and socially active will all help you stay in the early stage of dementia for as long as possible.

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Ways To Stop An Elderly Person From Driving

1. Anonymously report them to the DMVThe Department of Motor Vehicles allows people to report unsafe drivers, often anonymously. You dont have to be a doctor, anyone can file a report.

The benefit is that your older adult wont blame you for taking their license away. Instead, theyll be angry with the DMV.

Each states DMV has different procedures. Typically when someone is reported as an unsafe driver, theyre called in for a drivers license retest regardless of when their license expires. Contact your local DMV to find out what is needed in your state to request a retest.

If you dont feel comfortable filing a DMV report, speak confidentially with their doctor and share your concerns. Ask the doctor to write a letter that you can take to the DMV.

2. Use Alzheimers or dementia forgetfulness to your advantageAlzheimers or dementia can cause seniors to become irrational and stubborn about driving.

In these situations, an effective strategy is to remove the car and any reminders of driving. At the same time, creatively distract them from the topic until they forget about driving altogether.

This approach spares them from angry confrontations or getting depressed about not being allowed to drive.

3. Have a relative or close friend borrow the carIf your older adults car isnt in the garage, they wont be able to drive it. To keep them from getting suspicious, you could arrange for a relative or close friend to borrow the car.

What Are The Warning Signs

Everyone with irreversible dementia will eventually become unsafe to drive because of the degenerative, progressive nature of the brain disease. The question will always be: – at what point is someone unable to continue to drive safely?

Most specialists feel it’s important to help the person with dementia to stop driving as soon as possible. A rule of thumb is to ask yourself whether you feel safe riding in a car or having your family members, including children, riding in a car that the person with dementia is driving.

This is not an easy question for a family and as Alzheimers is increasingly diagnosed in its earliest stages, it can be hard to tell when a loved one is becoming a danger.

The person with Alzheimers will often make excuses to the family such as

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

It is important for the family to observe and keep a written record of observations to share with the person, family members and health care professionals. Observations that might indicate the need to stop driving are:

• Forgetting how to locate familiar places
• Failing to observe traffic signals
• Incorrect signalling
• Delayed response to unexpected situations
• Confusion at exits
• Stopping in traffic for no apparent reason

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