Should Someone with Dementia Be Driving?
Does a diagnosis of dementia automatically mean the person has to stop driving? This is one of the first and toughest issues families and caregivers will face.
Alzheimer’s disease and other types of dementia often present slowly over time in seniors. This can make it very difficult for even close family members and friends to notice that something is amiss in the early stages. Unfortunately, the insidious nature of these progressive conditions often leaves seniors extremely vulnerable during the time between the onset of symptoms and official diagnosis.
In addition to causing changes in one’s ability to perform daily activities like cooking, paying bills, bathing and managing medications, dementia can also seriously affect a senior’s ability to drive. Not only does their unsafe driving endanger their own health, but it also poses a hazard to the surrounding community.
Addressing Unsafe Driving
Driving is one of the most difficult issues that most caregivers face with their aging loved ones, and Alzheimer’s disease and related dementias complicate this matter even further. When Mom or Dad isn’t aware of their cognitive impairment and has trouble following the logic of your argument against them getting on the road, the talk about taking away the keys can turn into a repetitive exercise in futility.
It can be very tricky for a family caregiver to determine when exactly to step in. Different types of dementia can cause a whole host of symptoms that worsen at variable speeds. Furthermore, dementia presents differently in each person and symptoms can fluctuate in severity from day to day. The unpredictable nature of this condition necessitates strong, proactive measures to help ensure a senior’s safety and preserve their remaining functionality. This holds especially true for issues like driving that also affect public safety.
Dementia, Wandering and Driving Are a Dangerous Mix
Wandering or “elopement” is a common symptom that can begin at any stage of Alzheimer’s disease. It often occurs when a senior leaves a safe place, such as their home, to go somewhere or do something and then becomes disoriented and lost. According to the Alzheimer’s Association, six in 10 people with dementia will wander at some point during the progression of the disease. Anyone with the ability to walk can wander, but access to an automobile can significantly increase how far a senior can travel from home and the level of danger they may encounter while wandering.
Wandering has become such a problem that Florida developed a state-wide public warning system to help locate and recover missing seniors with dementia called the “Silver Alert Plan.” Since its inception in 2008, nearly 2,000 alerts have been issued for missing seniors with cognitive impairment. Researchers from the University of South Florida examined these alerts and uncovered several important patterns:
Over 70 percent of missing drivers were men who traveled an average of 116 miles from their homes before being found. Researchers hypothesized that men were more likely to go missing while driving.
Most drivers get lost while on routine trips (e.g. going to the doctor, shopping, visiting friends) that their caregivers agreed to let them go on.
Less than one-third of lost drivers took the car keys without their caregivers’ knowledge.
Only about 20 percent of missing drivers were still driving around when they were found. The rest had either been involved in an accident, were sitting in their parked car or had gotten out of the vehicle and were wandering around on foot.
Fifteen percent of missing seniors were discovered in potentially dangerous situations (i.e. parked on railroad tracks, parked in the middle of the road or walking in an isolated area).
Study authors stress the crucial differences between an elder wandering away on foot and going missing while driving. Wandering is typically a repetitive dementia-related behavior, but it’s harder to predict if/when a cognitively impaired senior will get lost while driving. Lapses in memory and judgment can occur during routine activities, such as going to the grocery store. Even if they’ve successfully driven a short route hundreds of times before, there is still a possibility that an elder may get lost while driving only a couple miles down the road.
A senior with mild cognitive impairment can still be very dangerous behind the wheel. Research has shown that people in the early stages of dementia often commit serious driving errors, including drifting out of their lane, making incorrect turns and driving the wrong way. There are numerous documented cases of horrible accidents that have occurred due to seniors with dementia driving when they shouldn’t have been.
How to Take Away the Car Keys
Car keys have become symbolic of independence for American adults, which can make taking them away a daunting task for family caregivers. As our loved ones age, we must be hyper-vigilant about looking for signs that their mental and physical abilities are changing. The minute you suspect that something is off, you must act. This is an extremely delicate subject for most seniors, but under no circumstances should you allow someone to drive if there is any sign of impairment.
Ultimately, preventing a loved one with dementia from driving requires taking away the car keys, revoking their license and/or automobile insurance and possibly even disabling the car. The extent to which you must go to prevent a senior from driving depends entirely on their stubbornness and desire to get behind the wheel. (Which, again, may be deceiving as these things fluctuate.)
Having “the conversation” is intimidating, but you must do it in a kind way that expresses your safety concerns. If presented correctly and early enough, you might find your loved one is relieved that they no longer have to navigate the roads alone. In some cases, their physician can be a valuable ally on the matter as well.
Hiding the car keys often requires some creativity and extra security measures, especially if others in the household still plan to use the vehicle. When it comes to a loved one losing their driver’s license, it can be helpful to contact the local Department of Motor Vehicles (DMV) for advice. They are usually very helpful, because they don’t want anyone who is impaired on the road. Your loved one may have to retake a driving and/or written test, or someone may have to file a formal complaint regarding their reckless driving before the DMV will act.
The early stage of dementia is one of the scariest times for your loved one. They often know that something is wrong, but they’re unsure what it is and afraid to talk about it. Be understanding and kind, but prohibit driving for those with cognitive impairment. It’s simply too dangerous and the risks are too great.
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