One of the biggest and most difficult conversations you may have following a dementia diagnosis is not about financial future. Or about future living situations. No, the biggest conversation is more than likely about something we all take for granted: the ability to drive.
“It’s a sad fact that, as dementia progresses, an individual will need to eventually stop driving,” says Beth Vellante, Executive Director of Bridges® by EPOCH at Andover, a memory care assisted living community in Andover, MA. “While in theory we may accept and understand this, it can become a point of contention as the actual time to give up the keys approaches. Many families have reported a struggle when it comes to having their loved ones hang up the keys – and for good reason. Being able to drive is a symbol of independence, and no one likes the idea of giving that up.”
Now, to be fair, being diagnosed with dementia does not automatically mean that you or a loved one need to stop driving. In fact, a third of individuals with dementia are still able to drive. The question is whether or not the individual with dementia can drive safely.
“Driving, for most of us, seems like an automatic activity,” says Beth. “However, it’s actually a very complex task that requires many decisions, as well as practically immediate thought processes and judgments that use a variety of our senses. It seems automatic because it’s something we’ve been doing for many years, but with the onset of dementia, it can become more of a task – and more dangerous.”
Driving Safely: What’s Required?
In order to be a safe driver, an individual must be able to use a variety of mental abilities, such as:
- Concentration and attention, which means being able to focus and quickly switch between different tasks while observing or “reading” what’s happening on the road
- Visuospatial skills, which means the ability to keep an appropriate speed and distance from other vehicles, while also maintaining the proper road position
- Problem-solving abilities, which allows the driver to respond to obstacles in the road, diversions or other incidents that require quick thinking
- Decision-making and judgment, which allows a driver to interpret and anticipate what may occur with other drivers based on what’s happening ahead
- Processing skills and reaction speed, which allows drivers to act quickly to avoid accidents and other incidents
- A calm and collected manner, allowing the driver to react appropriately and without panic
You’ll notice that “memory” doesn’t play a part in our list of skills required for safe driving. While memory loss as it relates to dementia doesn’t necessarily factor into safe driving, there are different aspects of memory that are required in order to drive safely: remembering how to change gear, or knowing a route or remembering what road signs mean. While these are all important, generally someone with dementia will first start to show difficulty with ability associated with driving (poor reaction time, bad coordination, etc.) rather than memory loss.
Having the Conversation
Eventually, you will need to have a discussion with your loved one about hanging up the keys and giving up driving. The time at which this happens will be different for each individual depending on their personal dementia journey. However, the average individual with dementia has to stop driving within three years of first noticing the symptoms. This syncs up with the moderate or middle stage of dementia; however, driving issues could begin sooner than that depending on the form of dementia your loved one has.
No one likes the idea of losing their independence. If you’ve noticed or decided that it’s time for a loved one to hang up their keys, you must remember the importance of acknowledging their feelings and finding ways to preserve their independence (while making sure they and others are safe). Here are some tips for starting and facilitating the conversation:
- Initiate the conversation by expressing your concerns. Let your loved one know that you are worried about their safety and their ability to remain on the road. Be sure to emphasize the positive – their desire to remain active and to get around town – and find ways to offer alternatives so your loved one doesn’t feel like you want to “take away” their freedom.
- Continually offer your unconditional support and love. Reassure your loved one that your only concern is for their safety because you care for them and you don’t want to see them – or anyone else – hurt.
- Appeal to their sense of responsibility. No matter what stage of dementia your loved one is in, they will recognize the desire to remain safe and make sure they aren’t putting themselves or anyone else at risk. Mention their responsibility to ensure that others are not put in danger due to their actions. Recognizing this may be the key to helping your loved one seek alternative modes of transportation.
- Make the doctor the “bad guy.” Many physicians will give you carte blanche to blame them about the driving issue. To go one step further, ask your loved one’s doctor to write a letter stating that it’s essential for the individual to quit driving. This “official” diagnosis can help reinforce your decision and back up your feelings in a way that will help your loved one feel less judged.
- Accept that this may take more than one conversation. When it comes to big life decisions, it’s very rare that one conversation will resolve all issues. Understand that you may need to revisit this discussion several times in order to come to a satisfying conclusion. While you don’t want to drag the conversation out, you also don’t want to create a wedge or cause your loved one to get so agitated that they shut down.
Dealing with Confrontation
It’s very possible that your well-planned conversation won’t go well for whatever reason. However, as with anything else important related to dementia, you’ll have to find ways to work through the difficult transition. Understand that your loved one may become angry or confrontational with you, due to the unique nature of this disease. If this happens, use these tips to help mitigate the situation:
- Be patient yet also firm. Remember, you’re helping do what’s best for this person, so be assertive yet show empathy and understanding.
- Acknowledge their pain and difficulty with the decision, and temper that with a desire for responsibility while providing alternative options to ensure your loved one retains his or her independence.
- Ask a third party to help “back you up” when it comes to the decision to give up the keys.
- Don’t blame yourself if the conversation doesn’t go well. Remember that dementia affects judgment and reactions, so the way your loved one reacts is due to the disease – not themselves.
- Finally, as a last resort, don’t be afraid to take away the car keys or disable the car in some way. When you do this, however, be sure to provide alternate transportation options so your loved one can still get around in a safe manner.
Giving up our independence is never a fun situation. However, with care and empathy, you can help make your loved one’s transition to a driving-free lifestyle as smooth and caring as possible. At Bridges® by EPOCH at Andover, we have helped many families navigate this transition with caring and understanding.
Engaging Lifestyle.
Now open! Bridges® by EPOCH at Andover provides memory care in an assisted living environment that is comfortable, positive, safe and engaging. Built solely to care for those with Alzheimer’s disease and other forms of dementia, Bridges® by EPOCH at Andover creates a wellness-focused lifestyle that promotes dignity and respects individual preferences. Our memory care teams receive specialized training that helps them safely support residents’ independence and elevate their self-esteem.
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Through early-, mid- and late-stage memory loss, residents and their families have complete peace of mind. Our compassionate dementia care, Personalized Services and unique programs are tailored to meet the physical, cognitive and emotional needs of each resident wherever they are on their own journey, allowing them to age in place safely, comfortably and with respect.
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