Driving is something that most of us do every day without thinking. It may seem to you like something you can do without thought. However, driving is an incredibly complex task that requires quick manual skills, fast reaction times and complex, problem-solving thinking. That’s why, when someone develops dementia, driving can quickly become a difficult issue.
“Driving is a skill that deteriorates with age overall, but it’s exacerbated in those with dementia,” says Reshma Nair, Executive Director of Bridges® by EPOCH at Andover, a memory care assisted living community in Andover, MA. “It can be very tricky for an adult child or family caregiver to know when to step in and take away Mom or Dad’s keys, especially if a parent insists that there’s nothing wrong with them.”
Anosognosia, which is when someone with dementia isn’t aware of their cognitive impairment, can make discussions about driving and taking away the keys incredibly difficult. It’s also difficult because different types of dementia progress at different speeds, which can also fluctuate in severity daily. One day a parent may seem just fine; the next, they are confused and don’t remember what you just said to them five minutes prior.
“Safe driving requires sharp mental acuity and the ability to problem-solve on the fly, which is why the minute you suspect something is wrong with your parents, you have to act,” explains Reshma. “Unfortunately, allowing someone with dementia to continue driving is something that can quickly result in significant trauma and tragedy, not just for you and the individual, but others on the road as well.”
Driving is a timeless sign of independence and freedom, which is why the decision to stop driving can be so difficult for everyone involved. However, the American Academy of Neurology has studies showing that people with mild dementia are at a much greater risk of unsafe driving than people of the same age without dementia. It’s recommended that people with mild dementia strongly consider discontinuing driving.
“In a perfect scenario, your loved one with dementia will decide to stop driving on their own because they’re concerned about safety,” Reshma says. “However, others may be reluctant to stop driving because they’re not aware of the decline in their driving skills.”
Signs of Unsafe Driving
If your loved one was diagnosed with dementia early on, they might still be able to drive and function normally – for a time. However, eventually, there will come a time that you notice signs of unsafe driving. Here are some things to look for that indicate that your loved one with dementia may no longer be able to drive safely:
- Becoming lost easily, even when driving to someplace familiar
- Not being able to stay between the lines while driving
- Mixing up the brake and gas pedals
- Making poor or slow decisions
- Driving too slowly or speeding
- Failing to observe traffic signs
- Hitting the curb while driving
- Becoming angry or confused while driving
- Getting into an accident or getting tickets
- Unexplained damage starts showing up on their car
If you begin noticing any of these signs, it may be time to begin the conversation about stopping driving.
How To Begin the Conversation
Knowing how to raise the topic of driving can be difficult and stressful for an adult child, especially when a loved one doesn’t believe anything is wrong with their abilities. Here are some suggestions for how to raise concerns about your loved one’s driving abilities.
Start the conversation early. Many aspects of dementia planning should be raised as early as possible after a diagnosis so that the individual with dementia can have as much input as possible. Besides financial planning and end-of-life care, driving is an important topic to consider. Talk with your loved one about driving and when they would like you to step in for their safety.
Have discussions often. Whenever possible, have continued discussions about changes in your loved one’s health status or medications instead of waiting for an accident or driving incident. It’s a good idea to have frequent, short conversations rather than one long discussion.
Acknowledge the loss. Giving up driving is and will be very hard for your loved one. While you know that this is the right decision, you also have to give your loved one the space and opportunity to grieve the loss of their independence in this way. Be respectful and understanding.
Focus on the disease, not the person. Your loved one’s history as a safe driver has no bearing on their current abilities. When talking about your concerns and your loved one’s safety, focus on the disease instead of on the individual themselves.
It’s recommended that people with dementia have regular assessments during their office visits in order to keep an eye on declining abilities. A doctor can recommend a roadside driving evaluation by an occupational therapist who can evaluate your loved one’s ability. Occupational therapists can provide strategies for driving safely and give expert opinions on when and how to reduce or stop driving.
Making the Transition
Your older loved one may be more amenable to stopping driving if you offer alternatives that allow them to remain mobile and active. Seek out alternatives to driving and start using them as soon as you can. Even if your loved one has mild dementia and is still driving, you can begin transitioning slowly into other transportation options. This can include:
- Taxi, car or community services that are available to transport individuals to and from appointments and errands
- Family members and friends who can provide rides for errands or appointments
- Delivery services for groceries and medication
- Transportation services offered by community centers, houses of worship or other organizations
Tips for Difficult Transitions
Even if you do everything “right,” you may find yourself in a situation where your loved one with dementia is unable to give up driving. This can be incredibly stressful and frustrating. If you find yourself in this situation, here are some last-resort strategies to ensure the safety of your loved one and the people around them:
Control access to their keys. One of the first strategies involves making sure that your loved one can’t get their hands on their keys. You may wish to hide the keys out of sight or keep them yourself. If your loved one is insistent on having keys of their own or keeps asking for the keys, consider offering a set that won’t start their vehicle. This can provide them with a sense of comfort and consistency without risk.
Disable your loved one’s vehicle. If managing the keys doesn’t work, you can always disable their vehicle in some way. For example, you could remove the battery from the car or simply disconnect a battery cable. You could also visit a local mechanic and ask them to install a “kill switch” that must be engaged in order for the car to start.
Sell the vehicle or otherwise get it out of eyesight. Removing the vehicle from eyesight can be a great way to keep your loved one from wanting to drive. If they ask, you can always say “it’s in the shop,” which can satisfy their interests quickly.
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