What is the first thing that comes to the mind of a family member when a dementia patient thinks about driving? He/she probably wonders whether the person should be allowed to sit behind the wheel at all or not.
Now, just because someone has been diagnosed with dementia does not necessarily mean they should completely avoid driving. According to researchers some people may retain the skills necessary to drive safely in the early stages of dementia. Of course, there are exceptions, but most types of dementia are progressive. To be precise, the symptoms will worsen over time and manifest in the form of memory loss, decreased cognitive function, and visual-spatial disorientation.
Understandably, the patient’s driving skills will decrease, and sooner or later, they have to put the keys aside. The thing about driving is that it is often associated with freedom and independence; therefore, losing driving privileges can be upsetting. Some folks recognize the risks. They eventually stop driving on their own, but others fail to assess their driving skills. They tend to insist on driving, even if it is not safe anymore. Family members must step in when that happens, especially if the patient’s symptoms pose a significant traffic risk.
How to Tackle the Challenges of Driving with Dementia
It is a challenge to determine when an individual can no longer drive safely, as the progression of dementia differs from one person to another. To that end, here are a few guidelines we have put together that may prove useful to you if you are caring for a dementia patient.
Making the Decision
As a rule of thumb, people with early-stage dementia or mild dementia should get their driving skills evaluated professionally as soon as possible if they wish to continue using a vehicle. Conversely, folks with moderate to severe dementia should never drive.
Watch Out for the Signs
How do you assess an individual’s functioning? Just observe their day-to-day behavior outside a vehicle. Here are a few signs you should watch out for. If you notice the following, know that the person no longer has the skills to drive a car.
- Lack of coordination
- Inability to judge space and distance
- Loses their way or feels disoriented in familiar locations
- Experiences problems in multitasking
- Increased memory loss, particularly for recent events
- Oblivious to things happening around
- Experiences mood swings, irritability, and confusion
- Needs prompting for self-care
- Experiences difficulty in information processing
- Experiences difficulties making decisions and solving problems
Family members must compare present behavior with behavior before dementia symptoms started showing up. For instance, you can try to differentiate the difficulty faced by the patient in handling several tasks at once from their previous abilities. Behavioral changes will be more noticeable to family members and friends who have interacted closely with the person for years. Share and discuss what you observe with other family members, friends, and healthcare providers.
Evaluation of an Independent Life
The best way to assess the patient’s driving skills is to set up an independent driving evaluation strategy. Before this evaluation, let the examiners know that the person being tested has dementia. Driver rehabilitation programs or State Departments of Motor Vehicles conduct these evaluations, but not always.
While the laws differ from one state to another, some states ask physicians to notify the DMV of a patient diagnosed with the condition being discussed here. This person may have to report to the DMV for a behind-the-wheel driver re-examination. A few revoke the licenses of individuals diagnosed with moderate or severe dementia. If you want to learn more, contact the Department of Motor Vehicles for the state where the patient resides.
There is one other less intrusive, less obvious way of evaluating a dementia patient’s driving. For example, the GPS tracking devices for vehicles from Vyncs can take a measure of the driver’s skills by scoring them according to their driving. Vyncs will notify you whenever the patient accelerates suddenly, makes sharp turns rashly, or applies the brakes harshly. The geofencing feature of Vyncs further ensures dementia patients from exiting a fenced area. Even if they do, you will be alerted immediately. Other noteworthy features of Vyncs that can help dementia patients are curfew hours and general vehicle tracking.
As mentioned earlier, the symptoms of dementia worsen with time. Naturally, those who pass the driving evaluation should be re-evaluated every six months. Others who do not pass should stop driving immediately.
Monitor How they Drive
Even if a patient demonstrates their safe driving capabilities, their family members and friends must monitor their driving behavior. Dementia can affect an individual’s driving skills significantly in a very short time. The purpose of monitoring is to detect problems before they turn into crises. If you have even a shred of doubt about the patient’s safety, you should not let them drive.
It is possible to figure out the patient’s chances of being in a traffic accident by letting them co-pilot the driver. For instance, when you sit behind the wheel, ask the person to instruct you about using blinkers, shifting lanes, and following traffic rules. You will know whether it is time for another independent driving test if they get frustrated easily or have trouble co-piloting you.
Some people are familiar with the problems they face due to dementia while driving. They are also happy to avoid sitting behind the wheel when someone engages them to stop. Others, however, will consider the loss of driving privileges and independence as discomforting. You need to talk to this patient about how this change will make them feel. Your imagination will help you envision what it is like to no longer be allowed to drive. Support groups usually offer a proper venue for families and patients to talk about their feelings and get advice from others facing similar situations. People often adjust better if they participate in discussions and make decisions about when to stop using vehicles.
What if the patient is reluctant to talk about driving? Just ask their physician to bring up the subject during doctor visits. Financial planners or lawyers may also be willing to talk about driving as part of the patient’s legal and financial planning.
Start discussions as early as possible, try to establish norms about when and how to limit, and stop driving eventually. Attempt to agree on the types of driving behavior that signal the need to stop driving entirely. Every family member has to find solutions that work best in their situation.
Less Time on the Road
As dementia progression varies from one person to another, people who demonstrate the ability to handle a vehicle safely must start modifying their driving. This strategy reduces the risk of an accident, especially if the patient’s driving skills decrease significantly between tests. Transitioning from a driver to a passenger over time can ease the adjustment process. Here are a few examples for patients to experiment with.
- Choose only familiar roads to drive on and avoid long-distance trips.
- Stay away from heavy traffic and heavily traveled roads.
- No driving at night and in inclement weather.
Patients who can maintain an active life usually adjust better to the loss of vehicle usage. Here are a few ways to reduce the need to drive entirely.
- Make sure all meals, prescription medicines, and groceries are delivered to the patient’s home.
- Get a barber or hairdresser to visit the patient at home.
- Friends and family members should visit regularly.
- Friends and family members should take the patient out for social gatherings now and then.
Arrange for Alternative Transportation
It will be vital to make arrangements for alternative transportation to ensure the patient’s mobility and activity levels don’t get restricted unduly. Here are some commonly used transportation options.
- Friends and family - Friends, family members, and neighbors can offer to drive the individual to social engagements and appointments. Create a list with the phone numbers, names, and times of availability of those willing to help the patient.
- Public transportation - For a person in the early stages of dementia, public transportation can be a reliable alternative to driving. It works for those familiar with the public transportation options available in their area. Someone in the later stages of dementia, however, may not be able to determine schedules or routes.
- Cabs - People in the early or middle stages of dementia who do not exhibit behavioral problems can travel in cabs. Of course, someone should meet the individual at both ends of the ride. You can set up a payment account with the cab company so the patient does not have to handle payment.
- Transportation services for seniors and people with special needs - You may not have the Yellow Pages anymore (you can always use the internet), but if you do, look for the special section in the front containing the names and addresses of various service organizations. Keep your eyes open for transportation or community service providers offering rides to folks with special needs.
- Eldercare Locator - This is an assistance service provided throughout the nation. It is designed to support older individuals and locate regional support resources, including transportation for the elderly.
If Persuasion Does Not Work
In an ideal situation, a dementia patient will stop driving or limit it without persuasion. Unfortunately, we don’t live in a perfect world. Some people will inevitably insist on driving, even if it isn’t safe. It is important to maintain respect for the individual’s feelings, but their safety is first and foremost.
You may need to stop the dementia patient’s access to their vehicle as the last option. Try the following methods.
- Keep the car keys out of sight.
- Replace the keys with a new bunch that doesn’t start the vehicle.
- Disable the car or sell it.
- Move the car away from home or keep it somewhere out of sight.
Striking a Balance Between Safety and Respect
The task of balancing safety with respect for a dementia patient’s desire to drive is challenging and emotionally trying. You will need the support of other family members, friends, and health professionals when creating and implementing difficult decisions about driving.