Driving With Dementia: 6 Dangerous Signs It’s Time to Step In

By Howard Raphaelson | February 25th, 2019

Driving with dementia can be a concern for loved one and people with dementia. But when should you take the keys? Here, 6 signs it's time.

Are you worried that your parent or grandparent is unsafe behind the wheel? Dementia affects everyone differently, but it often disrupts the motor skills and cognitive skills that are necessary for safe driving. While the pace and severity of the disease are unpredictable, a diagnosis is always a good reason to pay closer attention to driving with dementia.

From disorientation and aggression to slow response times and poor reasoning abilities, common dementia symptoms are downright dangerous when mixed with motor vehicles. As Alzheimer’s disease progresses, it may fall to loved ones to recognize the warning signs and take action for people who are driving with dementia.

Of course, you don’t want to make this call too early and risk alienating or limiting the independence of someone you love—or wait too long and take an even bigger risk. That’s why it’s so important to learn when and how to spot the telltale signs that driving is no longer safe. Here are six of the biggest indicators that your loved one’s dementia is a road hazard and it’s time to take the keys:

1. Recent Tickets, Accidents, or Unexplained Damage

Americans older than 84 don’t drive as often as other age groups, but according to the National Highway Traffic Safety Administration (NHTSA), they do have the most crashes per driven mile. This sobering car accident statistic is a reminder that aging drivers face increased risks, and that’s especially true for drivers with declining cognitive abilities. Unfortunately, accidents are sometimes the first sign of trouble. If your relative has already been in car accidents, received multiple tickets, or returned home with unexplained damage to their vehicle, it might be time to step in and prevent more severe incidents in the future.

Fortunately, accidents can make it easier to intervene, serving as wakeup calls for drivers who didn’t know their symptoms had progressed so much. Geri Taylor, a retired nurse who first realized she had Alzheimer’s disease at age 69, told The New York Times that she started “driving on an as-need basis” after sudden visual confusion caused the first accident she’d ever had. Even if your loved one hides the evidence of their recent mistakes instead of acknowledging them, it may mean they’re aware of the change and its implications.

2. Confusion Over Colors, Words, or Road Rules

Geri Taylor’s accident wasn’t 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 Alzheimer’s Society, dementia affects many of the mental abilities needed for safe driving, including visuospatial skills and memory. It doesn’t 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.

3. Refusing to Drive With Others

Riding with your relative is the easiest way to assess their driving skills. Accompany them on errand runs or offer to let them drive, and notice their reaction times, speed, and adherence to traffic rules. If they won’t let you get in the passenger’s seat, it could mean their driving skills are already getting worse, and they don’t want you to judge, worry, or even be in danger. That’s especially likely if they still give rides to other people, but won’t let close family members or friends tag along.

Refusing passengers may also be a sign that minor distractions (like a passenger’s voice or movements) are enough to make focusing impossible. Distractibility gets worse as dementia progresses, and symptoms like slowed-down response times are a lot more obvious to objective observers. Insist on spending some time as their co-pilot, and get acquainted with their current abilities as a driver.

4. Getting Lost in Familiar Places

Disorientation is one of the most common symptoms of dementia. Getting lost or showing up in strange places is a clear sign that this cognitive impairment is making it unsafe to drive alone. If your loved one experiences any bouts of disorientation at all, there’s a risk that these could occur while driving, leaving them vulnerable to getting lost or leaving inexplicably.

According to a comprehensive review of dementia and driving by the Alzheimer’s Association Policy Division and NHTSA, disorientation and access to car keys are a dangerous combination. Be especially aware of this particular risk, and take action if your loved one gets lost in familiar places.

5. Uncharacteristic Bouts of Anger or Road Rage While Driving With Dementia

Aggression, a common symptom of dementia, also causes another serious traffic hazard: road rage. If mood swings or rage are getting more common, they may be affecting your loved one’s ability to drive, too. Pay attention to their reactions to other drivers, their mood after driving, and their stories about interactions on the road. If emotion is getting the best of them, it may be time to talk to a doctor or seek an evaluation.

6. Failing a Performance-Based Driving Evaluation

Ultimately, an independent driving evaluation is the best way to truly assess anyone’s driving abilities. As dementia progresses, periodic road testing is an essential part of the treatment process, because it makes it possible to track deteriorating skills and determine when driving cessation should happen. If your loved one hasn’t agreed to road tests, you may still work with your state’s Department of Motor Vehicles to report an unsafe driver or request a driving assessment.

Of course, forcing an evaluation for your loved one driving with dementia should be a last resort. Dementia doesn’t interfere with driving skills immediately, but because deteriorating skills are inevitable, road tests are a practical way to protect your loved one and everyone who shares the road with them. They also replace your opinions and judgments with an unbiased, fact-based evaluation. If your loved one is resistant to your previous attempts, a test removes emotion from the equation and gives them a way to prove—or confront—their driving abilities.

Howard Raphaelson is a New York City car accident lawyer and partner at Raphaelson & Levine Law Firm.


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