How do you know when it's time to give up the keys? For science-backed, expert-vetted guidance on Alzheimer's and driving safety, check out our new interactive learning guide.
How do you decide when it’s time for someone with dementia to stop driving? And how do you have that tough talk about taking away the keys? For people with Alzheimer’s disease and other forms of progressive dementia — as well as for their loved ones or caregivers — deciding when to stop driving is a major milestone in the journey.
For science-backed, expert-vetted guidance on Alzheimer’s disease and driving, check out our new interactive learning guide. This guide is full of trusted knowledge and proven strategies to make informed decisions about driving safety, ensuring peace of mind for both people diagnosed and their loved ones.
FAQ: Common questions about driving and dementia
Hungry for more expert guidance? Occupational therapist Jenny Nordine, founder of Driving to Independence, shares insights on driving, cognitive assessments, and safety for aging adults in a Being Patient LiveTalk.
How do you approach a loved one with dementia about giving up driving?
Nordine recommends starting to start having conversations about driving safety and concerns early. Specifically, “focus on the fact that you’re concerned about their safety. Not that they’re a bad driver, but rather, “We want to make sure that you’re safe out there when driving as well.”’
However, it’s essential when considering driving ability to seek out a third party to make the call about driving. Nordine explained, “That’s a role that we take on to make sure that number one, it’s an objective assessment, that we’re looking at a wide variety of things that can affect somebody’s ability to drive… as well as the fact that if this individual is not safe to be driving, that’s a conversation that I’m having with him versus his daughter because that’s a really difficult position to put an adult child in. That can really disrupt that family unit.” Getting a third party to assess can keep the family unit intact while prioritizing the safety of your loved ones.
At what stage of Alzheimer’s or dementia should an individual stop driving?
It depends. Everyone ages at a different rate, so it’s essential to watch for some signs that driving may no longer be safe. Nordine explained, “In general, what we want to start to look for is external signs [they] have difficulty in driving. This level of anxiety, or even as a passenger, you know, if you get into the vehicle with your spouse who has a diagnosis, and they forget to put their seatbelt on, again, those are sort of early signs, or that we can identify different dings or dents on the vehicle itself.”
How does Alzheimer’s or dementia affect driving skills?
Memory is an integral part of driving, from remembering routes to making quick decisions on the road. Nordine explained that both short-term and long-term memory are both critical for driving. She provided the example that if you’re driving and there’s a “bicyclist in a bike lane, and then [you’re] immediately making a right-hand turn because that’s your route. You need to turn right at the next traffic light, but forgetting that that person on a bicycle was just there, and we need to be able to yield to them.” In addition, if there are any accidents on the road, you need to have the memory and decision-making skills to be able to find another route.
Driving assessments like the ones Nordine conducts look at memory, processing speed, time, judgment of space, prioritization of information, and the ability to divide attention, all of which are skills dementia can impact. Driving anxiety also affects driving skills, which Nordine has seen in clients with dementia. In her assessments, “[it’s] the fatigue level that somebody is experiencing, or the unknown, the being able to drive outside of one’s normal driving patterns.”
Are there specific tests or evaluations to determine if a person with dementia can continue driving?
Organizations like Nordine’s Driving to Independence and other organizations in the Association for Driver Rehabilitation Specialists do comprehensive driving assessments. As Nordine explained, “In our practice, we do it at the same appointment. We do a clinical assessment and a behind-the-wheel assessment. That clinical assessment is going to focus on the areas of the individual’s dementia that could be affecting their driving. We’re looking at memory, speed of processing, time and judgment of space, prioritization of information, their ability to divide their attention, and things like that.” The test also looks specifically at basic driving and roadside identification.
Should regular driving evaluations be scheduled once a dementia diagnosis is confirmed?
It depends on recommendations from the patient’s provider. Nordine explained, “We do reassessments probably annually for a whole group of folks, but that really is a much better judgment to be made through the medical provider simply because they know how fast the dementia is progressing.” Some clients she sees get evaluated every six to nine months, but she works closely with providers to provide recommendations.
How can families plan transportation for their loved ones with Alzheimer’s?
Early in diagnosis, families can familiarize loved ones with dementia with rideshare apps and public transportation. Family members can also set up scheduled rides if the technology is difficult for loved ones. As Nordine noted, “The shared ride apps have evolved…It used to be that you had to be standing someplace where you wanted to be picked up when you requested a car and things like that. The apps have evolved in that I can request a vehicle or a ride for somebody at a different location at a specific time.”
Family members and close friends can also make time to run errands and go out with their loved ones with dementia to lessen the shame of asking for help. As Nordine explained, “The other thing that I often will recommend to family members is setting aside a specific time for this individual to run errands or make appointments and things like that…They just know that that’s their dedicated time with me, and I’ll drive them on whatever errand or whatever appointment or out to lunch or whatever it might be. So they’re not having to ask me for help each and every time. Sometimes that’s just sort of a nice way to be able to bridge that gap.” Friends can also help out with transportation to social events or even errands. Deborah Kan noted the word her friend coined called “care friend,” a close friend that also takes part in some caregiving. Tapping a close friend of your family member with dementia to go out to the movies or social events can help your loved one stay social and have additional help.