Driving and Dementia: The Unseen Risks When You Don't Take The Keys

Driving and Dementia

I remember very clearly, trying to figure out why my mom who was always so social and wanting to go places like the symphony, or the library or even just a Sunday drive all of a sudden stopped wanting to go places. 

The “fighting” or nudging to try to get her to go out into the community with my dad. Her saying, things like: “I just don’t want to”. Or not wanting to drive to go get an ice-cream, like she always used to. The sun on her face, seeing the beautiful South Carolina countryside. Socialization and being in the community. 

Then one day I figured it out. She was afraid to drive with my father. You see, unbeknownst to me sometimes when visiting us an hour away, my dad would get lost driving home. 

And this scared my mom. 

She was not able to tell me why she didn’t want to go out with my dad, but her habits and behavior changed.

I did not recognize it for what it was. She was afraid of him driving, and could not tell us. 

As an experienced occupational therapist with nearly three decades of hands-on practice, I've navigated many such sensitive topics of driving with dementia with individuals and their families. 

Indeed, it's a tough subject, but one we must address with care and empathy. After all, driving isn't merely a way of getting from A to B; it's a symbol of freedom and independence. But when dementia walks into this picture, it complicates things. It's no longer just about independence, it's about safety — for both the individual and those around them.

You see, we forget that driving is a privilege and not a right. 

According to the World Health Organization, around 50 million people have dementia worldwide. As the condition progresses, memory, thinking speed, language, understanding, and judgment likely all will decline. These cognitive changes can significantly impact an individual's ability to drive. Recognizing these changes can be difficult, but it's necessary.

Let's dig in, face this issue head-on, and explore some ways to navigate this delicate matter of driving and dementia.

1. Recognize the Signs

The first step is recognizing the signs that suggest it might be time for your loved one to stop driving. Pay attention a few of the following:

Difficulty Managing Medications

If your loved one often forgets to take their medication or becomes confused about dosages, it could be an indication of a more significant cognitive problem that could impair their driving skills.

Confusion while Driving to Familiar Places

Another common sign of dementia is getting lost on familiar routes or having trouble navigating well-known areas. If this is happening, it may be time to reassess their driving.

Vision or Hearing Problems

Dementia can affect vision or hearing. If your loved one's visual or auditory perception is compromised, it can seriously impair their ability to react to hazards on the road.

Challenges in Handling Finances

Difficulty handling finances can be an early sign of cognitive decline. If they're struggling with money-related tasks, it's another warning sign that they may not be safe to drive.

Having been Scammed

Sometimes the first sign that a person is starting to struggle with the skills needed to safely make decisions related to driving is that they have succumbed to being scammed. This can be a subtle sign of cognitive changes, even though it is easy for anyone to be scammed and scammers are very effective with their scams. However, if your loved one has been scammed, pay attention to other subtle cognitive changes. 

2. Have the Difficult Conversation

Next, we need to address the elephant in the room. It's time for a conversation about driving. Here's how to approach this:

Preparing for Resistance and Emotional Upheaval

Be prepared for resistance. They might become defensive or upset. It's understandable. Try to approach the conversation with empathy and patience. Try to see if you can enlist the assistance of their primary care physician. We needed to have my dad evaluated by a driving rehabilitation specialist through our local hospital system. He did not pass the driving test, and then we included a course of therapy to see if it would improve before taking the final step of involving the Department of Motor Vehicles in our State. 

Emphasizing Safety Risks

The focus of this conversation should be safety — for them and others on the road. Give specific examples of times when their driving was risky to help them understand the seriousness of the situation. Understanding the implications of driving with cognitive impairment and the consequences related to car insurance is also important. Ask your car insurance agent for guidance. 

Communicating Concern and Empathy

Let them know you're concerned about their wellbeing and the wellbeing of others with them and on the road. Express that you understand this is a tough transition and reassure them that you're there to support them. Explaining that voluntarily stopping driving is much easier on everyone involved and less adversarial may be a good strategy. 

3. Develop an Alternate Transportation Plan

Once driving is off the table, it's essential to create an alternative transportation plan. Here are some options to consider:

Exploring Ride-Share Apps

Ride-sharing services like Uber and Lyft can be a convenient alternative for individuals with dementia. It allows them to maintain some degree of independence without the safety risks associated with driving, especially in the earlier stages of cognitive changes. You may need to help set up the rides, monitor the use of the app and ensure overall safety. 

Utilizing Volunteer Driving Services

Many communities offer volunteer driving services for seniors or those with mobility issues. These services often provide transportation to doctor's appointments, grocery shopping, and social events. Don’t forget to tap into friends and neighbors, especially if mom or dad have lived somewhere for a long time. 

Church-Provided Transportation

If your loved one is part of a religious community, check if there are transportation services available. Many churches and religious organizations offer this type of support for their members.

Agencies for Aging Services

Local agencies that specialize in senior services often provide transportation services or can connect you with resources to help your loved one maintain mobility and independence. Medicaid may have local transportation resources, adult day programs might be an option and senior centers locally. 

4. Resources and Insights

You don't have to navigate this journey alone. Here are some resources that can offer guidance and support:

"Driving with Dementia" by Debbie Ricker, OTR/L

This book offers valuable insights and practical advice for families navigating the challenges of driving with dementia. You can purchase the book here. 

Online Resources from the Alzheimer's Association

The Alzheimer's Association has a wealth of resources on their website, including articles and advice on handling dementia and driving. Access the resource site here

Other Resources Online: 

This website, HelpGuide.org has a wonderful article about aging well and driving. Check it out.  

Conclusion

Navigating the challenges of driving with dementia is a journey. It takes empathy, patience, understanding, and plenty of support. Recognizing the signs, having difficult conversations, and developing alternate transportation plans are all crucial steps in ensuring the safety and wellbeing of your loved ones. Remember, you're not alone in this journey. By accessing the available resources and leaning on each other, we can face these challenges together, one step at a time.

FAQs

Q: What are the signs my loved one may not be safe to drive?

A: Signs include difficulty managing medications, confusion while driving to familiar places, vision or hearing problems, and challenges handling finances. Other overlooked issues are the changes in range of motion of the neck needed to turn and look safely for turning and the decreased ability to judge speed, distance and time. 

Q: How do I approach the conversation about driving with dementia?

A: Approach it with empathy and patience. Emphasize the safety risks, communicate your concern, and be prepared for resistance and emotional reactions.

Q: What are some alternative transportation options for individuals with dementia?

A: Options include ride-share apps like Uber or Lyft, volunteer driving services, church-provided transportation, and local agencies specializing in aging services.

Q: What resources are available to guide me through this process?

A: The book "Driving with Dementia" by Debbie Ricker and online resources from the Alzheimer's Association can provide invaluable insights.

Until next time, stay safe and take care. We are on this journey together.

Read more:

How to Deal with Your Mother's Delusions Due to Dementia

Cognitive Decline: What You Need to Know

Disclaimer: These blogs, videos and any work done by Lizette Cloete OT, as a Member of Think Different Dementia, LLC, is given only as educational content and consulting work. This does not create an Occupational Therapist-Patient Relationship. The educational content and consulting work performed should not be considered medical treatment as an Occupational Therapist. The consulting work does not take the place of medical work normally performed by a licensed Occupational Therapist. Please consult a licensed Occupational Therapist for medical advice.

“Think Different” Dementia’s owner, Lizette Cloete, OTR/L graduated as an Occupational Therapist from the University of Pretoria in South Africa in 1992. She and her husband emigrated to the USA in 1993, and currently reside in South Carolina. They have 2 daughters and one son-in-love, 4 cats, one dog and 16 chickens.

Lizette has almost 30 years of experience as an Occupational Therapist in a variety of settings, the latest being in the home health environment. Among her many accomplishments, she served on the South Carolina Occupational Therapy Association’s Board of Directors from 2008-2014. She enjoys teaching on the topic of dementia, most recently presenting at a national conference on the topic “Dementia Made Simple”.