By Micha Shalev
When an individual is diagnosed with dementia, one of the first concerns that families and caregivers face is whether or not that person should drive. A diagnosis of dementia may not mean that a person can no longer drive safely.
In the early stages of dementia, some individuals may still possess skills necessary for safe driving. Most dementia is progressive, meaning that symptoms such as memory loss, visual-spatial disorientation and decreased cognitive function will worsen over time. This also means that a person’s driving skills will decrease and, eventually, he or she will have to give up driving.
Many people associate driving with self-reliance and freedom; the loss of driving privileges is likely to be upsetting. Some individuals, recognizing the risks, will limit or stop driving on their own. Others may be unable to assess their own driving skills and may insist on driving even when it is no longer safe. Families and caregivers may need to intervene when an individual’s symptoms pose too great a traffic risk.
You can assess an individual’s level of functioning by observing his or her behavior outside of a motor vehicle. A person no longer has the necessary skills to drive safely when he or she:
•has become less coordinated;
•has difficulty judging distance and space;
•gets lost or feels disoriented in familiar places;
•has difficulty engaging in multiple tasks;
•has increased memory loss, especially for recent events;
•is less alert to things happening around him or her;
•has mood swings, confusion, irritability;
•needs prompting for personal care;
•has difficulty processing information;
•has difficulty with decision-making and problem solving.
It is important to compare present behavior with behavior before the onset of dementia. For example, weigh an individual’s degree of difficulty engaging in multiple tasks in relation to his or her prior ability. Changes in behavior will be most noticeable to family and friends who have closely interacted with the individual over time. Share and discuss your observations with other family members, friends and health care providers.
The safest option for assessing a person’s driving skills is to arrange for an independent driving evaluation. Prior to the evaluation, inform the examiners that the person being evaluated has dementia. Evaluations are sometimes available through driver rehabilitation programs or State Departments of Motor Vehicles (RMV).
Another option is to write an open or a confidential letter to your loved one’s doctor, expressing your concerns. You may want to attend a medical appointment with your parent where the doctor will do an evaluation.
In some states individuals can file a concern with the Department of Motor Vehicles. Massachusetts has some very tough restrictions.
Many communities also offer riding services through the senior center or bus company. Or, family members could share the shuttling of a parent.
Some individuals with dementia may forget that they should not drive or insist on driving even though it is no longer safe. While it is important to maintain respect for the individual’s feelings, you must put safety first.
The following methods may be needed as a last resort:
•Hiding the car keys;
•Replacing the car keys with a set that won’t start the car;
•Disabling or selling the car;
•Moving the car out of sight.
Micha Shalev MHA CDP CDCM CADDCT is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 Randolph Road in Worcester. He is a graduate of the National Council of Certified Dementia Practitioners program, and well known speaker covering Alzheimer’s and Dementia training topics. He can be reached at 508-853-8180 or by e-mail at m.shalev@dodgepark.com or view more information online at www.dodgepark.com. Read more of his columns at fiftyplusadvocate.com
