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 continue driving. A diagnosis of dementia may not mean that a person can no longer drive safely. In the early stages of dementia, some – though not all – individuals may still possess skills necessary for safe driving. Most dementia, however, 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 have 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 day-to-day behavior outside of a motor vehicle. Following are some signs that a person no longer has the necessary skills to drive safely. The loved one:
- 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 them.
- Has mood swings, confusion, and/or 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 the person’s 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 primary care physician, expressing your concerns. Fortunately, you might be invited to the next physical, in which Dad, or Mom or their spouse, may be present. The doctor will do a thorough evaluation, then began to ask either the individual a series of questions, and then finally approaching the subject of “still driving”.
You may also want to consider, dependent upon the state in which you reside, would be to contact the RMV in your state. Quite often, you can file a concern with this office and they might (hopefully WILL) follow-up. I know that the state of Massachusetts has some very tough restrictions.