Nov 13, 2014

7 Signs and How to Get a Person Living with Alzheimer's to Stop Driving

Convincing a person living with dementia that can no longer drive might be one of the most difficult tasks you ever face as a caregiver.

By Nancy Wurtzel
Alzheimer's Reading Room

7 Signs and How to Get a Person Living with Alzheimer's to Stop Driving

Imagine how you would feel if you could no longer drive. The ability to get in your vehicle and go where you want, when you want is no longer available. Your freedom, autonomy and mobility are gone, and suddenly you must count on others for all your transportation needs.

As an Alzheimer's caregiver, I went through the driving dilemma with both of my parents.

When my dad was in the mild stage of Alzheimer's, he realized he could no longer safely drive. In fact, driving seemed to overwhelm and even frighten him. As a result, Dad self-regulated and made his own decision to turn over all driving duties to my mother.

Dad was the exception. Caregivers report that those with memory loss rarely relinquish their right and ability to drive without resistance.

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My two sisters and I experienced this a decade later, when it became apparent that our mom was now having cognitive issues. Not able to see the impairment in her abilities, Mom initially balked at the idea of selling her car. However, we all noted her driving abilities had deteriorated significantly. It took some convincing on our part and a conversation with her doctor, but she reluctantly relented.

Caregivers often rank the issue of driving as one of the most difficult hurdles. Complicating matters, there are no universal standards or set guidelines to follow.

To assess their loved one's driving ability, caregivers can look for these typical red flags:
  • Forgetting how to locate a familiar place
  • Having frequent near misses
  • Failing to observe the rules of the road
  • Driving at an inappropriate speed, often very slow
  • Experiencing delayed reactions
  • Hesitation when making driving decisions
  • Confusing the brake and gas pedals
  • Making frequent errors at intersections
If a caregiver notes several of these warning signs, it is probably time for the person with memory loss to dramatically curtail or stop driving altogether. Safety for your loved one and for others must be the paramount concern.

What's the best way to approach the topic?

Start by having a brief conversation in which you share concerns, cite examples and appeal to the person’s sense of responsibility. The next day, follow up with another short conversation and keep bringing up the issue. Always make the talks brief.

Eventually, begin talking about transportation alternatives as though driving was a thing of the past.
Speak with compassion, not blame. In return, listen and show empathy. Take the time to acknowledge feelings and resistance. Keep your cool by being patient but firm.

This all sounds good on paper but taking away driving privileges can be bring out all sorts of strong feelings.

Due to the disease, and especially if the person’s memory loss has progressed beyond the mild stage, there can often be anger, lashing out and even a refusal to discuss the subject. Remember, this is not the person’s fault. Cognitive loss can make it nearly impossible for a person to understand why operating a vehicle is no longer safe.
  • If there continues to be heavy resistance, seek professional intervention.
  • The family physician can tell the person he or she must “retire” from driving. Some doctors will even issue a “No Driving” prescription. Other caregivers have asked their family attorney or insurance agent to reinforce the message.
  • This decree from an expert often helps convince the person that the time to stop driving is now. Additionally, it takes the driving issue out of the caregiver's hands, so the "bad guy" is the authority figure and not the caregiver.
  • However, when talking, reasoning and outside intervention is getting nowhere, the caregiver may need to take away the car keys, disable or even remove the automobile.
Never underestimate the person’s desire to drive and never assume the driving is resolved until you have completely eliminated the person’s ability to do so. It is not uncommon for a person to stop for a period, but then begin using their car again without their caregiver’s knowledge.

While all of this is going on, the caregiver must put transportation alternatives in place.

Determine who will be taking the person to appointments and to run errands. Make a schedule and include time for some side trips or fun outings. Consider taxi or senior transport services. Ask other family members, friends and volunteers to give you a hand.

Consider all of the driving trips you will have to make. Many trips may not even be necessary. For instance, delivery services for prescriptions and groceries are available and many home items can be ordered online with free delivery.

As caregiver, never complain about driving the person. These comments will only serve to open a wound that is just beginning to heel. Be supportive and show through action that life can still go on after the car keys have gone away.

The driving conversation certainly ranks as one of the most stressful. Caregivers often feel isolated and alone when they encounter these major hurdles.

If you need additional help, contact the Alzheimer’s Association 24/7 Helpline at 800-222-3900 or visit the Dementia & Driving Resource Center on their website.

Nancy Wurtzel
Nancy Wurtzel writes Dating Dementia -- a slightly twisted and humorous blog -- about making big changes at midlife. Read about Nancy's journey through divorce, restarting a career, empty nest challenges, moving home, baby boomer issues and caring for an aging parent with Alzheimer’s disease. Visit Dating Dementia.

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Driving evaluation

At the earliest stages, a person with Alzheimer's disease may begin to have difficulty with complex tasks such as driving. Although family and caregivers can watch for signs of unsafe driving, a proactive strategy would be to get a comprehensive driving evaluation by an occupational therapy driving rehabilitation specialist. The evaluation provides a more objective understanding of the current impact of the disease on driving capacity and results in a plan of options. The goal is always to retain the highest level of independence and mobility in the community. Initial recommendations may include strategies to reduce driving risk during the early part of the disease. The occupational therapist can offer strategies specific to the individual's goals and needs. The American Occupational Therapy Association website includes a national database of driving specialists as well as a wealth of resources for both persons with Alzheimer's disease and their families.

Source Alzheimer's Association

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