Driving is a routine part of adult life for many people. It's also a symbol of independence. While the focused concentration and quick reaction time needed for safe driving tend to decline with age, Alzheimer's disease accelerates this process dramatically.
If you're caring for a person living with Alzheimer's disease, you'll need to address the issue of his or her driving and ease the transition to different ways of getting around.
Start the conversation.
At some point, a person living with Alzheimer's disease will no longer be able to drive. Talk about this eventuality with your loved one early and plan his or her retirement from driving.
This might be a difficult conversation—possibly the first of many. Losing the independence driving provides can be upsetting. Keep in mind your loved one's feelings. Show support and empathy. If you encounter resistance, explain that it is a safety issue and appeal to the person's sense of responsibility. Talk about the alternatives to driving. You might also ask the person's doctor, a respected authority figure or your attorney to help you reinforce your point.
If possible, have the person living with Alzheimer's disease sign a driving contract while still in the early stages of dementia. The contract will give you permission to help him or her stop driving when necessary.
When to stop driving
The sooner you address the issue of driving with your loved one, the better. Research suggests that people living with Alzheimer's disease tend to overestimate their driving abilities, despite the fact that even those with mild dementia are at higher risk for unsafe driving. Caregivers, however, can more accurately identify unsafe driving in people living with Alzheimer's.
Watch for signs of unsafe driving, including:
- Difficulty navigating to familiar places
- Poor lane control
- Confusing the brake and gas pedals
- Failing to observe traffic signs
- Making slow or poor decisions
- Hitting the curb while driving
- Driving at an inappropriate speed
- Becoming angry or confused while driving
To be proactive, have the person living with Alzheimer's disease evaluated by an occupational therapy rehabilitation specialist. The American Occupational Therapy Association has a national database of driving specialists. A specialist can evaluate the impact of the disease on a person's ability to drive and offer strategies for driving safely, as well as when and how to reduce or stop driving.
How to ease the transition
When your loved one stops driving, arrange for alternative transportation. Have family and friends run errands with your loved one, or arrange transportation through a senior van route. Establish an account with a taxi or car service so that your loved one can go places, but won't have to handle money.
Consider ways to limit your loved one's need to drive. Many items—such as groceries, meals, and prescriptions—can be delivered to your loved one's home.
Also, distract the person living with Alzheimer's disease from driving opportunities. If possible, have someone sit in the backseat with your loved one to distract him or her.
Remain firm as the disease progresses.
If the person living with Alzheimer's disease insists on driving, consider these last-resort preventive strategies:
- Control key access. Keep keys out of sight. If your loved one insists on carrying a set of keys, offer keys that won't start the vehicle.
- Disable the vehicle. Remove a battery cable to prevent the car from starting, or ask a mechanic to install a "kill switch" that must be engaged before the car will start.
- Sell the vehicle. If you can make do without your loved one's vehicle, consider selling it.
Whether your loved one stops driving all at once or in stages, he or she will probably grieve the loss of independence. Be patient, but firm. The consequences of unsafe driving can be devastating.
Publication Date: 2000-09-25