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Dementia and driving

What to Expect at Home

If your loved one has dementia, deciding when they can no longer drive is a difficult decision. They may react in different ways:

  • They may be aware they are having problems, and they may be relieved to stop driving.
  • They may feel their independence is being taken away.

Signs that Driving May No Longer Be Safe

People with signs of dementia should have regular driving tests. Even if they pass a driving test, they should be retested in 6 months.

If your loved one resists you getting involved in their driving, get help from their health care provider, lawyer, or other family members.

Even before you see driving problems in someone with dementia, look for these signs that they may be at risk for driving badly:

  • Forgetting recent events
  • Mood swings or getting angry more easily
  • Problems doing more than one task at a time
  • Problems judging distance
  • Having trouble making decisions and solving problems
  • Becoming confused more easily

Signs that driving may be getting more dangerous are:

  • Getting lost on familiar roads
  • Reacting more slowly in traffic
  • Driving too slowly or stopping for no reason
  • Not noticing traffic signs or not paying attention to them
  • Taking chances on the road
  • Drifting into other lanes
  • Getting more agitated in traffic
  • Getting scrapes or dents on the car
  • Having trouble parking

Steps to Take

It may help to set limits when driving problems start. Stay off busy roads, or do not drive at times of the day when traffic is heaviest.

Do not drive when the weather is bad. Do not drive long distances. Drive only on roads the patient is used to.

Caregivers should try to lessen the person’s need to drive without making them feel isolated. Have someone deliver groceries, meals, or prescriptions to their home. Find a barber or hairdresser who will make home visits. Arrange for family and friends to visit and take them out for a few hours at a time.

Plan other ways to get your loved one places. Family members or friends, buses, taxis, and senior transportation services may be possibilities.

As danger to others or to your loved one increases, you may need to prevent to them from being able to use the car. Some ways to do this are:

  • Hiding the keys
  • Leaving out car keys that will not start the car
  • Disabling the car so it will not start
  • Selling the car
  • Storing the care away from the home

References

Dave J, Hecht M. Dementia. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 119.

Smith DA, Brechtelsbauer DA. Delirium and dementia. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 48.

Iverson DJ, Gronseth GS, Reger MA, Classen S, Dubinsky RM, Rizzo M. Practice parameter update: evaluation and management of driving risk in dementia. Neurology. 2010;74:1316-1324.


Review Date: 5/13/2012
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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