In England, a person with a dementia diagnosis must legally register with the Driver and Motor Vehicle Licensing Agency and notify his or her insurer. Failure to do so can mean fines and loss of coverage. Here in the U.S. there is no national regulation for the dementia and driving skills combination.
For everyone’s safety, driving skills must include the ability to:
Sometimes families do not get worried until they see an unmistakable pattern of accidents or “near misses.” Struggles can be overlooked or dismissed. Perhaps a spouse wonders why her husband has taken much longer to get home from a routine trip to the barber shop, but gets distracted by a phone call and forgets to question what happened. Maybe a frazzled daughter defers a prickly driving conversation about her mother’s indifference to traffic signs until her sister will be in town. When worrisome red flags appear, families must look more closely for indications that might be missed.
Of course being truly proactive means being aware of indicators of possible trouble before that first “near miss” or when there is tell-tale bright yellow paint from a pole scraped onto Dad’s car. No one wants to consider the tragedies possible should someone with dementia confuse the brake pedal and accelerator.
The Alzheimer’s Association resources suggest that other behaviors may suggest the need for an assessment of driving skills.
One answer is to limit driving by reducing the need to drive. Finding transportation alternatives could be part of the solution.
Family members can be adamantly resistant to change. Since the decision-making patterns of seniors have been in place for decade, those decision patterns themselves are unlikely to change, especially when the senior is confronted by complex issues. Caregivers who are concerned that a senior is not driving safely must be willing to listen to protests, and not be seen as unreasonable to or controlling. When possible, guiding the senior to and/or spouse to make the decision themselves works best.
A personal perspective can help. Dr. Jason Karlawish, associate director of the Memory Disorders Clinic and fellow of the Center for Bioethics at the University of Pennsylvania has this to say
“In my practice, I recommend that family members and friends ask themselves a simple question,” he said. “‘Would you let your relative with Alzheimer’s disease drive the grandchildren, or someone else’s grandchildren, to an event?’ If they answer to this is anything less than a simple ‘Yes,’ then it is sensible to consider at least a driving evaluation
In Baton Rouge, The Baton Rouge Rehabilitation Center offers driving evaluations. There are many resources like this one to help with this and other challenges of having a loved one with dementia. Take advantage of the help available before your loved one’s struggle with dementia and driving skills drives you to distraction!