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Putting the Brakes on Driving
Individuals with Dementia Shouldn't Drive, But How Can You Stop Them?
Driving is a complex activity which necessitates quick reactions, clear sensory abilities, and split-second decisions. For the person with Alzheimer's disease, driving becomes a safety issue. While he or she may not recognize that changes in cognitive and sensory skills impair driving abilities, you and other family members will need to be firm in your efforts to prevent the person from driving.
Because driving is a learned skill, a confused person can still appear to be driving well when he/she is not really a safe driver. Driving requires a highly complex interaction of eyes, brain and muscle and the ability to solve complicated problems quickly. A person who is still apparently driving safely may have lost the ability to respond appropriately to an unexpected problem on the road. He/she may be relying entirely on the habits of driving and may not be able to change quickly from a habitual response to a new response when the situation demands it.
Considering the person's feeling of loss of independence can aid families in their actions to help the person understand why he/she can no longer drive safely. Assisting the person with dementia to make the decision to stop driving can be useful in helping to maintain a positive sense of self-esteem.
To better understand the effects of Alzheimer's on driving, research is focusing on people with Alzheimer's disease. Results from studies conducted at Johns Hopkins University and at the National Institute on Aging (NIA) support the belief that people should not be allowed to drive after a diagnosis of Alzheimer's disease.
In the Hopkins study, more than 40% of patients studied had been in an accident after a diagnosis of the disease. In addition, 11% had caused accidents; 44% had gotten lost routinely; and 75% continually drove below the speed limit.
In California, preliminary road and laboratory studies (at Sepulveda VA and UCLA) indicate that even persons with early Alzheimer's have markedly eroded driving skills.
In another study of Alzheimer's patients still driving, common mistakes included:
As a caregiver of a person with AD, you are in a difficult position. You need to balance two important considerations: keeping the AD person as independent as possible, and the need to protect everyone's safety.
It is important that you take time to evaluate the person's driving ability and be aware of methods you can use to discourage the person from driving.
Assess the person's ability to drive
Look for the following behaviors:
One or more of these behaviors may mean it's time for the AD person to limit or stop driving.
Strongly discourage driving if the person with dementia cannot drive safely.
If you believe the person can no longer drive safely, you have several options. You may have to try more than one to be successful. First, be sensitive to what a great loss giving up driving represents. If possible, formulate a "driving" plan early on and seek help from family, friends and the AD person's health care providers.
Ask a respected family authority figure or your attorney to reinforce the message about not driving. Also ask your insurance agent to provide documentation that your loved one will no longer be provided with insurance coverage.
The following comments were made by people with Alzheimer's or other dementia in a group for those in the very early stage in Colorado:
Lynn M. Rankin, MD, put it this way:
Removing Driving Privileges:
Some with Alzheimer's will give up driving as their confidence wanes, while others will stop driving at family members' urging. Still others remain in denial and may not even accept the news from a figure of authority. Here are a few suggestions to help ease the transition:
Remember: while this is a difficult, complicated problem involving the self esteem and independence of the impaired person, the safety of your loved one and others is at stake.
This article was taken from several excellent articles prepared by Chapters of the Alzheimer's Association.