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Whether or not we realize it, driving is often associated with self-reliance, independence, and freedom.  When someone is diagnosed with dementia, whether or not to drive is often one of the first concerns for an individual. Deciding not to drive may mean accepting that one’s abilities are changing, and that can be a terrifying and upsetting aspect of dementia.  Often, the decision to cease driving is a frustrating and upsetting one, for both the patient and the patient’s family, but it is a necessary one for the safety of the patient and others that share the road.  Below are some strategies to ease the transition and to make the hard conversations a little easier.

Begin the conversation as soon as possible. Involve the physician as well as the person with dementia.  It is essential to talk about not only the safety of the patient but also the safety of others.  Often in the early stages of dementia, a person is still capable of making safe decisions when driving.  At this time, it is essential to discuss the signs that would indicate it is time to stop driving.  These signs may include:

  • Confusion over colors, words, and road rules
  • Recent tickets, accidents or unexplained damage to the person’s car
  • Suddenly refusing to drive with family members or friends
  • Getting lost in familiar places
  • Not staying in the right lane
  • Driving too slowly or speeding
  • Confusing the brake and gas pedals
  • Mood swings
  • Delayed response times and lack of awareness
  • Increased difficulty with short term memory

Forming a written contract with the patient highlighting these signs may be beneficial to helping them cease driving when the time comes.

Look for alternatives to driving and start to use them, even if the person is still capable of driving.  Any or all of these may be helpful, depending on circumstances. Options may include:

  • Looking to family members or friends to provide rides
  • Delivery services for groceries and medications
  • Senior transportation services offered by the county or the city, places of worship, or other organizations within the community
  • Taxis or Uber services where a payment account can be set up and managed

If the person is unwilling to give up driving, last-resort preventative strategies may be needed, including controlling their key access, disabling the vehicle with a “kill switch,” or selling the car. 

Another strategy is to consider cognitive performance and road-side driving evaluations, often offered by an occupational therapist. These tests assess both cognitive and physical abilities, which are important for driving.  The Virginia Gay Hospital occupational therapy department provides a complete cognitive performance evaluation and a basic road-side assessment.  If you’d like more information, please talk with your primary care physician or an occupational therapist at Virginia Gay Hospital by calling 319-472-6372. Visit our therapy services page to learn more about what our department has available.