Driving and Dementia

Senior man behind the wheel. We explore driving and dementia

Learn about driving and dementia in the helpful article:

Living with Dementia: When Does Driving Become Unsafe?

By Ava M. Stinnett

A friend or loved one is diagnosed with dementia. Among the many concerns for caregivers and family members is determining when it’s no longer safe for the individual to drive. There are various signs to look for when assessing whether it’s time to give up the car keys; however, something just as important as safety is what the loss of autonomy will mean to your friend or loved one.

Try to imagine what it would be like if you could no longer drive. To most of us, driving means freedom and self-reliance. It’s a natural part of being an adult. Losing the independence that comes with driving may be upsetting. Having to rely on others to get around may feel uncomfortable for the person with dementia or Alzheimer’s. Keeping all of this in mind, how and when should you intervene?

A family member with dementia often adjusts better if they are involved in discussions about making the transition from driver to passenger. Some people, aware of the risks, will give up driving easily. Others may refuse to discuss the topic of driving, or they may exhibit resentment or anger when you start the conversation. You’ll want to be patient and acknowledge these feelings. The goal is to allow your loved one to maintain the highest level of independence and mobility while avoiding traffic risks. In some cases, it may be necessary to ask a physician or your family attorney to reinforce the message about safe driving.

When first diagnosed, a person with dementia or Alzheimer’s may still possess the skills necessary for safe driving. But because the disease is progressive, eventually driving skills will decrease and they will have to give up driving. Look for some of the following signs that indicate it’s time to limit or stop driving:

  • Loss of coordination getting in and out of the vehicle
  • Difficulty judging distance and space (e.g., parks inappropriately, hits curbs, drifts into other lanes of traffic)
  • Forgetting how to locate familiar places; returning from a routine drive later than usual; unexpected dents in the car
  • Difficulty seeing pedestrians, objects, or other vehicles
  • Making errors at intersections; difficulty with turns, lane changes, or highway exits
  • Failing to observe traffic signs
  • Stops in traffic for no reason
  • Driving at inappropriate speeds
  • Becoming increasingly irritated, confused, or nervous when driving

Once it’s determined that driving poses a hazard on the road, arrange for other forms of transportation such as friends or family members, taxis, public transportation, or special transportation services for older adults. (Note that taxis and public transportation work best for those in the early to middle stages of dementia.) In addition to transportation needs, the Alzheimer’s Association (800-272-3900) and the Eldercare Locator (800-677-1116) can help you find local resources and community services for having prescription medicines, groceries, or meals delivered to the home.

Bringing up the topic of turning over the car keys is a process. Over time, caregivers and doctors will need to begin the discussion and may need to return to it several times. Just as critical is knowing whether state laws require doctors to report any medical conditions that may affect their patients’ ability to drive safely. It’s never too soon to start planning a strategy to ease a loved one’s transition to becoming a non-driver.

Dementia and Wandering

Dementia and Wandering can be reduced by keeping active. Balloon volleyball

At the Adult Day Services (ADS) program we have participants that tend to wander. Dementia and wandering are common. Wandering usually occurs because the participant has an urge to “Go.” Usually, that means to “go to” the bathroom, they want “to go” home or “to go/ get away” from something that they don’t understand or find stressful (i.e. how to play a game or do a project). This is why it is very beneficial to have scheduled activities for our group. We have learned that routine keeps our group on task/busy so they do not have to wait or wonder what is going on. During small group activities and games, one might get up and go/get away from the group. If it is not a bathroom matter, we give the participant the option to switch activities or go to another group that is more to their liking. Participants also have the option to relax in the library.

 

Acknowledge and Redirect – Solutions for Managing Dementia and Wandering

 

When wandering occurs, first, the staff will see if the person needs to use the bathroom. Many times this is the reason for the “urge to go.” Another reason for wandering is the person is concerned about the whereabouts of a family member – the “urge to go home.” In order to guide the participant back to joining the group, our staff uses acknowledgement and redirection. First, the staff member acknowledges the participants concern and reassures them that their family knows they are here and will be seeing them at their discharge time. Then the staff member redirects the participant by asking him or her to help with a task, tell them what the group will be doing next and/or asking an open ended question. We have learned that wandering is a coping mechanism and allowing the participant to do just that can be a form of relief. Trying to stop the wandering may increase agitation and cause anger or frustration, so if the above suggestions don’t work, we just allow the person to take a stroll.

I have just highlighted three of the most common reasons that a participant might want to wander. Please keep in mind that there are many other possible causes for wandering.