Lack of independence and loss of control is a big issue for people living with Alzheimer’s dementia (AD) and their caregivers. As a physician, I have often been asked by the caregivers of my patients with AD to broach the delicate topic of asking someone to give up an activity they used to be able to manage well. Often, this situation comes up around driving, which is one of the most crucial topics when it comes to safety.
Sometimes, just bringing up the topic helps my patients understand their symptoms have changed. Sometimes it takes my writing a prescription instructing them not to drive. Other patients have their driving evaluated by an objective person who is not involved in their care. But almost everyone finds it very difficult to stop driving, because it is a loss of freedom. This can cause a great deal of tension in the household or family.
The Intersection of AD and Driving
People with AD can have changes in memory, judgment, sense of time and place, and behavior—all of which can have an impact on driving. Of course, every loved one with AD is different, and everyone experiences dementia differently.
Some signs that it may be time for your loved one with AD to stop driving may include:
Forgetting how to locate familiar places
Failure to observe traffic signals
Making slow or poor decisions
Confusing the brake and gas pedals
Starting the Discussion
The conversation about whether or not it’s safe to continue driving can be a difficult one. This is true for both your loved one and you.
Here are some tips given by the Alzheimer’s Association that may help:
When expressing your concerns, stress the positive, and offer alternatives for transportation
Have patience, understanding, and empathy when bringing up the topic
Remember that it may be an emotional time for everyone involved, so if things get tense, try suggesting that an objective professional conduct a driving assessment
Ask your loved one’s physician to write a prescription that says “No driving”
The most important thing is keeping your loved one safe. Though it can be a difficult conversation and a hard transition, you are not alone. Ongoing assessments by family and medical professionals will help to alert you to the changes in your loved one’s status as well as any current risks and challenges. For information on safety and support, you can visit the Safety Center at www.alz.org. Additionally, the Alzheimer’s Association has a 24-hour helpline where you and your loved one can get information and support.
Warachal Eileen Faison, MD, is a geriatric psychiatrist and the Medical Director of Primary Care Women’s and Men’s Health for Pfizer Inc.
After reading this article, how likely are you to speak with a healthcare provider or someone you know about Alzheimer's dementia and driving?
Asking someone with dementia to stop driving is a big decision. But for a number of reasons, especially safety, it’s sometimes necessary. On the Dr. Phil Show, Freda Lewis-Hall, M.D. and Dr. Phil discuss the issue.