This page outlines how dementia can affect driving, and what you can do if a loved one continues to drive with dementia.
It usually first appears as forgetfulness, then decreased problem-solving and language skills.
Difficulty with ordinary daily activities often follows, then severe memory loss and disorientation.
The most common form of dementia is Alzheimer’s disease. Alzheimer’s is a disorder affecting the function of the brain. A person can appear fully alert and awake, but their memory and judgement are impaired. With Alzheimer’s, recent memory goes first. People tend to forget events rather than details. Rather than ‘Who did I sit next to at the wedding?’, a person with Alzheimer’s will ask ‘What wedding?’
No single feature distinguishes Alzheimer’s disease – the total picture determines whether or not a person has Alzheimer’s.
If someone you know may or does have dementia, but continues to drive, discuss your concerns about their driving with them. It’s important to raise the issue early, while they’re still able to make decisions about their driving future, such as selling their vehicle. Sometimes people with dementia will recognise their own limits and accept that they’re putting themselves and others at risk. Give the person a chance to make the decision to stop driving.
They may be reluctant to stop driving, possibly because they can’t understand fully that they have had a loss of skills. The problem must not be ignored, even if they’re only travelling to the shops and back. You may need the family to help ensure the person doesn’t drive.
It’s often useful to involve the person’s health practitioner, who can assess their fitness to drive and, if necessary, take appropriate action if they don’t agree to stop driving. The health practitioner could be their usual doctor (GP), a registered nurse or nurse practitioner, or a specialist if appropriate.
These are the skills a person must have to drive safely:
A person with early signs of dementia may show the following decline in driving skills:
You should also note the condition of their vehicle – having small scrapes may indicate unsafe driving, eg the car hitting the side of a garage or gateway, and the driver misjudging widths and distances in driveways.
Alcohol and some medication will alter the driving ability and reaction time of a person with dementia. This combination is dangerous. You may need to take action by referring them to their health practitioner or advising the NZ Transport Agency that you have concerns about their driving. It’s important to remember that many driving skills are automatic. A confused person may appear to be driving well when they’re really relying on habitual responses.
Speak first to the person’s health practitioner and enlist his or her help (they may be able to arrange a driving assessment). A member of the Police Traffic Unit may agree to speak to the person too.
Get together with other family members and discuss your concerns. Involve other people if necessary, for example a social worker or Alzheimers New Zealand.
Insurance companies require that any condition likely to affect a driver’s ability must be disclosed or the company has the right to turn down a claim. After notification of this condition, whether the company will continue to provide insurance cover or not depends on the recommendation of the health practitioner and consultation with the insured parties. If the person with dementia is still driving, ask their insurance company if they’ll be covered by insurance if they crash.
Giving up the privilege of driving involves a loss of self-esteem and freedom. Anyone required to stop driving for health reasons may feel angry and frustrated.
Try to understand the person’s thoughts, feelings and fears. It may be the first time the person has had to face and accept they have dementia.
If you as a carer don’t drive, it’s important to consider transport alternatives. These are some options.
Some families decide to sell the car and place the funds in an account to pay for taxis.
The Transport Agency is required by law to be sure that all drivers are medically fit and able to drive competently and safely. If the person won’t voluntarily stop driving, the Transport Agency may revoke their licence – if it’s considered necessary in the interests of public safety.
Health practitioners may refer a person suspected of having dementia to an occupational therapist for an assessment of their driving. This isn’t the same as a driving test – it’s a more comprehensive assessment.
Health practitioners also have a legal obligation to advise the Transport Agency if they believe that a person unfit to drive is likely to carry on driving.
If you suspect a person may be showing signs of dementia, give them this simple test on common traffic signs.
Ask ‘What does the sign mean?’ and ‘What action should the driver take?’
Suggested answers:
