How can we stop mom from driving when Alzheimer's makes using alternatives difficult?

Htnevada asked...

My grandmother just went in to renew her driver's license and she was denied based on her usage of a cane. They said they would need a written note from a physician in order to renew the license. I was relieved to hear her license was not renewed as she also suffers from mild to moderate Alzheimer's. While she can still manage to usually get from point A to B, she does not drive well and is often oblivious to other traffic, speed limits, signs, and pedestrians. The slightest alteration will confuse her greatly (i.e. construction or events). It hasn't been a huge issue because she lives in such a small town, but we're all concerned for her safety and the safety of others (I for one refuse to ride with her). My mother is the primary caregiver for her and my grandfather (who is 99 and hasn't driven in about a decade), so while she tries to be there to drive her to her hair appointment and do a lot of her grocery shopping, she just can't manage it all. Meanwhile, my grandma continues to drive around to the grocery store, the pharmacy, etc. She got lost last week on a visit to her sister-in-law. She already becomes irritated on these outings because she repeatedly tries to fill prescritions she doesn't need or aren't ready to be filled, further adding to her confusion on her way home. She has set up an appointment to meet with the physician to get her license back. What can we do to keep her off the road? I researched and found that there is a service that could take her where she wants to go at no charge, but on a trial run she forgets they are coming for her, won't get in the shuttle because she doesn't know them, or can't remember to call them. Her AD complicates it much more. Any suggestions would be greatly appreciated!

Expert Answer

Elizabeth Dugan, a Fellow of the Gerontology Institute, University of Massachusetts Boston, is the author of Driving Dilemma: The Complete Resource Guide for Older Drivers and Their Families.

My family faced a similar situation -- and I know how hard it is to figure out exactly when to take the keys away from a loved one with dementia. Even experts sometimes disagree on when driving cessation is warranted for someone with Alzheimer's disease. But you are describing some red flags that suggest it is time for your grandmother to stop driving (e.g., getting lost in familiar areas, not oriented to date/time, alarming driving performance).

The good news is that the licensing authority recognized this and did not renew her license. Next I would call or fax her physician describing the red flags you have observed and your support for the licensing authority's decision. That may settle the licensing issue. (The time may soon come when the car has to be disabled or moved because she may not remember she is not legally permitted to drive.) Finally, and perhaps more difficult, is to have a family conversation about the situation. When someone stops driving, the burden to provide alternative transportation usually falls to family and friends. Your grandparents will still have all their current needs to get around but will need rides for groceries, medical appointments, shopping, faith activities, volunteer, social and leisure interests. What you have found from the ride program isn't unusual. They aren't always "dementia-friendly" -- as the disease progresses our brain becomes less able to remember to call for rides or remember when they are coming or even who the driver is. Good communication and mutual support will help your family pull together to help your grandparents when they are no longer driving.