Should my dad be driving with mild dementia?
Should my dad be driving with mild dementia? My father has always been an excellent driver, and at 85 he still doesn't seem to have any trouble driving. However, he was recently diagnosed with mild dementia. According to my dad, his doctor said it was OK for him to continue driving. I hate to second-guess the doctor, but that doesn't sound like very good advice to me. Is it safe for him to drive with dementia?
Your concern is well founded. All forms of dementia can undermine memory, attention span, vision, and judgment -- which can seriously erode one's ability to drive safely. Some people with dementia lack the judgment to realize that they should no longer drive.
All the same, if your father's dementia is mild, it may be OK for him to continue driving for now. But it is important that he understand that he will have to give up driving eventually. When it comes to dementia, it's not a matter of whether a person should stop driving but when. Dementia is progressive, although it progresses at different rates for different people.
You can support your father by addressing the situation directly and helping him develop a gradual plan for giving up driving. He is likely distressed and worried about his diagnosis, and it will be helpful for him to express his concerns openly and to brainstorm with you about how to handle driving and other issues in the weeks and months ahead.
If he resists the idea of giving up the car keys when the time comes, talk to his physician. Although privacy laws forbid physicians from disclosing medical information without a patient's permission (unless you have medical power of attorney), you can still let his doctor know that you are concerned your father could pose a driving risk. Your father will probably listen to his doctor when she tells him it's time for him to stop driving, but if he refuses to stop, you may have to take stronger measures.
This is a good answer, and always an important consideration. Here is a little handout we refer to a lot re: "the driving issue": http://www.agingwisely.com/wp-content/handouts2011/TakingAwayKeys.pdf. However, as mentioned in the article, it is important to keep in mind the judgment issues related to dementia, which compromise not only the driving but the decision-making about stopping. We all too often hear families say their loved one has mild dementia, and "only drives locally" or "during the day" or "two or three places within a mile"...which may be true until he/she ends up lost one day or something throws off the routine and complex thinking is compromised too much to manage it.
Some docs are better than others about this. As care managers, we often have to be the person's advocate as you are for your loved one--we've had a family doc of 30 years for one client...just too close to the situation so unwilling to do anything. There are independent driving assessment programs in many communities--one way to take the emotion out of it and let an indep. test tell. Some of our local memory clinics provide them, so that may be a way to have your Dad "check in" on how he's doing now (and then perhaps every so often if he's ok now).
Also, don't forget if he does give up driving...he still needs to stay active and vital...make sure he has ways to get around--friends, family, local transport services, home care company, cab, etc. We call it "Drive to Thrive":-) http://www.easylivingfl.com/wp-content/uploads/2011/01/Drive-to-Thrive-for-website.pdf since driving is vital to getting out and about in most areas in the U.S.
We worried about the driving question for my 88 year old mother who had Alzheimer's for 3 years. She drove everyday and just had to get out of the house (she lives alone). It was her freedom and independence. I noticed over time she began to shrink her driving area and stay more local. She never spoke of this however, so I am not sure she was aware. She bragged about how good a driver she was. I live out of state and when I was with her for a week, I let her do all the driving on purpose, so I could observe her. She usually let the "other person" do the driving if she was not alone.
I noted her weak areas were merging in traffic - she inadequately checked if traffic was coming - and driving in mall parking lots - she assumed she had the right of way and did not slow down to anticipate another car could be hidden. I knew she would be resistant to give up her license.
Then I made her an eye Dr. appt. since she had not been in 4 years and did not remember she should ever see one. She got lost and really agitated (cried) cause she could not find the drs. office yet she had previously gone there for years and it was down the street from her sisters house. I tried to get someone to help show her where it for her return visit but in the end she went to the 2nd appt. alone and missed the building, turned in a parking lot, and entered the busy street to turn around and drove right into a car coming from the left. The street was a busy one.
Luckily no one was hurt but had she entered the street seconds early the other car travelling 35 mph would have slammed into her driver's side seriously injuring her or killing her.
She now accepts she should no longer drive and has actually accepted it better than I thougt. By the way, she can not remember at all how the accident happened.
For years my mom did her own driving. She sustained a brain injury 6 years ago, but was driving again in months-doing very well. Three years ago, she began getting lost, or going back to work an hour after leaving-thinking it was the next day. (her office was a 45 minute drive each way!) We worked out a schedule between all of us so that she was taken along on all errands, so that she had no need to drive. She began trying to take off on her own, often at night. Although she had once been a great driver, her impulsive moves in traffic nearly got her and my older son killed. My adult children refused to get in the car with her. She began getting lost for hours-sometimes as long as 9 hours, alone, unwilling or able to answer her cell phone. We finally spoke to her MD, and had to take the keys from her. She is very angry, and yells at me alot if the one family member who drives her most is unavailable. Better this, than to have her lost, or killing someone.Last time she got out to her car, she sat in it, got in and out, walking around, etc. I was unsure what she was doing. Finally, I walked out to see if she was trying to locate something in the car. She had the key in, and was trying to back out, but could not figure out WHY the car would not move. It wasn't started. She couldn't remember how to start the car. That was the end :(
HBO has a documentary on the progression of Alzheimer's/dementia; the second installment is about a woman who does not want to give up driving. She was taken out for a driving test with two people who rated her skills. She was told she had to give up driving. What no one seemed to be hearing was that giving up driving, to her and probably to most of us, signifies the loss of our independence. It is a huge issue, and I do believe expert review, such as this driving test, should be applied before making a final decision. See how a person actually drives first, before saying they can't.
My dad was diagnosed with mild dementia and still drives. To give my siblings and myself a little peace of mind we purchased for him an i-tag-along GPS tracker. Fortunately, we have only had to use it once and it helped us find him quickly. Not sure how much longer he will be driving but we are working closely with our physician.
I just lost a dear old friend with Alzeimer's who was my age, 83. She was an excellent driver and a highly intelligent woman. When she was in the mild stage she was driving us to a birthday celebration to an address we'd been to many times before. She suddenly became disoriented and frustrated. She became flustered almost causing a crash. My friend gave up driving voluntarily following that near mishap, for as I said she was very intelligent.
I would say we older drivers are great defensive drivers when we have maintained our mental and physical health, however, if not, I think we have a moral duty to turn in our driver's licenses so we don't endanger others or ourselves.
Before retiring I was a caseworker in "Aging Services". On rare occasions I felt it necessary to report documentation to the DMV of a potential danger to the public for them to "road test" my client. I was gratified to learn I didn't rush to judgment; they were no longer "safe drivers".
My experience with my mother and the car question very closely mirrors simenas' experience above. My mother totalled a car one icy New Year's morning a few years ago on the way to church. She insisted on buying another car, and my brother and I at that point did not think too much about it, as an accident like that could happen to anyone. Long story short, what finally lead to our taking her car keys was her reaction and behavior when she locked herself out of her car in a store parking lot. She always instantly goes into a mindless panic mode when she believes she's lost a key or her purse. She did not think to retrace her steps and go back into the store she'd just left (where sure enough, her keys had been left on the countertop when she paid for her purchases). We think she began walking (temperature in the 90's) and someway reached a grocery near my nephew's apartment complex. The store manager was alarmed at how she looked and took her to the office of the nephew's apartment complex, got my last name from her (I'd recently moved from this very complex myself). The nephew just happened to be home and was able to fetch Mom and somehow find her car, as Mom did not have a clue. Needless to say, when strangers have to get involved to help fix a mess like this, it's time to take the car and the keys. To this day, Mom keeps asking me why I'm punishing her. I calmly tell her what happened to her many times when she gets angry over this. I can tell by the look on her face she doesn't believe any of these events even happened. I now note that even on foot, she will invariably walk exactly the wrong direction. She was a schoolbus driver for 20 years. I just feel grateful I won't have to worry about her harming anyone else and not remember anything. I do feel sympathy as I know a car to most folks in America today represents freedom, but this is a shame anyway, and that's a whole other topic. (I personally did without a car for three years and learned to use the local system, and it worked fine for me personally without much inconvenience. I did survive and actually enjoyed it, believe it or not). You must take the keys when your good sense tells you it's time.
QUESTION: When a parent is diagnosed with early dementia, and has passed a Sheriff's road test, yet family members know the elder is starting to not remember nouns, finding it hard to balance a checkbook; if the elder were in an accident no fault of their doing, might family members who knew of the dementia diagnosis be financially liable, even if the elder was driving their own car and not the 'kid's ' car?
Stay Connected With Caring.com
Get news & tips via e-mail