Can someone with Alzheimer's or dementia still drive?

A fellow caregiver asked...

My step-dad is in his 8 year of having Alzheimer's. The other day he drove a truck to a bank. A truck he has not driven in over 6 years. He knew where the keys were and every thing. The only mistake he had was parking the truck crooked a little. Do you think it is Alzheimer's or just dementia? Or can a 8 year Alzheimer's penitent can manage to drive a truck and know where the keys were hiding?

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

As we age, we may experience occasional memory loss, known as "senior moments." However, by the time we reach our mid-eighties, almost half of us will have more serious dementia. Similar to how we use "Cancer" to describe many different diseases, "Dementia" is an umbrella term used for numerous disorders that share several symptoms, starting with memory-loss and confusion, as in Alzheimer's disease, cardio-vascular dementia, multi-infarct dementia, alcohol related dementia, and frontal-temporal dementia. Alzheimer's disease is the most prevalent dementia, representing over 35% of all cases.

Living with Alzheimer's disease or related dementias is usually uncharted territory for everyone involved. Some days are good, others are chaotic and then there may be sudden clear and lucid moments. Your stepfather apparently was able to think clearly long enough to locate the keys and drive the truck.

Someone in the earlier stages Alzheimer's or other memory-impairment may still remember how to operate a vehicle. For most of us, driving is second nature, akin to other automatic motions, like walking or swimming. Problems arise with confusion in navigating traffic, forgetting routes, and not recognizing risks. Impaired drivers may neglect to stop at red lights or stop signs. They may mistake the accelerator for the brake pedal, which can lead to disasters. Most of us remember the incident in Santa Monica, California a few years ago, when a man in his eighties plowed into a crowd and killed several shoppers. When questioned about the incident shortly afterwards, he had no recollection of any of it. Whether his confusion and memory loss were caused by Alzheimer's or a related dementia was irrelevant. Obviously, his condition was so advanced he should have not have been driving at all.

It's up to us as family-members, friends, and caregivers of a person with memory problems to step in sooner rather than later. Taking a ride as a passenger is a good way to gauge his ability, reaction time, and awareness. It's important not to reveal your intent and not to interfere in his driving. If you're not able to keep quiet, it's better to observe by following in your own car.

Consult with your local motor vehicle department. Many states offer skill-tests that help drivers understand their shortcomings and hopefully recognize when it's time to surrender their driving privileges. That failing, you can hide the car keys, but as long as the car is in the garage or driveway, this can lead to chronic frustration, arguments, and repeated searches for the keys. A better solution is to remove both the keys and the car from the premises.