What's the best way to bring up the topic of unsafe driving to someone with Alzheimer's?

12 answers | Last updated: Oct 18, 2016
A fellow caregiver asked...

What's the best way to bring up the topic of unsafe driving to someone with Alzheimer's?

Expert Answers

Barbara Repa, a Caring.com senior editor, is an attorney, a journalist specializing in aging issues, and the author of Your Rights in the Workplace (Nolo), now in its 10th edition.

For starters, do everything you can to avoid a power struggle. Respect that as long as the driver is mentally competent and not a clear danger on the road, it's his or her decision whether to stay behind the wheel. Include the person in discussions of specifics and safety concerns so that, ideally, he or she will be the one to conclude that it may be better to limit or give up driving.

There are a number of practical steps you can take to help make the initial discussions go as smoothly as possible.

Choose the messenger carefully. Give some thought to the best person to broach the subject of problematic driving. The most forceful or aggressive soul may not be best for this delicate job; the most important ingredient may be trust. Most married drivers, for example, say they'd most like to have the discussion with a spouse. But for some couples, that pairing would be disastrous. Some people are more likely to respond to a close friend than a family member. And if the driver is particularly persuaded by medical advice, then his or her doctor may be invaluable in explaining how and why Alzheimer's and other medical conditions can contribute to perilous driving.

Choose a place and time to talk. Set aside some time and pick a quiet spot where the driving discussion can be held confidentially and without interruption. Although it may be tempting, don't bring up the topic while the person is behind the wheel -- that's likely to be distressing and distracting, and it may exacerbate the unsafe situation.

A car accident or a significant change in health may be a natural catalyst for the talk about giving up driving. Otherwise, you might consider beginning the conversation with an opening line that removes the personal focus, such as:

  • "With all the traffic and fast cars now in town, it sure is harder to drive around her than it used to be."

  • "Did you hear about that car accident on today's news?"

  • "When did (Grandma, Grandpa, a neighbor, a friend) stop driving?"

Be specific. If the person dismisses the idea that his or her driving has become a cause for concern, back it up with tangible things you or others have noticed: an increased number of dings or creases in the car, traffic tickets, or other drivers frequently honking at or passing the car. If the evidence still doesn't convince the person that your concerns are real, consider asking him or her to take a self-assessment test in private, such as "Am I a Safe Driver?," produced by the American Medical Association. More comprehensive (but less simple) is the Driving Decisions Workbook, published by the University of Michigan's Transportation Research Institute.

Research alternatives. Listen to the individual's particular concerns about not being able to drive -- missing hair appointments, grocery shopping, or a weekly card game, for example -- and consider other ways those needs could be met: a stylist who'll make house calls, online ordering and home delivery, a member of the poker group willing to provide a weekly pickup for the price of an occasional gas card.

Be prepared to offer alternative transportation plans, which may include:

  • Names and phone numbers of friends and relatives willing to help with rides.

  • Phone number of a dependable local cab company; some may even provide cost-savings vouchers for older passengers or those with disabilities.

  • Phone numbers of local shuttle services; local community centers and religious groups often provide such transportation for older residents free or at a low cost.

  • Bus and train schedules that cover routes the person commonly travels; if the idea of taking public transportation seems daunting or intimidating to the person, get someone to accompany him or her for a trial run or two.

Representatives from the nearest Area Agency on Aging may be able to suggest additional transportation possibilities that are available locally.

If possible, discuss these options with the person and include his or her thoughts and preferences when making an alternative transportation plan.

Be persistent. In a recent survey of older adults who reported that someone talked to them about their driving, more than half -- the majority of them women -- said they listened to and followed others' suggestions. While that still leaves a large number who remain reticent, the odds of listening go up with repeat conversations. If the person shuts you out or becomes too agitated when the topic of giving up driving is first broached, let it go. But gently raise your concerns again in a later conversation. Your persistence may help overcome the initial resistance to the idea.

Community Answers

Janet beeching answered...

not only the driving is a concern, but what if, while driving, they go to places unknown. It's happened far too often. Sometimes they end up states away and lost because of the fog of alzheimers.

Jeng answered...

Please. If a person is an unsafe driver, the person should be OFF the road. I agree with being sensitive when raising the issue: kindness is always appropriate. HOWEVER, if there is real concern about a person's ability to drive, react quickly, find the destination and then find the way back , this is not a situation for open-ended repeated conversations or discussion.

Sjaweha answered...

We just made a Dr.s appt., (after twice my Alzheimer's step father never came home from work until sunrise the next morning) I agree with the person above, swift and wise action. If you know the person is going to be a potential harm to to others, argue with you or get very upset, definitly hand the baton over to a Profesional. Let it go then you can rest well.


Cindyoh answered...

I believe you're right about letting a professional handle this one. We're taking Mom to the neurologist next week and probably to the neuropsychologist (she had baseline testing in 2008 and an MRI back then). Hoping now for an actual diagnosis. In the meantime, we've taken her car. She's furious but when reminded what's happened recently calms down a good bit, as her memory is awful. (She'd walked away from her locked car in a parking lot - "lost" her keys again - and made her way on foot in the 90+ degree heat to a supermarket close by where I used to live - thought I still lived there. Long story short, strangers were involved this time and said she was very disoriented. They got hold of my nephew and niece, both of whom testified how out of it she was. The gist of it is we have told her repeatedly we can take her anywhere she needs to go. She's still in her own home close by me, and I do work from my home in the evenings. The above incident was not the first "car" incident. She totalled a car two years ago and walked away from that and we had our suspicions then. We'll be relieved when she's told no more driving, and I believe she'll get through this just fine. (Turns out her car keys were left on a counter at the Dollar General. Her latest thing is clutching either her car keys or her ATM card in one hand constantly instead of putting them in a pocket or purse when not in use - drives me crazy, as you can imagine).

Tootsie @ 60 answered...

Cindy Oh, It is time to pull the "Ole Switch-er-roo" on your mother. If she has a habit of losing her keys, she probably is not competent to drive.
So frustrating, after three doctors still "allowed" our 83 y.o. mother to drive, we finally replaced her car keys with a non working blank, four months ago. She has not mentioned that she cannot start her car, but has lost two more sets of keys. Trying to talk to her about the situation only agitated her - it was not pretty. The local Area on Aging evaluated her and advised she is still capable of living alone, but advised she not drive or use stove any longer.
Disconnecting the battery works also. I am relieved that her not driving really is not as hard as we had anticipated. We have a grocery list for her to complete weekly and we take turns getting her to doctor appts. Hope this helps you.

Cindyoh answered...

Tootsie, you are so right. Wow, so three docs said it was okay for her to drive?? That's scary, had not occurred to me but hoping neuropsych testing can show she should not drive. There's also the factor with Mom of needing cataract surgery, which is definitely something that plays a part here, I'm hoping the confusion will prevent the driving. She denies she's having trouble seeing, which is silly, she's been told she'll need to have that done. Funny, she'd been okay for the most part about not driving for now but called me twice around 4 p.m. out of the blue yesterday, fretting again about it. need to understand more about sundowning. Hoping many problems can be solved by getting more supervision during this part of the day as time goes on. Anyway, thanks again, Tootsie.

Rescue mom answered...

We just went through this with my dad. At a visit to the neurologist's office, I asked the doctor for ideas on how to assess my dad's driving, as we didn't feel qualified to properly make that decision. The neurologist gave us the name of a local hospital's rehab department that provided 2 types of driving assessments: a two-hour cognitive testing session that evaluates many different skills required for safe driving, and if that one is passed, a separate two-hour assessment of driving in a car.

Each test is scheduled separately, and each test cost $225. The best $225 we have spent! Our dad failed the cognitive test. The facilitator was well-trained, kind, and compassionate. My dad really liked her. It gave us an objective standard to use to discuss driving with our dad. He couldn't drive until he passed the driving test.

A word of caution: just when we thought we'd addressed the driving and our dad was settling down about it a bit, he surprised us with a third car key that we didn't know he had. He tried to sneak over to my brother's house where his car was parked and take off with it! We were able to stop him, but it was upsetting for all of us.

The biggest help in having our dad adjust was making sure he had someone to drive him places. We used a number of resources and called him regularly to see if there was anywhere he wanted to go. That helped a lot, especially, I think, because he really enjoyed the company.

Txmm answered...

I am going through this with my mom. She is 74 and has shown signs of dementia since around 2010. It has recently escalated and she has been having delusions. She thought my husband was trying to sell her land and having an affair with her neighbor which is preposterous. We had to remove some guns from her home for her safety and she discovered they were gone. She drove herself to the Sheriff's Dept. to tell them we were stealing from her. My husband had followed her in his truck unbeknownst to her. She drove down all kinds of streets and kept stopping and turning around, completely lost before she finally made her way to the Sheriff's office. They would not let her drive home and I had to go get her. We have since disabled her car because she can't remember what is going on from one day to the next. Sometimes one moment to the next. She still lives alone, so I worry CONSTANTLY about her, but it is a big relief that she is not out driving. BUT IS SHE EVER FURIOUS! She says we have ruined her life and calls me beginning at 6 am and continuing all day long. She has an appt. with a neuropsychologist for extensive testing. I question every decision I make. Does anyone else do this?

Lisa436roberson answered...

My mom is also 74 and three doctors told me (her daughter) that she is unable to drive because of hydrocephalus and Alzheimer's. It upset her, but now I find out that her sister has been telling her how awful it was of me to take her car keys away and that I am only doing to have control over her. I am so hurt. This sister lives next door to my mom so she has a lot of contact with her. She continues to be negative and will not be honest with my mom about how sick she is. My mom, of course, is furious with me. She has called up to 37 times in one day going back and forth between our home phone and my cell phone. What can I do about her sister who is trying to turn my mom against me. My aunt and I have not really been close and I think she is jealous of the relationship I have with my mom. My aunt has no children.

Hdpartsman0032 answered...

I have a sign that I've held on to for years. It reads: "When I die, I want to go peacefully, in my sleep, like Grandpa .... and not screaming like the other passengers in the car".

Steve. answered...

I read several mentions in the comments that a professional should be utilized when a person with Alzheimer's does not want to give up driving. Where would I find one of these professionals? Thank you