Dementia and driving: when is it time to turn in the keys?

How would you like it if your access to driving was suddenly cut off? What if this form of independence and mobility, this right, was taken from you instantly? Well, take away your car keys for the next 24 hours and you’ll soon find out!

It’s always easy to give advice to others, especially when we don’t have to ‘walk the talk’ ourselves. Telling a dementia sufferer they can no longer drive is a classic example of such advice.

Of course, dementia sufferers will have to give up driving at some point, but the question is when, and how do we go about getting someone to relinquish what has been up to this time, a right, and quite often a part of their identity.

There are many issues around dementia and Alzheimer’s, so let’s get a few facts straight. According to Alzheimer’s Australia’s Driving Policy Statement, a diagnosis of dementia should not automatically preclude someone from driving.

“Each person has individual driving capabilities and will experience a different pattern and timing of impairment as their particular condition progresses.”

– Alzheimer’s Australia

Contrary to popular belief, and perhaps for many, our natural reactions, a diagnosis of dementia does not mean we need to hand in the car keys instantly. As a society, we want to be safe, so it’s natural that we all want to jump to precautionary measures. But according to experts in this area, the matter really should be assessed on a case-by-case basis – taking into account the severity of the disease and also what driving means to an individual.

For some individuals, driving has been associated with their personal identity, along with freedom, independence, adventure and more for a very long time. It’s also a ‘vehicle’, quite literally, that enables elderly people who may already be isolated to stay in contact with friends, join social activities and have regular medical check-ups. Simply throwing away the keys might do too much harm. And this harm may be unnecessary, causing depression and other negative consequences for the individual.

Giving up driving for the dementia sufferer though, is inevitable, as once again Alzheimer’s Australia state in their policy:

“All people with dementia will reach a point where it is unsafe for them to drive.

So, when do we reach that “point”?

It is now widely accepted that those recently diagnosed with dementia are safe to drive. This is based on statistics for motor vehicle collisions that show that those driving with without dementia are just as likely to be involved in a collision as those with dementia.

The key issue seems to be regular assessment of the dementia sufferer’s health to monitor the condition. Professor Joseph Ibrahim from the Department of Forensic Medicine at Monash University and consultant physician in geriatric medicine believes that a certain amount of risk management is involved. He argues that as a society we don’t want people to drink and drive, but accept that driving with a blood level lower than that of .5 is acceptable. However, with dementia, the public sentiment seems to be one of zero tolerance.

Other contributing factors that must be put into the equation are where the patient lives – if it is a rural or urban setting, how close they are to friends, shops and medical support, and again, what driving means to them. Sensible rules can be put in place such as limiting driving to certain times of the day or only to certain destinations. For example, driving to the corner store for milk during the day is far safer than driving down the freeway at 6.00 pm…

Scaring individuals from diagnosis

Another reason for embracing a small level of risk with dementia drivers is that a zero tolerance approach may prohibit many from seeking a diagnosis. It’s thought that currently a percentage of the community are too scared to ask for a dementia test, for fear of losing their independence on the road.

Allowing time for adjustment

Senior lady driving - Sage Institute of Aged CareGiving up driving is usually a gradual event, and it is recommended that for dementia sufferers the issue is spoken about and planned ahead of time. As mentioned, setting rules as to where and what is acceptable with driving is a good starting point. Having a carer or family member help with driving from time to time also helps the individual adjust to no longer being ‘in the driver’s seat’ and will take some of the stress out of the transition to not driving.

Above all, regardless of where an individual sits in the car, the focus should be kept on maintaining activities for the dementia sufferer outside the home (social, physical exercise, shopping, chores), to maintain brain activity – and quality of life.

Sage Institute of Aged Care – it’s more than a job, it’s a rewarding career.

Vicki Tuchtan

Vicki Tuchtan

Vicki Tuchtan is the Academic Director at Sage Institute of Education. She oversees learning processes, teaching outcomes, resources and course development. A passionate advocate for bettering standards of training in Australia, she is currently writing her PhD thesis on defining quality training in the Australian vocational education sector.
Vicki Tuchtan

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