Dementia Driving Interventions

Dementia Driving and Safety

Dementia driving and alternativesDementia driving at some point becomes a safety issue. Some characteristics of normal aging include changes in vision, hearing and slower reaction time. Add a Dementia into the mix, most commonly Alzheimer’s Disease or Lewy Body Dementia and the person may have to seriously give up driving or be forced to hand in their license. Older drivers have been behind the wheel for fifty plus years and it is a huge part of their being independent. Driving is part of the American mystique and here in Florida, with limited public transportation, basically a necessity. Therefore, having to give up driving is a psychological as well as a logistical double hit to one’s self esteem. Dementia driving issues will affect more seniors in the coming years as the Boomers age.

Myths about Dementia and Driving:

~Older people should not be driving.

~Some memory or cognitive impairment automatically results in loss of driving ability.

~Someone who has been driving for a long time maintains the same skill or ability.

~Cognitive assessment has nothing to do with one’s ability to drive.

In 2015, older adults made up 18% of all traffic fatalities and 10% of all people injured in traffic crashes.

As with most things, it is all based on each individual and comprises several variables – co-morbidities (other medical conditions, i.e. stroke and medication side effects.  The age group with the most auto crashes is the 18-24 year old males. Distractions and risk taking cause more people to have auto accidents than advanced age. However, if you are uncomfortable being a passenger or will not allow your children to be in the car with an elderly driver who has some cognitive issues; driving dementia, than at the very least, have the driver evaluated.

Cognitive and other Abilities Needed for Safe Driving:

~Memory -much of driving is done through “Procedural Memory” – habitual over a long period of time.

~Maintain attention

~Visuospatial Skills and scanning

~Ability to process information and react appropriately

~Executive Functioning – problem-solving, decision-making

~Judge Distances

~Correctly understand traffic signs and signals

~React quickly

~Manage multiple stimuli at the same time

Warning Signs that Driving Ability is Compromised:

~Becoming confused or even lost in familiar places

~Does not observe traffic signs or speed limits

~Makes poor or slow decisions while driving

~Becomes angry, confused or frustrated often while driving

~The car has new dings or dents.

At the very least, if you suspect your driving or a loved one’s driving is suspect, get an evaluation, take a driving course. Contacting the DMV to suspend a license is traumatic for all involved and should be the last resort. If the evaluation shows that the person should not be driving any longer, be sensitive to their feelings – anger, shame, anxiety, resentment etc. and to the practical impact on their lives and effects on others, i.e. the spouse or other family members who are also caregivers.

Do your research to find solutions for the change in mobility/independence. Take stock of where most driving destinations are – shopping, doctor appointments, social events etc. Present alternatives: hiring an aide/driver, Uber, Lyft, taxis other family members, senior transportation organizations– in Palm Beach County it is Palm Tran. In Broward County it is TOPS, medical transportation, friends or volunteer, other city or county services. Dementia driving has to stop as the cause of the dementia progresses. There is time to plan ahead. Some part of the longer term plan may include moving to a senior community which has its own buses or even a care community which provides transportation.

Remember, should you or a family member or friend be diagnosed with a Dementia, it does NOT mean that they must immediately stop driving. Some restrictions can be applied first limit driving within a smaller area, no highway driving, not during rush hours or heavy traffic times or locations. Technology offers a lot of ways to compensate for the loss of driving mobility. Shopping online with home delivery extends to groceries as well. The use of a GPS system to track the driver, cars now have more safety features such as: reverse screens to see behind you or anti-swerving warnings.  Check out www.car-fit.org to find out ways to make sure you have the best car fit for your mobility status.