Driving and Dementia: When to Give up the Keys
After a dementia diagnosis, one of the many concerns facing caregivers is whether driving is still a safe option for their loved one. Some people with mild dementia are able to drive safely for years, but because most dementia is progressive and motor and cognitive skills get worse over time, at some point driving and dementia becomes dangerous. Unfortunately, it is often up to families and caregivers to make this difficult decision before there is a crisis. If you are caring for a loved one with dementia, here are some warning signs to help you know when to act and strategies to support you through this decision.
Although some people with dementia recognize the risks and stop driving on their own, others may hesitate to turn in their keys or be unaware of the impact of the disease on their driving. If your loved one is in the early stages of dementia, your primary care provider will likely recommend that their driving skills are checked by the Ministry of Transportation. Even if your loved one shows that they can drive safely, you should continue to monitor their behaviour closely because a decline in abilities can happen quickly. Here are some signs—both inside and outside of the vehicle—that your loved one no longer has the necessary skills to drive:
On the Road:
- Getting lost on familiar routes.
- Confusing the brake and gas pedals.
- Making sudden lane changes.
- Receiving increased traffic tickets.
- Becoming nervous or angry about driving.
- Ignoring traffic lights or road signs.
- Driving too fast or too slow, or stopping for no reason.
- Refusing to take passengers or relying on other drivers.
- Failing to drive according to weather conditions.
- Having near misses or not braking in time.
- Signaling incorrectly or failing to use turning signals.
- Falling asleep or getting drowsy while driving.
- Struggling to see pedestrians, objects or other vehicles.
- Parking inappropriately.
Off the Road:
- Getting lost or confused in familiar surroundings.
- Declining hand, eye, leg coordination and reflexes.
- Struggling to multi-task, solve problems or make decisions.
- Difficulty judging space or distance.
- Needing reminders for personal care.
- Experiencing increased mood swings and irritability.
- Taking medications or combinations of prescriptions that can affect judgement or reasoning.
Strategies for a Difficult Transition
People often connect driving with independence and freedom and losing the ability to drive can be really upsetting. As a family member or caregiver it can be difficult to have this conversation and may cause upset and create tension in your relationship. It is often helpful to involve other family members, friends or an objective professional like an occupational therapist or physician to explain to your loved one why driving is no longer safe.
In some cases, people with dementia may insist on driving or forget that they should not be driving because of their memory loss and behavioural changes. This can be particularly challenging if other people in the household still need access to your vehicle. If your loved one’s symptoms are a traffic risk, you may need to take action by:
- Hiding the keys or replacing them with a set of keys that won’t start the car.
- Installing a switch that has to be turned on before the car will start.
- Moving the car out of sight or parking away from the home.
- Disabling or selling the car, if possible.
Look for Alternatives
If your loved one is still able drive safely, it’s a good idea to look for other transportation options now to make a future move from driver to passenger less upsetting. These alternatives include:
- Pre-paid taxi plan
- Public transportation
- Transportation services through community organizations
- Willing family members or friends
- Delivery services for groceries and prescriptions
Balancing everyone’s safety while respecting your loved one’s independence can be difficult and emotional for caregivers and family. If you have any doubts, it’s recommended that your loved one stop driving immediately.
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