When Is It Time to Take the Car Keys Away?
Dementia and Driving
It is one of the hardest decisions family members must make. Taking away the car keys signals a loss of independence and autonomy, but nearly everyone with dementia will have to give up driving.
The American Academy of Neurology offers some very helpful guidelines that can help inform a family’s decision. The three biggest warning signs are an increase in:
Other warning signs to consider are if a person gets lost on a familiar route or is gone for hours with no explanation.
Although there is conflicting research, the guidelines do state that “patients with mild dementia should strongly consider stopping driving.”
One of the best ways to identify if someone is an unsafe driver, is a standard test called
the Clinical Dementia Rating (CDR) scale. Administered by a doctor with input from caregivers, the CDR is a rating scale for staging patients diagnosed with dementia. The CDR evaluates cognitive, behavioral, and functional aspects of Alzheimer disease and other dementias. Rather than a mental status examination or inventory, the rater simply makes a judgment on six categories based on all the information available.
Mobile Apps and Devices That Might Help
There are many mobile apps a caregiver can use to track a person with dementia’s phone including Life 360 and Google Maps. This could help offer some insights if their location is a concern. There are also dozens of GPS car trackers on the market. These trackers transmit data via a cellular data network, which requires a monthly or yearly subscription fee.
Doctors, patients, and caregivers must also know their state laws. Some states require physicians to report any medical conditions that may affect a patient'ss ability to drive safely (Ohio is not one of them as of 3/16/2022).
How to Initiate the Conversation
Initiate a dialogue to express your concerns. Stress the positive and offer alternatives.
Address resistance while reaffirming your unconditional love and support.
Appeal to the person's sense of responsibility.
Ask your physician to advise the person not to drive. Involving your physician in a family conference on driving may be more effective than trying to persuade the person not to drive by yourself. Ask the physician to write a letter or prescription stating that the person with Alzheimer’s must not drive. You can then use the document to remind your family member what’s been decided.
Consider an evaluation by an objective third party.
Understand that this may be the first of many conversations about driving.
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American Academy of Neurology 62nd Annual Meeting, Toronto, April 10-17, 2010.