This section was contributed by Theresa Klein, OTR,
Emerald Crest Director of Research and Development. For more
information on the subject of driving and dementia, please see the
final section of this page.
Do you remember getting your driver’s license – that
feeling of accomplishment, freedom, and independence? Now imagine
the devastation of having someone tell you you can no longer drive,
taking that feeling of freedom and independence away. For many
seniors and their families, this emotional and difficult decision is
a reality.
Driving is a complex activity, and as individuals age, their ability
to manage this once almost automatic act becomes more difficult. At
some point, they become a danger to themselves and to others on the
road. Unfortunately, the drivers themselves are often the last ones
to realize this. Caregivers and family members must be diligent in
their observation of the elderly person’s driving habits and skills.
How does aging affect driving?
Several physical and mental changes contribute to diminished driving
abilities. They include:
Slower response times. Drivers react more slowly to other
vehicles, pedestrians and animals.
Vision problems.
The inability to see lane lines, curbs and road
signs, especially at dawn and dusk, poses a risk for drivers with
vision loss. Other common problems include the loss of depth
perception and a decrease in peripheral vision. Some drivers are
also bothered by the glare from headlights at night
Hearing loss. Loss of hearing, even a little, affects an
individual’s ability to hear car horns, children’s voices, emergency
vehicles or screeching tires.
Loss of muscle strength. Just moving one’s foot from the gas to
the brake takes muscle strength. Sometimes this movement needs to be
made quickly.
Medication side effects. Common side effects of medications often
taken by the elderly are drowsiness and dizziness.
Loss of flexibility. Looking over one’s shoulder when merging is
necessary for safe driving.
Inability to focus or concentrate. Many elderly drivers admit to
being easily distracted and overwhelmed by all of the sights and
sounds of traffic.
Confusion.
Getting lost is a byproduct of confusion.
There are many warning signs that alert caregivers to impending
driving problems of their loved one:
Getting lost while driving
Frequent accidents
Unexplained dents and scratches to the car
Increased moving violations
Difficulty changing lanes
Driving at inappropriate speeds
Forgetting how to operate the car
Pulling out into moving traffic
Trouble navigating turns
Requiring constant cueing from a passenger to drive successfully
If you are faced with the task of taking away the car keys from a
loved one, here are some ways to approach the subject.
Express concern for the safety of your loved one. Present the
facts, as you see them. Be aware that those with dementia often have
difficulty reasoning and may not be able to understand or agree with
your concerns.
Enlist the help of your loved one’s physician. Many physicians can
assist by providing letters to the Department of Transportation,
stating the patient’s deficits and requesting that their license
either be revoked or not be renewed. They also can provide an
outside authority figure which family members often can not provide.
Some physicians have even written prescriptions for a patient “not
to drive.”
A free online guide offered by The Hartford Insurance Company
provides educational resources as well as checklists to help you
determine if and when intervention is needed. Go to
www.thehartford.com/alzheimers/105013final.pdf to download this
guide.
