PRESERVING INDEPENDENCE IN THE CASE OF ALZHEIMER’S DISEASE: DRIVING
Deciding when a person with dementia should no longer drive a car is a very tricky problem. Not only is it usually a matter of pride for the driver, but the ability to get about by car can be of great practical importance in the everyday life of the sufferer and his or her carers. It is therefore very tempting to assume that all is well when there is no obvious risk. Driving is an automatic activity that often doesn’t require thought — until some untoward event occurs, that is. It is quite possible for a person with dementia to undertake a journey that he or she has made many times in the past without any difficulty at all. However, should something happen that requires fast and logical thought to avoid an accident, or the road layout be unexpectedly changed, major problems can ensue. Although familiar journeys will probably remain possible for some time, as the dementia progresses an attempt to make a journey that breaks new ground may well produce a crisis and, if you are unlucky, an accident.
As soon as you are aware that driving ability is even only a little impaired by dementia, it is essential that the person concerned stops driving, but if you are in any doubt, consult your doctor. There is also a legal requirement to inform the licensing authority of any disability that may impair fitness to drive, unless it is only a temporary affliction. Many insurance companies also require their policy holders to be fit to drive. It is technically possible, if an accident were to happen and the insurance company were to argue that the driver responsible was unfit through mental incapacity, that they would consider the insurance invalid. Not only could this result in their failing to make appropriate financial compensation, it may also leave the driver open to a charge of driving without insurance.
It is therefore probably a good idea to start getting a person who has early dementia used to the fact that he or she will eventually have to give up the car. This may well cause great sadness or anger. Nevertheless it will eventually be in the best interests of all concerned.
If you are unable to prevent a relative with dementia from driving by reasoning with him or her, you may have to ‘lose’ the car keys or, if necessary with the help of a friend, immobilize the car by some means. A belief that it has broken down may act as a natural break-point, enabling you to persuade your relative that it is not worth making the necessary repairs.
This is a situation that must be dealt with gently and tactfully, avoiding confrontation if possible. If you can drive yourself, you may be able to think of an excuse to do the driving on most, if not all, occasions. Remember that being able to drive a car requires physical fitness (good sight and hearing especially), coordination, and the intellectual ability to react and make decisions rapidly when this is necessary. You may find that your doctor will be able to help you if your advice to stop driving goes unheeded.
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