The Impact of Brain Changes On Driving

People with dementia eventually lose the ability to drive because it becomes  unsafe. This happens because of changes to their: 

• Memory  
• Attention 
• Reaction time 
• Ability to problem solve or anticipate consequences 

Doctors are required to alert the local licensing authority when they determine  someone isn’t safe to drive. It’s important to know that once this happens, a  person’s license and car insurance are no longer valid. This means that they’re  not legally allowed to drive.  

This can be a very difficult and emotional conversation to have. If your care  recipient doesn’t understand that they can’t drive, or they forget, they may try to  drive anyway. They may not have the insight to understand the seriousness of the  situation. You may have to explain it numerous times. Family members are often  tasked with making sure the person with dementia doesn’t drive anymore.

When Is The Right Time To Stop Driving?

Ask yourself: “Would I want a young child in the back seat when my care  recipient is driving?” 

If your answer is “No,” that’s a sure sign they should no longer be driving. You can also ask yourself: 

• Are there any unexplained dents or scrapes on the car?  
• Have they become lost or taken longer than usual?  
• Have they received more traffic tickets recently?  
• Have they put themselves or others at risk recently, like driving too slowly for  traffic conditions? 

If your answer is “Yes” to any of these, it’s a sign that it’s time to chat with them  about stopping driving. 

Prepare For Common Reactions

There are three ways your care recipient can respond to the request to stop driving.  

1. Acceptance. They may recognize their driving abilities have changed  and they may even give up their license voluntarily. They may feel  relieved that this responsibility has been removed.  
2. Accept but forget. The person may agree with the need to stop  driving, but may forget about their acceptance to stop. This conversation may need to be repeated. In this case, it’s recommended  that you remove the keys or car.

3. Resistance. The person may refuse or dispute the message. They may  be uncooperative, find it humiliating, or lack the insight to understand  how brain changes can impact their ability to drive despite years of  good driving. They may not want to give you the car keys or their  driver’s license. This situation will require support to ensure everyone’s  safety. See the “Creative Approaches” section below for ideas.  

If the talk doesn’t go well, you may blame yourself. This is completely normal;  however, consider that your care recipient may have lost the ability to reason.  In this case, it’s best to end the discussion and change the topic to one that is  more pleasant.

Consider This

Whatever their reaction may be, it will likely be accompanied by feelings of loss, grief, and low self worth. Sometimes this can require the help of a mental health professional.

Having The Conversation

It is best to have another family member or healthcare professional present  when you have the conversation about driving. Pick a time when your care  recipient is seated, relaxed, and calm. A private and quiet area is best. It could  be over a cup of coffee in the kitchen or living room.

What To Say & Do  

Here are some ideas to help you with different parts of this conversation. 

Conversation Starters

• “There’s something I’d like to talk to you about.” 
• “I’d like to talk with you about your driving.” 
• “How long have you been driving now?” 
• “I’ve noticed your car has some scratches. Did you hit something?” 
• “Are you still enjoying driving?” 
• “How’s the car running?” 
• “What did the doctor say about you driving?” 

Sharing The News

• “The doctor (or other person) says it’s no longer safe for you to drive.” •“We’re concerned about your safety behind the wheel, and we’d like you to  stop driving.”  
• “We love and care for you, and we need to tell you the time has come for you  to give up your driver’s license.”  
• “Driving a car takes great skill like quick reaction times and problem-solving  skills. We’ve noticed you are having more difficulty with these things. We’re  concerned about your driving.”  
• “We’d like to support you concerning the news you received that you have to  stop driving.”

Managing Resistance

• “I’m sorry, and I understand how hard this must be for you.” •“Retiring from driving is usually not something that we think about and  prepare for.” 
• “Lots of people have had to give up driving, and they are doing great.” •“We’ll make sure you get to where you need to go.” 
• “I can see you’re upset about this, how about we talk about this at another time.” •“We can arrange for you to have a road test to assess your driving skills.” •“I love you and want you to be safe. I wouldn’t want to see you getting into an  accident and hurting yourself or someone else.” 

Moving Forward

• Gently ask them to hand over their license. 
• Think of alternative options for transportation. For example, arrange for a  friend or family member to drive, take a cab, or rideshare. Private driving  services or volunteer driver programs may also be available.
• Develop a transportation plan for activities that require driving. For example, getting  groceries, haircuts, religious services, doctor’s appointments, and social outings.
• Get the car key from them and help them make a decision about what to do  with the car. Will they keep the car and let others drive it? Will it be sold? Will  it be gifted to a family member?

Did you know?

In the US, a formal driving assessment can be done by an occupational therapist who provides their recommendation to the DMV and then a road test happens if needed.

Creative Approaches

When brain changes affect someone’s ability to reason, extreme measures may  be needed when a person refuses to stop driving. It’ll take a creative approach  to prevent the person from driving. You may have to enlist the help of someone  else to do it for you. Here are some ideas:  

• Have a traffic police officer come speak to them. They can educate the person  on the dangers and consequences of unfit, uninsured, and unlicensed driving.
• Get a written statement from the doctor. This may help someone understand  the seriousness of the situation.  
• Disable the car. You may want to consult with a mechanic to remove the  battery or spark plugs. You can also consider installing a steering wheel clamp  or emptying the gas tank.  
• Hide or pretend to lose the car keys. You could also replace the key with one  that doesn’t work.  
• Bring the car to the shop. Say it’s for seasonal maintenance, a factory recall,  repairs or storage. It may not be available for a while.  
• Offer your care recipient a ride. Tell them that you happen to be going that  way anyway. 
• Get a tracking device for the car.  

Helping a care recipient to stop driving can be difficult. Don’t hesitate to reach  out for help. Ask your doctor for a referral to a driving evaluation done by a  certified driving rehab specialist.

Expert Tip

It can be helpful to review how much it costs to drive and how this money can go towards other forms of transportation  and getting things done. Be sure to include cost savings on insurance, car repair, and gas in your calculation.