Should people diagnosed with cognitive impairment be allowed to drive? Taking away someone’s license not only deprives them of a means of transportation, it deprives them of their independence and their sense of control. On the other hand, people who pose a threat to themselves and others should not be allowed to drive. While some experts advocate for immediate cessation of driving upon a diagnosis of Alzheimer’s disease, the Alzheimer’s Association encourages decisions about driving be based on an assessment of the individual, and not on a diagnosis alone.

 

A Balancing Test

Even if those with mild cognitive problems are safe to drive, the illness will progress to a point where they are not able to drive safely. If the goal is to successfully balance the need for safety against the desire for maximum independence and connection to the community, how do we know when it is time to take away the keys?

 

Assess Competence

Once you know that family members have cognitive impairment, assess their driving ability. Drive with them, or drive behind them and observe how they react to traffic signals, whether they maintain an appropriate rate of speed, and if they drive erratically. Look for signs of problems, such as dented fenders or unexplained car damage.

 

Plan for the Future

Figure out what the options are once your family member is unable to drive. They may include a taxi, senior van service, friends, or a hired driver. Start using these services while your loved one is still driving so that there can be a gradual transition from driving themselves to using the services of others. Generally speaking, mass transit is not an option, unless there is a companion.

 

Home Delivery

One way to reduce someone’s driving it to arrange for home delivery of needed products. Most grocery stores and pharmacies offer home deliveries. Many other products can be purchased on line without the need to go to a store.

 

Take a Graduated Approach

For all aging people, driving need not be an all or nothing activity. As vision fades and reflexes slow, it makes sense for older people to scale back on driving in difficult circumstances. Those with dementia are no different. Discuss common sense limitations, such as not driving at night, avoiding highway driving, rush hours and bad weather. If possible, limit driving to familiar places. The Hartford, in collaboration with the MIT Age Lab has created an excellent guide for families who are worried about driving.

 

Add Safety Features

Encourage the person to always carry a cell phone so that they can call if they get disoriented. Consider installing a GPS device that will enable you to locate the car.

 

Regular Testing

Since Alzheimer’s and other dementias are progressive, you must re-evaluate the competency of the driver at regular intervals. It is often more effective if an objective third party makes the assessment. Many hospitals have created testing programs that evaluate the ability of older people to drive safely. Check with your local hospital to see if they offer such a program. In the Boston area, Spaulding Rehabilitation Hospital, Beth Israel Hospital and Newton Wellesley Hospital all have such programs.