Dementia and Driving

“Memory Matters” for ALL Ages  LINK TO PROGRAM

Driving is so important to a person’s independence. Suggesting a loved one give up driving is not a conversation you look forward to, never mind having to take the keys away. Sometimes family is not around to see the red flags and for others, they may not want to be the one to bring it up. It is certainly an important conversation and sometimes families are proactive. One couple decided to downsize and move closer to town so they could take advantage of public transportation and be closer to shopping, restaurants, church and the library knowing it is possible their ability to drive may change in the next few years.

While it is never easy to see the changes in a loved one when memory loss becomes more obvious, concerns about safety and judgment while driving often arise. All too often I see patients who insist they are able to drive, not realizing that is not the same as being safe to drive.

Some things to think about:
1. No one wants to give up their car keys. Infrequently will I hear someone say that they realized they were not were not safe and gave up their car keys.  Hopefully those who have walked the journey with a loved one will consider having the conversation with family as to how they would like the situation handled if it is time to stop driving and they are being resistant.

Here are some frequently occurring scenarios.
—- A friend told her children that she did not want to drive if she was not safe. She gave them permission to do what they needed to do in the future if she was not safe, even if she protested. She made her decision known to all when she had good judgment.
—- A friend had not driven in years for a variety of reasons and decided to take a driver refresher course before taking a long trip.  Another person had a complete driving evaluation and was given the okay to continue driving.
—- Sometimes a family will talk with the patient’s doctor ahead of time about their observations and the doctor can make the recommendation for an assessment or to give up driving.
—- One son followed his dad in a friend’s car when he was going to a doctor’s appointment because neighbors told him they had some concerns as to whether or not his dad should be driving. The son saw that his dad was going too fast on the back roads and 15 miles below the speed limit on the highway. He missed his exit and ended up being late for the appointment because he had trouble finding his way when he got off at the next exit. He planned to have a discussion with his father to explore options for transportation.

2. There are often some things that happen that might help you to make a decision to observe more carefully what is happening. Some of the red flags include:
—- Being away much longer than planned and the gas tank much lower than expected. The person did not share that they got lost, did not call for assistance and may not have returned with what they were going shopping for.
—- Seems like there are an increasing number of scratches and dents on the car.
—- The older adult talks about having trouble finding familiar places.

Tips to consider:
1. Does the older adult have a significant hearing or vision loss?  Not being able to hear a siren, someone yelling to warn them, or when a passenger gives them a direction puts everyone at risk. Trouble reading signs and delayed reaction times can result in causing an accident by making a quick turn.
2. The Alzheimer’s Association has some excellent resources including some videos  showing how to approach difficult conversations about driving.
3. There are driving assessment programs in your area which usually include a battery of tests including cognition, reaction time and a road test.  When my mom lost the sight in her left eye as the result of a fall in her late 70’s I wanted to be sure she was not going to be in danger on the road. While she had learned to compensate for the vision loss when reading and writing, being behind the wheel of a car presents a lot more challenges. She was an excellent driver and liked being able to come and go as she pleased. She passed the tests and even had to drive an unfamiliar car on the highways in my area. It was worth the peace of mind having taken these precautions.
4. Remember the earlier the discussions, the more choices that may be available.  Many years later before my mom decided to give up the car keys, I talked to her about safety concerns and later some solutions should she stop driving. In the end she said it was her choice and surprisingly, never mentioned it again.

Many times as a home health speech-language pathologist, I may need to bring up the concerns about one of my patients driving. Sometimes families are in agreement and in other cases they may report that they are too busy or do not live close enough and cannot help out with transportation. Some older adults may have some mobility and balance issues, making public transportation not the best option. Helping them look at the bigger picture and sharing local resources are the best starting place for those conversations.

TO DO THIS WEEK: If you are in this situation with a loved one, explore the resources available in your area. Think about how you would want someone to approach you with such a discussion? Would you be proactive? Would you be open to a driving assessment?

“”As we have no immediate experience of what other men feel, we can form no idea of the manner in which they are affected, but by conceiving what we ourselves should feel in the like situation.” Adam Smith

Link to “Memory Matters” for ALL Ages  cable television show: Dementia and Driving

Memory Fitness products by Kathryn Kilpatrick including “Walking the Path to Memory Fitness One Week at a Time.”

About Kathryn Kilpatrick

Kathryn Kilpatrick received her Master's degree in Speech-Language Pathology in 1968 from the University of Massachusetts. She has worked in a variety of settings, primarily in Ohio, including hospitals, rehabilitation centers, and for decades in the area of home health care. Kathryn is president of Memory Fitness Matters (www.memoryfitnessmatters.com) and Communication Connection(www.connectionsincommunication.com). She offers memory coaching for all ages and has a geriatric consulting practice. She is a national motivational speaker and author of more than 30 products to enhance communication and connection as well as a Memory Fitness Toolkit. Kathryn brings her decades of experience as a speech-language pathologist to all those wanting to enhance their quality of life, particularly when there are communication, memory and cognitive challenges. Her websites offer information on a wide variety of topics related to elder care concerns as well as memory fitness and successful aging.
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