At the window with Dementia - Episode 10 "Is it time to stop driving?"

No one wants to address the issue of driving safety with their loved one with dementia.  How do you know when it's time to have them stop driving?  This episode provides insight about when and how to handle this difficult topic.

Transcript

A question that I'm frequently asked is, when is it time to have my loved one stop driving. This is absolutely one of my least favorite questions. And the reason it is, is because all of us associate driving privileges with independence. It's something that most of us started doing when we were teenagers and had been driving, ever since then, some with unblemished records and others with a few mishaps along the way. But what I can say is almost everybody, if not everybody. When asked if they're a good driver, they'll tell you yes. Unfortunately, unlike awareness that some people, again, not all have about some memory impairment, loss of driving ability is something that seems to escape almost everyone.

When you ask about their driving ability, they'll tell you they're fine. Maybe they haven't had any traffic citations or accidents. They may or may not report, getting lost or turned around in familiar locations even if it is happening. And when we ask people if they know how to drive, what they interpret often is the actual procedure of driving, putting the key in the ignition, putting it into gear, turning the steering wheel and braking or accelerating. But what they are not thinking about is are they safe? What is their response time? What happens in that split second when they have to make a decision because someone else pulled out in front of them? Are they prepared? Are they able to go ahead and make those good decisions in a split second? And this is where it gets really tricky.

It's definitely one of my least favorite parts of my clinic practice.
I certainly don't take revoking someone's driving privileges, with any kind of comfort or without a lot of thought. I know what it means. It can mean isolation, which can then progress into a depression, on top of cognitive impairment.

What if the individual is able to live alone with perhaps frequent check-in visits. But now you've taken away their driving privileges.
Now you've really isolated them. Most people don't want to ask others to take them to the grocery store or to the shopping mall. And a lot of people really just enjoy the actual activity of driving. So taking it away is something that weighs very heavy on my heart.

But that said, what I've always tried to rely on to guide my clinical judgment is by putting safety first. And I want you to think about that. Keep safety in the very front of your mind when you're thinking about whether or not your loved one should continue driving.

The reality is, it's very uncomfortable, is a child to go ahead and tell your parent regardless of age, that they can no longer perform an activity. It feels unnatural. And it actually is. But it doesn't mean that it's not what needs to happen.

One of the things you need to consider is. Do you feel safe, being the passenger in your loved one's car? A lot of people will say, well, I'll only let them drive if I'm in the car with them. But think that through, what does that really do? Absolutely nothing. Because again, going back to that split second. Can the passenger go ahead and put their foot on the brake or on the accelerator? Can they go ahead and grab the wheel, away from the driver and make an appropriate turn to avoid something?

Probably not, but I think it just makes us comfortable, to be able to say,
I only let them drive when I'm in the car. So if you find yourself saying that. Or if you won't even drive with your loved one in the car, then it's probably time to decide to take away their driving privileges. And I know it's not comfortable and it's not easy, but if you're not willing to drive in the car with your loved one. Then is it really safe to everyone else out there, and in fact even to your loved one to allow them to continue to drive?

Again, you have to think about safety first because it has to be what guides your decisions. It has to be the highest priority for the safety of everybody. And if you can, by all means, let your loved one's healthcare provider, be the one to take away the driving privileges, it's that important. It can't be neglected. It can't be pushed off

It shocks me. Well, shocked probably isn't the right word. It saddens me. How many people are driving out there, yet they can barely string together enough words to make a coherent sentence.

It's frightening. We have to do what's in the best interest of everyone, even when it's uncomfortable, and we don't want to do it. Let me tell you I don't take this lightly. I've talked about my mom on the podcast before. And as most of you know, she lives with me, and she is struggling with memory issues. I will drive with her, but I don't enjoy it. It does make me a bit uncomfortable. I watch her. I make sure she's following the rules of the road. And I do watch her response time. And I'm fairly certain that in the not so distant future. I'm gonna have to go to that really uncomfortable place, and tell her that I don't think it's safe for her to drive anymore.

I get lots of different responses when I tell people that I don't want them to drive. Some people, tell me they're disappointed, but they understand. And even though they think they're a good driver, they couldn't live with themselves if they ever harmed anyone.

And I respect that. I can only imagine what it must feel like to have someone tell me that I am not capable of doing something that I feel
that I'm doing fairly well, but other people, they're adamant, no matter what I say, they refuse to understand that they are just not safe.

So, if you find yourself in that position, know that you have options. You can always go ahead and have your loved ones driving assessed; there are organizations out there that do driving assessments. And from what I've seen so far, they're fairly reliable. They come back with information about their response time, their ability to formulate good decisions, how do they follow directions, how quick, are they able to take their foot off the gas and onto the brake, or make that turn. I will tell you that these assessments are fairly expensive, and I don't believe they're covered by insurance, but the price of allowing your loved one to drive is far greater than any driving assessment ever would be.

It's something to consider, again, no one wants to take away anyone's independence. But we want everyone to stay safe, and we don't want anyone to be hurt.

So, something to consider. Yes, it's true that some people are able to drive a lot longer than others. And some people depending on where in their brain they're really impacted most, they have to give up driving a bit sooner than others. I recommend if there's any question in your mind that you discuss this with your loved one's healthcare provider because ultimately, we all have the same goal, and that's to keep everyone safe and not to jeopardize anyone else's safety.

This is just one more thing you have to think about.
If in doubt, talk to your family members, Talk to your loved one's friends, see what their thoughts are. Anyway, I promise you; you're not alone.

I hope you found this helpful.
If you have any questions or any topic you'd like me to discuss, please feel free to send me a direct message, either through my Instagram or through my website, I hope you subscribe to my podcast I release new episodes every Tuesday. Thanks so much for listening, and have a great day. Bye.