When a person’s driving skills appear to be deteriorating, families can face decisions that are difficult for everyone involved. The safety of the driver and other road users is a matter that has to be considered, especially if there is any suggestion that the person may be affected by dementia or Alzheimer’s disease. However, the ultimate solution of taking away someone’s right to drive is an emotional issue that can cause distress if not handled carefully and with sensitivity.
Before a family agrees that such a decision should be made, it is necessary to recognize the warning signs of Alzheimer’s or dementia and to decide whether they are serious enough to warrant concern about the person’s driving ability. This is not always easy, as the warning signs are often hard to identify. Even if observed, the signs may be rare enough to create doubt about whether the driver is experiencing occasional moments of distraction, rather than the effects of a progressive decline in functioning. An additional problem is that a person with Alzheimer’s disease or dementia is often unaware that his or her driving skills are declining, and so will not know to seek advice or assistance. In such cases, the family itself needs help in deciding whether the matter is so serious that the person should stop driving.
This type of help has now become available through a guide provided by The Hartford and the Massachusetts Institute of Technology (MIT) Age Lab. Obtainable on The Hartford’s website, and entitled “At the Crossroads: A Guide to Alzheimer’s Disease, Dementia and Driving”, the guide resulted from a study examining how 45 caregivers and nine people with dementia coped with the problems of driving and the accompanying issue of losing independence. It provides practical advice and a variety of suggestions to help families become aware of symptoms that may have an adverse effect on a person’s driving ability. The guide also suggests ways in which a family can then handle the problem with the least distress to everyone involved.
The guide advises that anyone who is worried about whether a family member’s driving is being affected by Alzheimer’s or dementia should travel as a passenger with the person on a number of occasions to see if warning signs occur regularly. These warning signs may include evidence of confusion at places such as highway exits, or driving at speeds that are inappropriate for the conditions whether those speeds are too fast or too slow. The driver may also have difficulty making turns, may hit the curb at times or may even drive onto lawns accidentally.
Head of gerontology for The Hartford, Beverly Hynes-Grace, says such symptoms should be noted, as well as the dates and times when they occur. This can indicate if there is a pattern with the symptoms, showing whether they are regular and frequent enough to cause anxiety. If so, she offers a number of further suggestions for dealing with the situation. These include talking the matter over with other members of the family and then, at an appropriate time, discussing it tactfully with the person whose driving is causing concern. Rather than just presenting the problem, however, Hynes-Grace encourages people to offer transport alternatives at the same time. These could include organizing transport with relatives and friends, using senior citizens’ vehicles or hiring a car service when necessary. The help of health care providers can also be sought when there is a need to make decisions about whether or not a person with Alzheimer’s or dementia symptoms should be driving. It is important for the person to be included in any discussion and decision-making, so that he or she does not feel a complete loss of independence.
MIT’s Age Lab director, Joseph Coughlin, says the study that produced the Hartford-MIT guide found the change from driver to passenger can be managed gradually. Driving can initially be limited to daylight hours and familiar roads. Later, arrangements such as help with transport or deliveries can be made to help the person cope with shopping and other needs.
Another Hartford spokesperson, Marnie Goodman, says that while the study and guide do not work on the assumption that only elderly people suffer from Alzheimer’s disease and dementia, the project’s success has encouraged The Hartford and MIT to carry out more studies of problems that may be encountered by aged drivers, with The Hartford funding some of the work. She also agrees that a lot of emotion surrounds the decision to ask a family member to give up driving. Because of this, and because there is yet no reliable driving test to assess the abilities of people with Alzheimer’s disease, families often postpone the decision. However, as Goodman points out, the study shows that such a delay can be hazardous. A person with Alzheimer’s or dementia may experience increasing confusion and loss of judgment resulting in such driving problems as difficulty with judging distances. Drivers may also be unable to make necessary decisions in time, leading to the risk of danger on the road for themselves and others. With timely help, such dangers can be averted.