Deciding that it is time for someone with early Alzheimer’s disease to stop driving can be an incredibly difficult decision for both Alzheimer’s patients and their families. Patients may be understandably reluctant to admit that they are having difficulty driving because they do not want to give up the independence that driving allows them to maintain, or to become a burden on those that they will have to rely on for transportation. Whenever possible, families should discuss the issue of safe driving soon after diagnosis, and allow their loved one to be part of the discussion and decision-making process before it becomes a pressing safety issue.
There are ways that families can assist a loved one in the early stages of Alzheimer’s disease with staying safe on the road for as long as possible. Planning ahead and taking advantage of available resources can also help patients to preserve as much independence as possible when the time comes to surrender the car keys for good. If families can help loved ones with Alzheimer’s make the decision to stop driving themselves, itcan help them maintain their self-esteem and retain a sense of control over their lives. However, if a loved one vehemently refuses to stop driving, the family has a responsibility to take action for the safety of their loved one, as well as the safety of others on the road.
Challenges Alzheimer’s Patients Face When Driving
Driving is a complex activity that requires quick reaction times and fast decision making. Therefore, there will eventually become a time when patients with Alzheimer’s disease will no longer be able to drive without posing a serious risk to themselves or others. In addition to normal symptoms of aging which may make driving more difficult, such as worsening eyesight and hearing and physical difficulty turning around to look over the shoulder to back up or change lanes, Alzheimer’s patients will experience declining cognitive and sensory abilities that will impair the skills they need to drive safely.
Ways You Can Help Loved Ones Stay Safe On The Road
Before Alzheimer’s patients have to give up their keys for good, there are ways to help them maintain safety while continuing to drive, at least in some limited circumstances. Families and patients may mutually agree on appropriate driving limits; for example, the family may suggest that the patient should follow certain guidelines, such as:
- Only drive during daylight hours
- Stick to certain, familiar areas
- Avoid busy highways
- Refrain from taking longer trips
- Avoid driving in bad weather
- Use a GPS system
A person with Alzheimer’s disease may wander or get lost when driving. Using a GPS system can help the person concentrate on driving instead of remembering directions. A GPS device can also help to locate someone who becomes lost or travels outside a specified area. Families can enroll loved ones in a program such as MedicAlert® + Alzheimer’s Association Safe Return®, a 24-hour nationwide emergency response service for individuals with Alzheimer’s or related dementia. This program will provide 24-hourassistance if a person wanders and becomes lost, including activating a community support network of local Alzheimer’s Association chapters and law enforcement agencies. Families can learn more about this program by contacting their local Alzheimer’s Association (the Connecticut Chapter is located in Southington and can be reached by telephone at (860) 828-2828), calling the national 24/7 Helpline at 1-800-272-3900, or registering online at www.alz.org.
How To Determine When It Is Time To Revoke Driving Privileges Altogether
There is no magic formula for determining when it is no longer safe for a person to drive. Patients and families need to continually assess their individual situations in order to make responsible decisions about when it may be time for someone to stop driving. It is important for patients and families to be aware of signs of dangerous driving so that they know what to look for. Warning signs of unsafe driving include:
- Getting lost or forgetting how to locate familiar places
- Failing to notice or observe traffic signs and signals
- Making slow or poor decisions in traffic
- Erratic driving or driving too fast or too slow
- Becoming angry or confused while driving
A third party driving evaluation may be helpful when making a determination about whether a person should stop driving. These evaluations can be conducted by an occupational therapist or other trained professional. The Easter Seals Mobility Center in Meriden, Connect cut provides driving assessments to individuals who have an injury or impairment that may impact their ability to safely operate a motor vehicle. The screening takes approximately 2-3 hours and includes a clinical and an on-the-road assessment. A prescription or referral from a medical provider is necessary to obtain a driving assessment. You can call (203) 630-2208 for more information. Hartford Hospital also conducts assessments of older drivers through their Mature Driver Safety Program. For more information call the Injury Prevention Center at (860) 837-5318.
What If A Loved One Insists on Driving? Steps To Take As A Last Resort
If a patient will not stop driving when it is clear that they can no longer do so safely, you may have to take additional steps to prevent them from endangering themselves and others. You may consider:
- Controlling access to the car keys. Leave the keys with one designated person and put all copies of the keys in a safe place.
- Temporarily disable the car by removing the distributor cap.
- Park the car out of sight, such as down the street or around the corner.
- If no one else in the household will be driving the car, consider selling it. Selling the car, with the additional savings from related costs such as insurance premiums, gas, and maintenance, may help to pay for alternative modes of transportation.
- If the patient is particularly attached to the car and is unwilling to sell it, you may want to take steps to more permanently disable the car, such as removing the battery.
Many families of Alzheimer’s patients are able to turn to their loved one’s physician for help. A doctor is often seen as an authority figure that the patient trusts. Therefore, he or she might be able to convince the patient to give up the car keys. Alternatively, the doctor may write a prescription for a driving assessment or even simply write the words “Do Not Drive” on a prescription slip. Doctors are often aware of the stresses that go along with revoking driving privileges and are willing to step in and “be the bad guy” if a patient is reluctant to stop driving. Although Connecticut law does not require doctors to report a physically or cognitively impaired driver, Conn. Gen. Stat. § 14-46 does authorize doctors to report a patient’s information to the Department of Motor Vehicles if they believe the patient has a chronic health problem that will significantly affect the person’s ability to safely operate a motor vehicle.
Another possible option is to contact the licensing authority in your state. You can write a letter to the Department of Motor Vehicles that requests that the person’s license be revoked due to their Alzheimer’s disease. The state may require a statement from your loved one’s physician stating that the person is no longer able to drive. Substitute the person’s driver’s license with a non-driver photo identification card.
You want to protect your insurance coverage when taking steps to revoke a loved one’s driving privileges. In Connecticut and most other states, insurance companies can cancel policies if a driver’s license is revoked. Especially if the patient has a healthy spouse, insurance cancellation may jeopardize the healthy person’s coverage and it may be difficult for the spouse to obtain a new policy or one that is affordable due to advanced age. You may want to simply exclude the patient from the existing policy, but be aware that if the excluded driver continues to drive, the insurance company might not fully honor a claim for personal injury or property damage.
How To Reduce The Need To Drive And Find Alternate Modes Of Transportation
Families should work together with patients to help them begin to scale back driving activity and implement acceptable alternatives that help maintain patients’ independence and allow for continued opportunities to leave the house for socialization or to run errands. These types of opportunities are very important to maintaining these patients’ quality of life. Examples include:
- When possible, have groceries or prescription medicines delivered. Look into courier services and/or Meals on Wheels programs in your area.
- Ask friends and family members who offer to help whether they would be willing to provide some assistance with transportation. You can also ask for volunteers at your place of worship.
- Investigate government-funded transportation for people with disabilities and look into how to qualify to these services.
- Gather information about public transportation. Sometimes they will offer discounts for older or disabled individuals. Also calculate round-trip taxi fares from the patient’s home to frequently visited locations like the grocery store or beauty parlor to determine whether this would be a viable option.
- Nutmeg Senior Rides is a not-for-profit offering rides for seniors (age 50 and over) and adults with visual impairments (age 18 and over) in ten towns in North Central Connecticut. Their mission is to provide community-supported, affordable, door-through- door, personal transportation. Volunteers provide over 50% of their rides and are the key factor in keeping rides available & affordable, keeping program costs down, and keeping their program intrinsically connected to the community. Service is available 365 days a year and rides can be used for any purpose including errands, and trips to medical appointments. There is a small annual membership fee and individual ride costs vary depending on the distance traveled. Rides are invoiced directly to the member or loved one on a monthly basis so that no funds are exchanged with the driver and there is no tipping. For more information, contact Nutmeg Senior Rides at 860-758-7833 or visit their website at www.NutmegSeniorRides.org.
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