For many older adults, driving represents freedom, social connection and an emotional attachment that’s difficult to let go of—even when all signs point to the end of the road.
It can be subtle at first: Their parking is off kilter. Scratches from knocking over garbage cans appear on their car. They complain more often about how bad other people are driving. Friends and neighbors start to notice their driving is unsafe.
To determine if it’s time for the older adult in your life to stop driving, start by observing them on the road, advises Laura Vaillancourt, a geriatric mental health specialist with Eldercare Counseling and Guidance Services in Olympia, Washington, and host of “Life on Repeat,” a podcast for caregivers of older adults with dementia. Drive behind them or ride along with them: Are they hitting curbs?
Recognize that some individual’s cognitive capabilities are greater at certain times of day. They might drive better in the morning when they’re well-rested versus nighttime when it’s dark outside and confusing. Driving requires the executive functioning skills of multi-tasking: operating the gas, blinkers and brakes while focusing on where you’re headed and any conversation that’s going on. It also requires rapid response times. If any of those abilities are impaired, it makes driving less safe.
To find out if someone is challenged by the executive functioning skills necessary for driving – the mental processes that help us plan, remember instructions, focus and do it all at the same time – she suggests they take the Montreal Cognitive Assessment (MoCA) or a similar test to measure those skills, among other cognitive functions. The results will do the talking for you.
Dementia adds another layer of concern
While a diagnosis of dementia does not necessarily mean someone has to stop driving, especially in the early stages, Vaillancourt explained it does mean you have to be aware of certain warning signs it’s time to stop driving:
- Coming home late or taking hours to get home from the store
- Forgetting where they park more frequently
- Becoming lost more often
- Forgetting where they’re going
Confirm the problem
Enroll them in a senior driver’s assessment and training course to see where they’re at and brush up on their skills. Or seek a driving assessment with an occupational therapist, which is the gold standard, Vaillancourt said. With a dementia diagnosis, it’s necessary to do a driving test every six months or so.
“Sometimes it’s one and done,” Vaillancourt said, noting if they don’t pass, they’re done driving. “Often it’s more of a gradual kind of agreement you’re making.”
They might agree to only drive during the day, when they’re most sharp, make short trips to familiar places, and stay off the freeway.
Framing the conversation
Ideally, with dementia, it’s best to be proactive early in their diagnosis and let the care recipient create a plan with you to gradually stop driving. If they’re involved in the decision-making, they’re more likely to agree to it.
The Alzheimer’s Association has a drivers contract that you can use to set parameters for driving; maybe they agree to not drive in bad weather or after dark and to call if they get lost or cannot find their car in a parking lot.
Putting a tracking device on their car can help you locate them in those instances. Also, include red flags they agree signal it’s time to stop driving and whom they would like to tell them when the time comes, such as a relative or doctor.
Vaillancourt cautions: “Don’t make the family the bearer of bad news. Sometimes it has to be. If possible, it can be really helpful to have a doctor or some other authority figure whom they respect have that conversation for them. Sometimes a doctor will put it in writing. That way, they can be reminded it was the doctor’s recommendation and not the family’s decision.”
Still, older adults with mid-stage dementia are more confused and resistant to the idea of not driving because they don’t understand their own impairment, Vaillancourt explained.
“With dementia, any change at all feels threatening,” she said. “Taking away the ability to drive feels threatening. You want them to feel safe and secure, not defensive or angry.”
It may require creativity, saying it in a way that makes sense and still meets the needed outcome. For example, tell them the car is at the shop for repairs or you lost the keys. Also, keep the car out of sight, or it will be a heartbreaking trigger that reminds them they cannot drive.
Whether or not they have dementia, focus the conversation on safety. Talk about the condition of the car, their safety and the safety of other people. Mention the money they’ll save on gas and car insurance. If they still insist on driving, you can make a report about their driving to your state’s licensing department, but be specific. A diagnosis of dementia alone won’t cause the DMV to take away their license, Vaillancourt explained. You need to give examples, like they blew out a tire from hitting too many curbs. However, beware that the information is not confidential. If they ask, the state will tell them who made the report, which is why it’s not the best route.
“It’s another reason why we encourage a doctor or neurologist to write that letter for them,” she said. “So, the family is not being set up to be the scapegoat. It’s hard enough. You want to maintain these relationships going forward and keep as much trust as possible.”
Most importantly, consider their routine and the activities they need a car for, and fill the void by having a taxi, rideshare, friends or family members drive them. Otherwise, they may feel trapped at home and lose the opportunity to socialize with people at all the places they used to go—connections vital to their happiness. You want to keep them on the road, just not behind the wheel.