Alzheimer’s and Driving: How to Have a Conversation With Older Parents

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Even before the possible onset of dementia or Alzheimer’s – in which an individual’s senses, coordination and reflexes become more severely impaired – there is a general deterioration that can occur simply because the individual is growing older.

A parent or loved one’s health and safety are top concerns so it’s important to evaluate their driving habits when impairment becomes an issue. At first, it could be a matter of minor driving adjustments but be prepared to eventually have the conversation that getting behind the wheel is no longer an option.

It can sometimes be difficult to differentiate the symptoms of Alzheimer’s from common physical changes, so be sure to consult a doctor. Knowing exactly what may or may not be the problem will better help you assess a loved one’s current driving abilities.

Don’t wait until an accident happens or your parent fails a driving test to have a conversation. It is critically important for any individual with an aging loved one to be aware of any changes that may affect the individual’s ability to drive an automobile.

Symptoms of Alzheimer’s:

  • Disorientation in familiar places
  • Lapses in memory
  • Individual appears confused, or less alert
  • Coordination appears difficult, especially when attempting to perform more than one task
  • Individual grows more irritable often
  • Individual has difficulty making a decision or staying focused on task

If you begin to see any of the above signs with increasing frequency, it may indicate an early onset of Alzheimer’s. The above changes can also impair the individual’s driving skills; it is important to effectively gauge the individual’s ability to drive. Early stages of Alzheimer’s may have little to no effect on an individual’s driving skills, but as the disease progresses, it can be dangerous both for the individual and for others to be on the road operating an automobile.

A research study conducted at Brown University attempted to determine at what rate the stages of Alzheimer’s resulted in a serious impairment of driving abilities. 128 patients were tested, some with varying stages of Alzheimer’s, and others who were just simply older drivers.

The research study showed a direct correlation between the health of the patient and their ability to drive, with skills rapidly deteriorating as the disease progressed over a span of 18 months.

Most medical experts state that patients with Alzheimer’s need to have their driving monitored on a consistent basis, and if the individual exhibits signs that they may no longer be able to drive in a safe, reliable manner, then as friends or family, you must have an important discussion.

Watch for these behaviors when monitoring driving skills

dementia_medicineThere is no immediate need to tell your loved one or friend that you are concerned about their driving and are embarking on a monitoring expedition. Simply pay careful attention to their behavior as they drive, and make mental notes of any actions that seem to indicate a decrease in their ability to drive the car in a safe and attentive manner.

If you feel the individual is still performing adequately, then there is no need to worry them at that particular point in time. However, it is important to remain vigilant and conscious of any future changes that may occur.

After driving with the individual, it may be helpful to keep a record for yourself of some of the behavioral changes you might have noticed, in order to utilize it for reference at a later point in time.

These behaviors may include:

  • Changing driving speeds erratically or driving much too slowly
  • Being confused about which direction to go in
  • Forgetting to use turn signals
  • Ignoring traffic lights or traffic signs
  • Stopping in traffic
  • Anxiety during simple maneuvers such as changing lanes or making a turn
  • Bad parking performance

More serious and dangerous behaviors also include:

  • Drifting into oncoming traffic
  • Falling asleep while driving
  • Reckless driving leading to potential or actual accidents
  • Drifting into other lanes or driving on the wrong side of the street

If you see your loved one exhibiting any of these behaviors with increasing frequency, it is imperative that you sit down with the individual and speak to them about the possibility of no longer driving.

If you are unsure about taking such measures, then you may first opt to have an Independent Driving Evaluation performed.

Propose an independent driving evaluation

Dementia and Alzheimer’s affect everyone differently, with symptoms growing worse on varying scales of time. Due to this, you may not be entirely certain at which point your loved one’s driving should be halted before symptoms grow worse. To gain a better sense of when you should seek to prevent the individual from driving any longer, you may have a qualified examiner perform a driving evaluation with the individual.

Evaluations can usually be scheduled through the DMV, but dependent upon the state you reside in, you may have to seek through other means, such as a driver rehabilitation program or upon recommendation from the individual’s physician.

At such point that you do decide to have an evaluation, or if you have decided to take it upon yourself to talk to your loved on about the loss of their driving abilities, you will need to be prepared for a wide range of reactions. Sadness, anger, stubbornness, defensiveness and defiance are all normal, as the patient is suddenly being confronted with a large loss of their freedom and independence, and this can be perceived as a threat to the lifestyle they have grown accustomed to.

It can also be frightening, as losing the ability to drive also stands as a precursor to losing more cognitive abilities and a deteriorating mental state.

When it’s time to stop driving

Such a discussion is not going to be easy, and you are likely to be met with resistance. The keys to ensuring that your loved one takes you seriously and accepts the fact that they can no longer drive is persistence and vigilance.elderly_driver

When you first approach the subject with the individual, you might consider having others with you that can lend further support to your claims. It is especially helpful if they have also witnessed the same driving behavior that you have. It will also be beneficial to have a record of the facts so that you can present the individual with documentation of what you have seen. They may not want to believe it at first, but revealing recorded documentation lends more credence to your concerns.

Try to make the individual understand that it is for their own safety and the safety of others that they must stop driving. And, listen to the concerns of the individual, and pay attention to their own feelings. They will need to vent, and it will be helpful for them to feel as if their own feelings are being recognized and heard.

There are support groups available for individuals with Alzheimer’s who have surrendered their ability to drive. Sharing their feelings with others who have experienced similar situations may help to ease the transition. The individual’s physician might also want to get involved and tell the person himself that driving is no longer an option.

Options for older drivers who give up their license

Not every discussion goes smoothly, and not every individual will so willingly surrender his or her need to drive. But there are steps you may take to prevent the individual from driving and eventually curb their desire to do so.

  • Find alternative means for them to travel—have someone, either yourself or another loved one be available to drive them where they might need to go, such as shopping, a friends home, etc.
  • You can also arrange for driving services if no one is available to drive the individual
  • Have common things delivered, such as groceries, medication, etc., eliminating the need for the individual to go out to get them
  • Distract them from feeling the need to go out somewhere

For individuals with Alzheimer’s who are more persistent with their insistence that they still drive, you may need to take more drastic measures, such as:

  • Take away their driver’s license
  • Hide their car keys in a place they won’t find them
  • Disable or sell their car

Remember that an individual with Alzheimer’s may not always act the way you expect them to, and so being able to effectively gauge their initial reaction to this conversation is not going to be fully possible. Additionally, the individual’s mood and feelings on the subject may change from day to day, and they might even forget that they have agreed not to drive.

It is important to always ensure that the individual is not presented with any opportunity to get behind the wheel of a vehicle, such as if you accidentally leave your own car keys on the kitchen table and the individual finds them and takes them while you are in another room.

Look into local programs for individuals with Alzheimer’s, and you will likely find a wide range of resources available to you and your loved that are designed to help both of you cope with this hard decision, as well as many others.

 

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