When should the person stop driving?

Eventually a person with Alzheimer's Disease must stop driving.
Driving a motor vehicle is a complex activity that requires quick reactions, good judgement and adequate eyesight and hearing. It also requires an understanding and recall of the rules of the road, and the reasoning ability to find a destination. Alzheimer's Disease creates a loss of orientation, loss of judgement and visual spatial difficulties that may place the affected person and the general public at risk.

Removing driving rights can limit independence and self-esteem.
Some individuals will recognize their failing abilities and stop driving on their own. For others, if the removal of the privilege is discussed openly in a trusting environment, they will accept the loss. Some may resist, or simply forget that they are no longer able to drive. For many, the freedom to drive represents independence and competence. Removing this right can be devastating and there may be serious resistance. It may be necessary to hide the keys, remove the vehicle from sight or modify it so that it cannot be driven.

Negotiation may be important.
An "all or nothing" approach should be avoided. Discussing the situation openly in a trusting environment may often help the person with Alzheimer's Disease accept the loss more easily. Compromise and adjustment are possible, provided that the person with Alzheimer's Disease has insight into his or her diminishing mental abilities and loss of competence. A gradual, caring, negotiated approach to restrictions may help diminish the sense of loss of privileges and freedoms. Working closely with outside support (doctors, health care workers) can provide support and reassurance to families. Offering an alternative, for example, having friends and family drive the person to regular activities, may help compensate.

Declining abilities need to be monitored.
A diagnosis of Alzheimer's Disease does not automatically mean that the person is instantly incapable of driving. Depending on the rate of progression of the disease, people may be capable of driving for several years after the diagnosis. Throughout the course of the disease, the person's driving ability needs to be monitored collaboratively by family members, a physician and/or health-care professional. There is no standard test to determine the precise moment when a person becomes unable to drive a motor vehicle safely. Psychological tests can help determine whether someone with Alzheimer's Disease has the memory, perception and coordination needed to drive safely. But there are no definitive, quantifiable, standardized tests to pinpoint when driving should be discouraged or stopped. In some places, authorities may provide official driving assessment. Often, however, carers remain responsible for continually reassessing the driving abilities of a person in their care.

Signs that driving abilities are declining include

• inability to locate familiar places
• failure to observe and obey traffic signs and speed limits
• poor or slow decision-making in traffic
• anger, confusion or frustration while driving
• accidents
• taking too much time to reach a destination or not reaching the destination at all