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Does an Alzheimer’s Diagnosis Mean Giving Up the Car?

Mom has been diagnosed with early-stage Alzheimer’s disease. She insists that it’s still perfectly safe for her to drive—but is it? This conversation has led to some tense moments as the family discuss the best way to care for Mom as the disease progresses.

Experts say that people in the early stages of the disease may still be able to drive, with certain limitations. Sometimes as the disease progresses, a person is well aware that their driving is impaired, and they self-limit, driving only during the daytime and on familiar routes. They eventually give up driving voluntarily.

But, reports the National Highway Traffic Safety Administration (NHTSA), sometimes seniors with dementia are unaware that their driving skills are deteriorating. Then it may be time for family to step in. Driving safety isn’t something to be in denial about.

When is it time to give up the keys?

The NHTSA says people with dementia and their families should be alert for the following signs that Alzheimer’s is affecting their driving ability and it’s time for an evaluation:

• Needing more help with directions or with learning a new driving route.
• Trouble making turns, especially left turns.
• Misjudging gaps in traffic at street crossings and on highway ramps.
• Trouble seeing or following traffic lights and road signs.
• Stopping at green lights, or hitting the brakes at the wrong time.
• Trouble staying in one’s driving lane.
• Less muscle control, so it’s hard to push down on the pedals or turn the steering wheel.
• Unexplained dents and scrapes on the car, fences, mailboxes, or garage doors.

Studies show that family members are often the first to notice these red flags. Urge your loved one to talk to the doctor about their driving. The doctor might recommend an evaluation by a driver rehabilitation specialist. You can find one of these experts through the American Occupational Therapy Association. In some states, doctors are legally required to report medical conditions that could make it unsafe for a patient to drive.

Having the conversation

The decision about driving can be one of the most difficult conversations seniors and adult children can have. The Alzheimer’s Association recommends that families begin the discussion earlier rather than later, while the person with Alzheimer’s is still able to participate in the decision-making process.

It is definitely better to have this conversation before there is an accident or other crisis! It may take a little time for your loved one to accept this change. Be respectful, and allow your loved one to express their feelings—which may range from anger to grief to relief or a combination of them all. Experts warn that it can be very difficult to prevent a person with dementia from driving. Even if they have lost their license and you’ve hidden the car keys or even disabled the car, your loved one may try to drive anyway.

Giving up the car doesn’t mean giving up mobility

It’s important to ensure that a person with Alzheimer’s doesn’t succumb to inactivity and isolation, which can hasten the progression of the disease and lead to depression, agitation and sleep problems.

One thing that can make the decision and conversation easier is to pair it with an exploration of transportation alternatives. Research mass transit (bus, train or subway), taxis, rideshare programs, or transportation services for older adults—which of course may be limited during the coronavirus pandemic. Call your local senior services agency to find out about paratransit and other special transportation for people with dementia.

Adult day care, home care, or a memory care community—all with the proper COVID-related precautions—may also be a good choice to keep your loved one safe and connected.