Taking away the car keys from a person living with dementia is difficult, because driving is important for independence. Before I dive into the “how to” part of this blog, I want to talk about emotions and beliefs around driving. Knowing this information can help you strategize.
Emotional Voltage of Driving
I grew up in Philadelphia. Driving was a nightmare. I lived on public transportation. In fact, taking the train or subway was often quicker than driving and cheaper than paying premium parking rates. I did not learn to drive until my senior year in high school; I dreaded it. For me, driving is not a pleasant thing and my goal is to become rich enough to only use Uber or Lyft!
For others, driving has extreme emotional significance. When I lived in rural Pennsylvania, my daughter Sara took driver’s education in her high school. Having a car and a driver’s license in Philipsburg Pennsylvania was mandatory. There were no ubers, no cabs, no public transportation. Even the closet store was a couple of miles away. To Sara and her friends, there was a lot of emotional voltage around driving. Driving meant independence and freedom.
I offer some suggestions that I have used, or other family caregivers have used, to end driving. The worst thing you can do (in most cases) is to hold a “family meeting” and explain to mom or dad why everyone wants them to stop driving. If the person with dementia is unaware of their memory problems and driving issues, this approach will get you nowhere!
- Take a “break” from driving. In my practice, I often tell the person living with dementia that I want him or her to “take a break” from driving until I can see them again (3-6 months later). Most times, the person living with dementia is unaware that he or she has memory problems and will hotly deny it if someone brings up the topic. I try to use a physical, non-threatening reason for the “break” (see #2). Think about it: what feels better to you, “Give up chocolate for a couple of months” or “You can never have chocolate again”?
- Use a physical reason for the driving “break.” As we age, we have more and more physical problems that could create driving issues. If the person has any physical limitation that could REMOTELY pose a problem, I use that. Some examples include neck pain (Since you can’t turn your neck, take a break from driving until we get that fixed), hip or knee problems, and even foot numbness from diabetes. Six weeks after my right knee replacement, my son accompanied me while I drove around. I thought my driving was fine, but he had concerns about my reaction time and use of the pedals. I stopped driving for 3 more weeks until my reaction time improved. Now, if you had told me I needed to stop driving because of my memory…I probably would have fussed about that!
One note: These strategies can backfire when the person living with dementia has behavioral-variant frontotemporal dementia. People with bv-FTD have what is called “executive dysfunction.” This means that people living with bv-FTD have problems with judgment and impulsivity (and emotional reactions) MORE than memory problems—at least in the beginning of their dementia journey. Sometimes, using a physical reason for not driving and suggesting a break does work in these cases. Sometimes, the person with bv-FTD decides that they have NO driving issues and you are going to give them back the keys. If I suspect that the person living with bv-FTD is not going to respond to the “taking a break” strategy or the “physical reason for not driving” strategy, I flat out tell them “No, you cannot drive. Period.” I then encourage the family to “blame me” so that they are not the recipient of FTD rage.
If #1 and #2 don’t work:
- Disable the vehicle. Depending on the year, make, and model of the car, this can be done in a variety of ways. For cars that use the electronic fobs (keyless), remove the battery from the key fob (or have the dealer do this). For older makes and models, disconnect the battery cables. I’m sure there are other ways to disable vehicles; my family caregivers never cease to amaze me with creative ways to render the vehicle non-drive-able. One caveat: I had one situation where the patient with dementia asked a neighbor to look at her car, and the helpful neighbor reconnected the battery cables. If you go this route, you may want to let the “helpful neighbors” know what is going on. Also, I had another situation where the person living with dementia called AAA. The family also called AAA and explained the situation.
- Remove the vehicle. One family member told his dad that the car needed some recall work. He drove the car over to another family member’s house and placed it in the garage. For a couple of weeks, dad asked about the car and the response was, “It is still in the garage getting work done.” Ultimately, dad stopped asking about the car. Many other creative family members used variations on the theme of “the car is getting work done.” No matter how tempting, DO NOT tell the person living with dementia that the car has been stolen. You will cause feelings of fear and anxiety, which is not only a crappy thing to do but these feelings may trigger a domino-effect of other emotions. Or the person living with dementia may report the car stolen and YOU have created a ginormous mess.
Once you realize it is no longer safe for your loved one with dementia to drive, select a plan and stay with it. Sometimes family members or friends feel badly. They will let the person living with dementia to drive “just one more time” under controlled conditions (like with another person in the vehicle) but this is a bad idea. You will literally have to start over.
Need more help? I offer programs for caregivers of people living with dementia. Contact me for more information!
Dr. Rita Jablonski
Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.