Depends on the answers to the following questions:
- Any recent accidents or “near-misses”?
- Any new damage showing up on the car?
- Is the person with dementia getting lost in familiar places?
- Any impulsive or road-rage behaviors?
- Would you feel comfortable riding as a passenger if the person with dementia were driving?
- Would you feel comfortable having your child or grandchild as a passenger if the person with dementia were driving?
A “yes” response to #1, #2, #3 or #4 suggests that the person should not be driving. I put in #4 because I’ve had experiences with persons with frontal lobe problems who became overly aggressive; I recognize that a “yes” to #4 would apply to many people without a dementia diagnosis. A “no” response to #4 or #5 is a definite NO THE PERSON SHOULD NOT BE DRIVING. I guess you could make the argument that any driver, regardless of cognitive abilities, getting a “no” to #5 or #6 has no business behind the wheel of a car.
What if there are no problems right now and no concerns?
This is a little trickier. In the clinic, I recommend limiting the trips to local, well-known places that the person has driven to for years (supermarket, barber shop, hair salon, church); no highways; only during daylight; and only during good weather. It is a good idea for someone to be a passenger on a regular basis to make sure the driving is still OK.
I completely understand how important personal freedom is to all of us, especially persons with dementia. But if a person with dementia is unaware of his or her driving problems, you are going to have to take away the keys. In some cases, remove the car because hiding or removing the keys is often not enough.
Bottom line: if you have questions or concerns about whether or not a person with dementia should be driving, talk to your primary care provider, a clinician (physician, nurse practitioner, physician’s assistant) experienced with dementia care, or even local law enforcement.
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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.