How to cope when a loved one has dementia and still drives
March 28, 2016
By: Dr. Helen Senderovich and Joshua Tordjman
Imagine suddenly realizing you don’t know where you are or why you are driving just moments after starting your car. You can’t remember how you arrived at this point, but your foot is still on the gas as you pick up speed. The light in front of you turns red, but by the time you’ve processed what that means, you realize there isn’t enough time to avoid an accident. This is a scary thought for many drivers, and a reality for drivers living with dementia or cognitive impairment.
Canada’s population is quickly aging. Along with it is the associated increase in the prevalence of dementia. Some 750,000 Canadians currently have Alzheimer’s disease or other forms of dementia. This figure is expected to double within 15 years.
A 2004 study from Queen’s University reported that by 2028, there will be approximately 100,000 drivers within Ontario that suffer from dementia.
Driving requires many skills that diminish with the onset of dementia: the ability to remember destinations, quick judgment, remembering rules of the road, reaction time and the ability to divide your attention.
Living with dementia is a tough, daily undertaking. Forgetfulness complicates normal routines and impaired reasoning, deficits in judgment, disorientation in time or place, and changes in personality can all cause increased stress. The thought of having to abandon independence-infused tasks like driving can be a lot to handle. For family members hoping to broach this issue with aging relatives, it can be a complicated conversation.
A 2013 study at the University of Queensland, Australia, highlighted the need for a structured approach to the subject. Caregivers who broached the subject using an “in it together” method faced less tension and enjoyed smoother family dynamics.
By 2028, there will be approximately 100,000 drivers within Ontario who suffer from dementia.
It has been shown that senior citizens who drive have the highest rate of fatality when involved in car accidents. If you’re concerned about yours or others’ ability to drive safely due to cognitive impairment, memory loss, or a sudden change in judgment, it’s important to complete a driving assessment at any accredited Ministry of Transportation driving centre in Ontario. And any driver who is 80 or over must renew their licence every two years in Ontario.
This may be a difficult task, as most of those suffering from dementia know they aren’t likely to pass the driving assessment. A study by the University of Groningen in the Netherlands showed that a neuropsychological assessment by their physician could accurately predict the patient’s fitness to drive about 95 per cent of the time. Furthermore, they showed that a clinical interview had an accuracy of about 80 per cent when predicting the patient’s driving fitness. When used together, these tools may provide an alternative to driving assessments.
People suffering from the onset of memory impairment need to hear that while losing the ability to drive is inevitable, it’s never too late for them to lead a meaningful and enjoyable life.
For example, John was a patient who stopped driving when he was diagnosed with Alzheimer’s. From the money he saved, he took the opportunity to fulfill a lifelong dream of his — to sail the Caribbean with his family.
Ending the stigma associated with age-related cognitive change is becoming more important than ever in our aging society. Beginning the conversation is the most difficult, yet necessary step. Though it may represent a loss of independence, self-worth, and dignity, it can both help reduce the risk and harm to yourself, your loved ones and people around you.
Tips To Consider When Broaching The Subject:
- Invite their physician, family, friends, and caregivers to participate in the conversation
- Have a relaxed atmosphere
- State that the goal is to ensure safety of themselves and others, while maintaining independence
- Reduce their need to drive by delivering necessary items
- Provide a list of alternative forms of transportation (public transit, caregivers, community resources)
- Begin the conversation before they need it so that they are not surprised
Benefits of Driving Cessation:
- Saving money on insurance, gas, car payments, parking
- No fear of being a liability on the road
- Less stress, more exercise
This article was first published in The Toronto Star on March 28, 2016. Dr. Helen Senderovich is a lecturer in the University of Toronto, Department of Family and Community Medicine and a geriatrics, palliative care and pain medicine physician at Baycrest Health Sciences. Joshua Tordjman is an MSc Candidate at the University of Western Ontario, London. Doctors’ Notes is a weekly column by members of the U of T Faculty of Medicine.