Overview

Whether a person with Alzheimer's disease or another dementia should still be allowed to drive is a common dilemma faced by people who have the disease and by their caregivers. Taking away driving privileges may reduce the person's sense of independence and increase dependence on family and friends. This can be a very stressful time for the person and for family and friends. But it is extremely important to prevent the person from driving when it is no longer safe.

Experts recommend people not drive if they have moderate Alzheimer's disease—when memory loss is noticeable and complex activities are impaired.

A diagnosis of Alzheimer's disease or another dementia does not mean that the person needs to stop driving immediately. People in the very early stages of the disease should have their driving performance checked to make sure they can drive safely. Also, their doctors should reassess their condition about every 6 months, because the disease is likely to progress. Family members can help detect changes in the person's ability to drive by riding along when the person is driving. Some people who have very mild Alzheimer's disease may be able to continue to drive safely for a year or more.

In addition to adequate vision, hearing, and coordination, safe driving requires the ability to:

• Make quick decisions.
• Use good judgment.
• Remember the rules of the road.

These abilities decline at different rates in different people who have dementia. So it is important to monitor changes in ability to continue driving. It often is up to family members or other caregivers to watch for signs that the person should not be driving anymore. Warning signs may include:

• Trouble remembering how to get to familiar places, or having a hard time with new directions.
• Ignoring traffic signs.
• Forgetting which pedal is the gas and which is the brake.
• Driving too slow or too fast.
• Stopping at the wrong times (for example, at a green light).
• Being confused or overwhelmed during driving (for example, being confused by traffic signals).
• Making bad decisions during driving, or making decisions too slowly.
• Having trouble making left turns.
• Noticing that other drivers honk a lot.
• Dents or scrapes on the car.
• Being angry or frustrated during driving.
• Not staying in the correct lane (for example, drifting).
• Not looking when changing lanes.
• Taking much longer than it used to take to get somewhere.

The family doctor may also be able to offer some guidance on whether the person is able to drive safely.

Some people may become angry or depressed when they are told they can no longer drive. They may try to get access to the car anyway. If you are the caregiver, you may need to hide the car keys or park the car in a different location. Be sure to arrange other options for transportation so that the person does not feel cut off from activities that take place outside the home.