Ceasing to Drive

Many people view driving as a significant aspect of their freedom, mobility, and autonomy. Without the mental acuity or legal ability to operate a vehicle, individuals with dementia can feel a sense of loss, frustration, and depression. But, as dementia progresses, ceasing driving becomes a necessary step to keep a loved one and the community safe, even if it is a difficult matter to broach.

Meuser, Carr, Berg-Weger, Niewoehner, & Morris (2006) addressed this issue by educating health care providers with a two-hour program about dementia and driving. After this education, they began to include questions about impairment while driving in their assessments of their patients with dementia. This way they were better able to gage when patients were no longer able to drive themselves safely and make well-informed decisions about contacting the DMV.

Cameron and colleagues (2017) also confronted this issue by creating a standardized tool to help health care providers evaluate an individual’s fitness to drive and decide when to report those who can no longer drive safely due to cognitive impairment, called the Driving in Dementia Decision Tool, or DD-DT. While this was a helpful instrument for physicians that requires further implementation on a wider scale, the researchers noted the importance that family and loved ones serve in the process of driving cessation. With the stigma surrounding older drivers and people with dementia, it is crucial for family and caregivers to support their loved one through the process, especially when it means they must give up driving for their sake and others’.

Carr & Ott (2010) gathered an opinion about driving with memory loss from Mr. W, a man with cognitive impairment. They also examined the tension of providing persons with dementia autonomy and a good quality of life with the reality of driving with cognitive impairment and the safety of both the driver and others on the road. The article noted that a dementia diagnosis does not immediately require a revoking of the driver’s license; however, it does mean that discussing that inevitability is necessary early on. In their interview of Mr. W, he admitted to memory and cognition problems, but felt that he was a good driver. His wife, also his caregiver, shared the same ideas. They expressed great concern over the possibility of his having to stop driving, as they would have to drastically change their lifestyle and where they lived because of a lack of public transportation or finances to pay for a driving service. The researchers affirmed this expression, explaining that driving cessation can adversely affect those individuals’ lives, as it is linked with increased anxiety and depression and decreased outside activities and socializing.

As communicated in these articles, driving cessation is an eventual necessary action to take in the progression of dementia and some cases of cognitive impairment. There is no hiding the fact that it is not preferable that a person with dementia feel that they have less autonomy – revoking their license is a frustrating and unfortunate requirement to protect them and others from avoidable risks and harm. By knowing about this consequence of cognitive impairment before it comes to fruition, caregivers and individuals with dementia have an opportunity to discuss what that will mean for their futures. Being informed ahead of time allows them to deal with it more smoothly when the time comes and hopefully replicate activities and socializing in new ways that minimize the loss associated with driving cessation.

Access these articles to read more in-depth at Driving and dementia in older adults: Implementation and evaluation of a continuing education project, Development of a decision-making tool for reporting drivers with mild dementia and mild cognitive impairment to transportation administrators, and The older adult driver with cognitive impairment: “It's a very frustrating life”.