When some one is first diagnosed with a dementia disease it can be devastating for both the patient and the family to realize that he or she will eventually need to rely on others to provide their care. One of the first areas of independence that is lost is the ability to drive. To drive safely, one must be able to react quickly to potential situations that may arise while on the road. This requires concentration, good judgment, and the ability to reason and make decisions. All of these skills and abilities become impaired as people with dementia progress through their illness.
Families and physicians have a responsibility to keep a person with dementia from becoming a danger to themselves and others by driving unsafely on the roads. “Research in Canada and the U.S. confirms that people with Alzheimer Disease who continue to drive are involved in more accidents that other drivers. One U.S. study compared 30 drivers diagnosed with Alzheimer Disease with 20 healthy control subjects of the same age over a five year span. The data collected showed that the people with Alzheimer Disease were involved in five times more crashes that the control group.”
It is often difficult for a family member or friend to tell a person that he or she should no longer be driving – it signifies a loss of independence and for especially challenging for those who live in rural areas- transportation alternatives may be limited.
If family members l feel that they cannot talk to their loved one, they should speak to that person’s physician about their concerns. Physicians in many Provinces have a legal responsibility to report patients with medical conditions that may impede driving ability to the Medical Review Section of the Ministry of Transportation. This responsibility overrides their obligation to keep their patients’ histories confidential.
“If a physician’s failure to report is later shown to be a direct cause of an accident, the physician may be held liable to injury to the person with Alzheimer Disease as well as to third parties. In recent court rulings in Ontario, doctors have been assessed with heavy damages as a result of their failure to report the medical conditions of patients who later caused traffic accidents.”
Once the physician sends a letter to the ministry of Transportation, the ministry will send a letter to the client advising them that they can no longer drive. The only way to have this reversed is to have the patient reassessed with Ministry approval. But what can a family do if the patient, despite words from their doctor and a ruling from the Ministry that they cannot drive, refuses to stop driving? The Driving and Dementia Toolkit, designed by the Regional Geriatric Program of Ottawa-Carleton suggests the following as possible options:
- Try parking the car out of sight, perhaps in a neighbour’s garage or driveway. This may lessen the person’s frustration at seeing the car, but being unable to drive it.
- Try hiding the car keys.
- Ask a mechanic to install a “kill switch” that will prevent the car from being started.
- If you are not using the car, it may be best to sell it.
It is certainly hard to take on the responsibility of taking away the right of a loved one to drive, even if you have the backing of their physician. But, remember that you have the best interest of your loved one and those they may come upon on the road at heart – and that is the most important thing.