Driving and Dementia
Do I have to give up my Licence?
Having a Diagnosis of Dementia does not mean you have to give up your licence. But if you have been diagnosed with dementia, you may need to adjust your driving habits. You may have difficult family conversations about dementia and how it may affect driving ability.
While it’s understandable that you may be concerned about having to stop driving, it’s also worth considering your safety and wellbeing.
As your dementia progresses, you may feel less confident or more agitated when driving. And the risk of getting lost and misinterpreting road signs will sadly increase. If you do have to stop driving, or you make the difficult decision to stop driving straight away, then it’s worth discussing this with your friends and other family members and plan ahead for the future.
Enlist the support of other family, friends, caregiver support groups, and health professionals when making and implementing difficult decisions about driving.
Your doctor will help you and your family determine at your hospital appointments if you need to change your driving behaviour. If you are concerned about driving safely at any of the stages of dementia, you will need to talk to your doctor. But ultimately, if any adults with dementia feel like they shouldn’t be behind the wheel, then they shouldn’t be.
You are Legally Required to Tell Authorities
When the Vehicle Licencing Agency (DVLA) determines that someone with dementia needs to give up driving, they will usually refer them to a Driver Assessment Unit (DAU) for an assessment. If the DAU finds that the driver with moderate dementia is still safe to drive then they may issue a restricted licence instead of a full licence.
Types of driving licence you may receive following your assessment.
A restricted licence allows older drivers to continue to drive if they follow certain conditions. These conditions might include not using alcohol or drugs. Not carrying passengers, to avoid driving at night, etc. After being given a restricted licence, some drivers who are having dementia care choose to give up driving altogether.
If the DVLA decides you are eligible to drive, it will issue a new driving licence for a fixed period. The licence will usually last around one to three years, depending on the current, understanding stage of your dementia.
Your condition will usually be reviewed once a year.
It is a good idea to have the person's driving skills assessed regularly by a professional.
How Dementia Can Affect Your Ability To Drive
Dementia affects everyone differently. Even people with early-stage dementia may forget what they need to do when getting behind the wheel and may become confused about where they are or get lost.
People with dementia may also have trouble remembering turn signals, checking mirrors, and paying attention to other road users, and pedestrians. These problems lead to accidents.
Safe driving requires a range of cognitive skills
Driving may feel easy and natural for people who drive often or have been driving for many years.
However, it is a complex task that involves quick thinking as well as sensory (vision, hearing) and manual skills.
A safe driver must use a range of mental abilities including:
- Focus and attention – to switch between different driving activities while 'reading' the road.
- Visuospatial skills – to keep the right speed and distance from other vehicles.
- Problem-solving skills – to deal with any challenges encountered on the road, such as diversions or obstacles.
- Judgement and decision-making – for example, to understand what other road users will do next and prepare accordingly.
You need to be able to react quickly to avoid accidents. Memory is important, because you need to remember your route and the rules of the road.
- It can be difficult to remember the meanings of traffic signs and other driving regulations if you have memory loss.
- Concentration problems can impair your ability and reaction time to make decisions while driving.
- Even Mild Dementia can cause poor judgement. Which can make it difficult to evaluate the distance and speed of other vehicles on the road, especially at intersections.
- Getting disoriented or confused can cause you to lose your way or leave you unsure of how to respond to particular circumstances.
- Long journeys can be difficult if you have trouble organising and planning. You may find it difficult to map out your route and stop for gas. Or calculate how long it will take, or foresee potential problems like rush hour or closed highways.
- Recklessness can result in behavioural changes, which could be highly dangerous.
In the early stages of dementia, some—though not all—individuals may still carry the skills necessary for safe driving.
Dementia causes problems with both reaction skills and memory. These problems get worse as the severity of dementia gets worse. All patients with dementia will eventually become unsafe to drive. How soon this happens depends on the person.
It is also important to remember that pathology may affect brain regions, producing different patterns of cognitive deficits that could impair driving. Such as in other dementia disorders, like frontotemporal dementia, Lewy body dementia and vascular dementia.
Family Members Can Help
If possible, go out in the car with the elderly driver at regular intervals so you can see if they are driving safely.
If you believe they are no longer safe to drive: sit down and explain why you are worried.
It is vital that you stay calm. They will feel respected and hopefully see that you recognise that it’s a difficult situation. You just need to talk to them about the benefits of not driving. For example, they’ll start saving money on taxes, insurance and fuel. Why not also suggest some benefits of not driving? Like walking to get some fresh air and exercise.
You may find it easier to discuss any concerns you have with the person’s doctor, family members and health care providers present. All involved will need to weigh potential risks and decide whether they can continue driving.
When Driving Becomes Unsafe
Here are some ways to stop people with Alzheimer's disease from driving:
- Try talking about your concerns with the person.
- Take them to get a driving test.
Following are some of the common warning signs that a person no longer has the necessary skills for road safety:
- Drives too slowly.
- Stops in traffic for no reason.
- Ignores traffic signs.
- Become lost on a familiar route.
- Lacks good judgment.
- Has difficulty with turns, lane changes, or highway exits.
- Increasingly nervous.
- Take them to get a driving test.
- Drifts into other lanes of traffic.
- Drives on the wrong side of the street.
- Signals incorrectly.
- Ticketed for traffic violations.
- Falls asleep at the wheel.
- Parking is inappropriate.
Speaking to others who have been through the same thing may be helpful. Seek advice from support groups like memory cafés, online groups and forums that offer opportunities to share experiences. You can call the Admiral Nurse Dementia Helpline for information about local services.
Finding Other Transportation Options
If a person with Alzheimer’s can no longer drive, find other ways that the person can travel on his or her own. Contact your local Area Agency on Aging or Eldercare Locator for further information about transportation services in your area.
Driving Mobility Centres provide ‘driver retirement support’ for people who have stopped driving due to dementia.
However, it is still possible to have a fulfilling life after giving up driving.
For example, they could look for nearby services like support groups and day centres to reduce any social isolation caused by stopping driving.
They could invite friends and family over to their house to avoid having to travel.
It’s easy these days to order food shopping online! A family member could pop by to help set them up and teach them how to do this in the early stages of their dementia.
Apply for a Blue Badge! A blue badge enables people with disabilities to park for free in disabled parking areas. It makes it easier when a family member or friend takes them out by car.
Alzheimer's Disease and Driving
Most drivers who suffer from Alzheimer’s disease will need help stopping driving at some point during their illness. There are several reasons why this may happen.
First, there are many different types of dementia. Each type has its own symptoms, and some types of dementia start earlier than others.
Second, there are various stages of Alzheimer’s disease.
At first, you may notice changes in their memory. Then, later in the disease, you may experience other problems like language difficulties, mood swings, and behavioural issues.
Finally, there are also different levels of severity of Alzheimer’s disease. They may have mild cognitive impairment, moderate cognitive impairment, or severe cognitive impairment.
- Mild cognitive impairment means that you have some memory loss, but you still function well enough to drive.
- Moderate cognitive impairment means that you're not functioning as well as you were before, and you may need to get someone else to drive you around.
- Severe cognitive impairment means that you cannot safely operate a vehicle.
The Law on Dementia and Driving
Drivers should always notify their insurance company and the DVLA when they have a condition that could affect their ability to drive safely. If you have any concerns about your own driving abilities, please contact your local DVLA office.
When DVLA decides that a person with Alzheimer’s disease must stop driving. They must stop driving altogether. Even if they have previously been given a restricted licence.
If the person does not tell DVLA/DVA about a dementia diagnosis.
Many people who are diagnosed with Dementia do not tell the Driver Licencing Authorities (DLAs) and keep driving. This could be because they do not understand what their diagnosis means, or they are unaware of how much their dementia affects their ability to drive safely.
You must tell DVLA if you have dementia. Just like anyone with cognitive medical conditions. You can be fined up to £1,000 if you don’t tell the DVLA about a medical condition that affects your driving. You may be prosecuted if you’re involved in an accident as a result.
It also puts the person at risk if they continue to drive without insurance as their current policy might be invalid.
If this occurs, the driver should be encouraged to contact DVLA immediately. If the driver refuses to do this, then the doctor should inform the DVLA about the incident. The doctor should also write down all the details of the accident in a report.
It can be very challenging for people living with dementia when the DVLA stops their licence because they cannot drive safely. So it is important to keep patient with them as they adjust not only to their lack of driving independence but to the realisation of their health conditions.
But it is also hard for family and friends, as you may have to take on more responsibilities.
Frequently Asked Questions
Drivers who have dementia must immediately inform their insurance provider. If not, their policy may not be valid.
In England, Scotland, and Wales, you can send a CG1 form to the DVLA, and in Northern Ireland, you can write, call, or email the DVA. It is crucial that you be truthful while answering questions concerning your ability to drive. If you intentionally lie in order to preserve your licence, you risk being fined or imprisoned.
The DVLA or DVA will consult with your doctor to determine if you are fit to drive once you have reported your condition and completed a questionnaire. The decision-making process must prioritise the public’s safety. For those with mobility issues or those who depend on their car, this can be quite challenging, but it is vital.
