Alzheimer's: When to stop driving

When it's time to stop driving, your loved one with Alzheimer's may resist. Instead of arguing, provide other ways of getting around and maintaining routines.

Driving is a powerful symbol of competence and independence — besides being a routine part of adult life. But the focused concentration and quick reaction time needed for safe driving tend to decline as you get older. Alzheimer's disease accelerates this process dramatically.

When to stop driving

Because Alzheimer's diminishes reasoning skills, it often is up to caregivers to determine when their loved ones become unsafe behind the wheel. Warning signs of unsafe driving include:

Forgetting how to locate familiar places
Failing to observe traffic signals
Making slow or poor decisions
Problems with changing lanes or making turns
Hitting the curb while driving
Driving at an inappropriate speed
Becoming angry and confused while driving
Confusing the brake and gas pedal

The transition: Abrupt or gradual

Opinions vary on whether driving should be allowed at all after an Alzheimer's diagnosis. For some people, it may be easier to give up the wheel early on, when they can still grasp the potential hazards. On the other hand, people in the early stages of the disease may be able to safely limit their driving to short daytime trips in familiar surroundings.

Most specialists feel it's important to help the person with dementia stop driving as soon as possible. A rule of thumb is to ask yourself whether you feel safe riding in a car or having your family members, including children, riding in a car that the person with dementia is driving. If the answer is no, then you know it's time for him or her to retire from driving.

Pre-emptive measures as the disease progresses

Even if your loved one willingly gives up driving at first, it may become an issue later on, as his or her understanding of the risks diminishes. Here are some strategies for keeping your loved one out of the driver's seat.

Get a note from the doctor. Sometimes it helps if an authority figure — physician, lawyer, insurance agent — tells your loved one to stop driving. Having something in writing can be a useful reminder.
Control access to the car and keys. In many cases, it's a simple matter of "Out of sight, out of mind." Parking the car around the corner may be enough. Some caregivers sell the family car and buy one that's a different color so that the person with Alzheimer's thinks it belongs to the neighbors. If your loved one insists on carrying a set of car keys, you can replace them with keys that don't work.
Disable the car. Removing a battery cable will prevent the car from starting. Or a mechanic can install a "kill switch" that must be engaged before the car can start. Although this may seem extreme, the consequences of having someone on the road with dementia can be devastating.
Ease the transition. Arrange for alternative transportation, perhaps via the city bus service or a senior van route. You may be able to establish a payment account with a taxi service so that your loved one won't have to handle money. Many items, such as groceries, meals and prescriptions, can be delivered. Some barbers and hairdressers make house calls.

Be patient and firm

Whether your loved one stops driving all at once or in stages, he or she will probably grieve this loss of independence. Be as patient as you can throughout this process, but remember to stand firm. Arguments and explanations rarely make it easier to accept.

What will help is to keep routines as normal as possible despite the prohibition on driving. Arrange for family and friends to visit regularly and to take your loved one out to run errands. When you're together, focus on activities your loved one can still do and enjoy.