When to Stop Driving With Dementia — Updated Guidelines

One of the most challenging aspects of living with Alzheimer’s disease or another form of dementia is coming to terms with the need to stop taking part in certain activities as the condition advances. This necessity is usually due to safety concerns, as tasks that were once considered to be easy and safe, like cooking and cleaning, become more dangerous. Driving a vehicle may be the best example of such an activity. It can be very hard for a person to accurately judge when their driving ability has been significantly impaired, especially when dealing with dementia.

Even medical professionals have a difficult time advising people with dementia on when to stop driving, so much so that guidelines have been developed through the UK’s National Institute for Health Research (NIHR) to aid in this task. While the materials in this guide were tailored specifically for medical practitioners, they offer many insights that could prove useful for anyone with dementia, or those who are concerned for a loved one with the disorder.

Identifying the Signs

According to the newly updated guidelines, the following six main signs indicate a person should no longer be driving due to the impact of dementia:

1. Changes in Visuospatial Judgement: They have trouble estimating the distance between vehicles, maintaining position on the road, and/or responding to subtle changes in direction (turns and curves).

2. Difficulty choosing appropriate driving responses in busy areas.

3. Problems maintaining attention, even in low traffic, leading to feelings of being overwhelmed.

4. Decision-Making Impairments: Poor choices, over-correction, erratic driving, and needing assistance from passengers.

5. Sequencing Errors: Doing things in the wrong order, failing to release the emergency brake, not checking for obstructions before pulling out, and missing gear changes (for drivers of manual vehicles).

6. High Passenger Vigilance: Passengers notice driving changes and become more active in monitoring and/or trying to help the driver.

While these guidelines are valuable for both professionals and people affected by dementia (either directly or through a loved one), they do not provide a way to definitively identify a person who should no longer be driving due to the condition. However, if someone is displaying several of these signs (or even just one, if it is severe enough), then it is reasonable to suspect that their driving ability has deteriorated to the point where they are presenting a danger to themselves and others if they drive.

Remember the Goal

The researchers involved in this publication were very clear that the goal of their work is not to dissuade people with dementia from driving, but to give them a better understanding of the risks that they may face over time. Being diagnosed with dementia is not in itself a reason to stop driving, but the reality of the matter is that the symptoms of the disease will eventually progress to the point where it will become a serious hazard to drive.

Using this guide, professionals, concerned loved ones, and people with dementia themselves can more accurately judge when this point has been reached. It could also serve as a good conversational ice-breaker for initially discussing driving concerns with someone who has dementia. The topic can be delicate, but placing the focus on maintaining independence should make it much easier to discuss. Presenting them with these guidelines would make it more likely for someone with dementia to come to their own accurate conclusion regarding their driving abilities.