May 4, 2009 -- Question: How do I talk to my loved one with Alzheimer's about giving up driving?
Answer: Giving up driving is an enormous challenge, but is usually one that must be confronted by caregivers and the person with dementia.
I believe that this isn't something that automatically comes with the diagnosis -- that is, you get the diagnosis of dementia and away go the car keys. It's something that should be discussed early on with the person with dementia participating in how and why they want to be informed about the time has come to give up driving.
Family members are often reluctant to bring this up because driving means so much more than just having a means of transportation in our society. It means maturity. It means freedom, and, therefore it's larger than just the act of driving itself.
So we really need to find ways to compensate for taking away the person's car keys. We need to have others, friends, neighbors, grandchildren, who will drive them places.
We need to provide alternative forms of transportation: Go with them on the bus. Call a taxi for them. We don't want to limit their freedom completely. But when the time comes, when they're unsafe either for themselves or for others on the road, it's a decision that has to be made and one that should be made based on a long period of observation of their driving and the changing skills that are involved.
Also with cognitive impairment, the person with dementia loses the ability to understand things like 'rules of the road', like "no right turn on red" and that sort of thing. So we really need to be observing. Keeping notes and then discussing, involving the person with dementia in the decision to stop driving rather than just taking away their car keys or disabling the car itself.