JOAN’S BLOG – WED/THUR. SEPTEMBER 1/2, 2010 – A PRIMER ON DRIVING AND DEMENTIA

I am discussing this issue again only because we have so many new members who are confused about the situation. The driving subject makes me break out in a cold sweat, experience heart palpitations, and want to crawl into a hole and hide. For those new members who wonder why this would be the case, I will advise you to read just a few of the blogs on this subject -39, 66, 128, 227, 231, 261- for the insight into the horror my husband put me through over what has come to be known as “the driving issue”.

This will be a straightforward blog based on facts related to reasons why someone with dementia should not be behind the wheel of a car.  If you are going to ask me advice on how to make that happen and how to deal with it, forget it. My husband was voted the WORST case ever seen, of refusing to give up driving, by three social workers, a neurologist, psychiatrist, psychologist, and all members of my support group. His behavior was so vile and obsessive that his own Alzheimer buddies turned on him, refusing to be with him, because they could no longer stand listening to his constant ranting and raving. It was the fear of losing his friends that finally shut him up, NOT the realization that his behavior was putting me on the verge of a nervous breakdown.

And let it be known that although he has stopped talking about it incessantly, his feelings about it have not gone away. Two years after the fact, he is still angry, hurt, and completely clueless about why he cannot drive.

  THE BRAIN WITH ALZHEIMER’S DISEASE:
Logical reasoning is severely compromised, if not altogether gone.
Physical AND mental processing is slowed, and continues to slow as the disease progresses.
Spatial orientation is faulty.
Routine is necessary to keep them on track – the unexpected, such as always happens in traffic, can cause loss of impulse control, confusion, and anger.
Directional orientation is faulty.
Short term memory is faulty – affects such tasks as remembering to put on directional signals, remembering to look before changing lanes.
Attention and focus are shortened.

Now I ask you to look at the above list. Do you want to be in the car or on the road with anyone whose brain is working in such a manner? Would you allow your children or grandchildren to ride in a car with that person?

Those with dementia and many “experts” tout the use of extra mirrors, GPS systems, and back up “beepers” as aides to keep those with dementia driving longer. Those devices cannot repair slow processing and faulty judgment.

INSURANCE FACTS:
If you DO NOT alert your insurance company to the fact that a driver on the policy has a dementia diagnosis, you can be prosecuted for insurance fraud.
If you DO alert your insurance company to the fact that a driver on the policy has a dementia diagnosis, YOU are liable for any damage, injury or loss of life that occurs if they have an accident.

STATE’S POLICIES ON DRIVING WITH DEMENTIA:
Every State has different rules. In some States, a doctor is legally obligated to report the diagnosis to the DMV, and the license is automatically pulled. In some States, a driving test is mandatory after a diagnosis, but remember, most early to mid dementia patients pass those tests, because they examine normal driving skills, not reasoning and judgment. In some States, such as Florida, where I live, the rules are “subject to interpretation”. You will have to check the laws in your own State.
 
CRITERIA FOR STOPPING DRIVING:
There are countless websites on the Internet that list criteria for a dementia patient to stop driving. They are too numerous to list here – type “driving and dementia” into Google, and you will have reading material for months.

Many doctors will advise you to allow your spouse to drive only if YOU are in the car with them. That never made any sense to me. What is the point? So that BOTH of you can be killed? Others advise short distance driving. Does that mean that a child or animal will not run out into the street unexpectedly between your house and the store a mile away? Does that mean that your spouse will actually FOLLOW the rule of local driving only? If YOU are questioning the ability of your spouse to drive safely, you have answered your own question, and the answer is .

2011 UPDATE: Dementia and Driving Resource Center from the Alzheimer's Association

Please post comments under the new Message Board Topic: Joan's Blog - A Primer on Driving and Dementia.

Also, be sure to look at the topic: The Driving Issue

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The Alzheimer Spouse LLC
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