My DH was diagnosed with MCI in 2010 and has continued to slowly but steadily decline, but flatly refuses to follow-up on his condition. He’s decided he will never see the doctor and that way he can never be told he has Alzheimer’s. A month ago he started talking about going in for a physical, having forgotten his pledge. Unfortunately the talk never translated into actually making an appointment. So I suggested that he make an appointment for a physical and ask for an AMYVID Pet scan, now that they are reduced in price. That did not go over well. So I suppose now he has renewed his vow to never visit a doctor – and I am sure by now he’s set it up as a daily reminder on his I-Phone – “DO NOT SEE DOCTOR”.

I wish I could just say, as our PCP does, “Oh well, if it’s Alzheimer’s at some point there will be no doubt.” I could – if not for the fact that he is still driving and probably shouldn’t be. We (my teenage son and I) do all the driving when we are present, and DH does not argue about that. But there are occasions when DH drives, for instance once a month or so he will drive to his company headquarters which is about an hour away, and each Monday night he drives to bowling. I know it does not matter how many times or how far –it only takes one time – and he could kill a child 50 feet from our driveway.

I absolutely cannot figure a solution to this. There is no reasoning with him, so that is not an option. I lay awake at night with my brain running in circles over this, but I get nowhere. Without an Alzheimer’s diagnosis, I have no power of this. And I cannot force him to get a diagnosis.

I’ve decided I am going to develop a sudden interest in his bowling league and go with him to drive there. But, it would seem that this can only be completely resolved over time. Eventually he will lose his job (and from what I can tell that’s probably going to happen sooner rather than later) and then he will never have an occasion to drive.

Am I right? Or am I missing something?

I know there are lots of threads on the driving issue – but I am too sleep-deprived to wade through them all. If anyone has a magic solution, please let me know.

This is a very difficult situation. My suggestion would be for you to go see his dr. and tell him your story and ask for his suggestions (if he has any) on some possible way to get him into the dr.'s office. Maybe the dr. could send him a notice that he needs to come into see him for insurance approval, some shot he might need, or something else. Could it be that he doesn't want to live like he is and so the hell with it all?

Maybe your older children and talk with him when you are not there and tell him how unfair he is being to the entire family and that they love him and want him to get treatment. They could also tell him they don't want him to keep getting worse when there could be medications that would help him and by waiting until he gets worse the medications might not help. And/or you might ask his boss to help with this or his best friend, etc.

Or...as a last resort...tell him you can't live like this and you love him but you are going to have to move out and leave him to fend for himself...that he is not being fair to his family, his co-workers, the company...etc.

Get his keys when he's asleep, file down one of the notches, that way the key won't work, do it today. You'll end up having to do all his driving, bowling, etc. Start lying about getting it fixed, tell the garage, if it goes that far, to tell him they're waiting for parts, whatever. I don't blame you for putting off the inevitable fights this may start, but it is one more responsibility we have as caregivers for someone with dementia/AD. In many states the doc has the responsibility of telling the DMV about dementia of any type, but it is your responsibility, not the doc, not the insurance company, not the state, it doesn't depend on a test, you already know he is not a responsible driver anymore. It doesn't matter what you tell him, he'll either dismiss what you say or soon forget, he doesn't understand fair, he'll drive without a license. He cannot reason, but you can. I wish it were otherwise, we all do, but it is what it is. Good luck, I know it's not easy.

Mary22033--- The above advice is good. You say, "But how do I..."

Here's a suggestion.

You call the Dr.'s Ofice. Give them a short explanation why he needs to be seen. Make the appointment for as soon as you can. Send a note of your questioins and concerns ahead of time., Tell them he is resistant to testing but has been declining. Put it on the calendar. If you DH notices, just tell him the Dr.'s Office needs to update his records (or whatever excuse you decide) No discussion. If he doesn't notice, just remind him of the appointment shortly beforehand, like it's been set up for a while,.
Take him to the appointment. Sit in on the appointment or be clear that you must speak to the Dr. while you're there. You cannot rely on your husband to remember what's said, instructions, ---nothing.

You have to take over, however you can manage it---fiblets are wonderful.
As soon as possible, you need to get a Durable Power of Attorney, and Medical POA also. Explanation to him is that if hewas injured badly, you need to be able to take care of things. These require his signature, otherwise you'll have problems because Medical people aren't authorized to talk to you, and you can't take care of money matters in his name.



I know this is a lot to digest but these things must be done for both your sakes.

Get the car keys away. My DH did really loose his keys several times in the house and I kept finding them is strange places. Finally found them but did not return them to him, so he no longer had them. He ranted and raved for a few weeks but finally accepted me doing all the driving.

I recently went though this same situation. I could see my husband's driving progressively declining. I was in the postion that I had to get the medical neurologist to take this on and my husband would not accept my opinion. Patients with AD or FTD don't realize that their motor skills, visiual, reflexes, and judgement are impaired and reasoning with them will only cause you more frustration. Contact your doctor IMMEDIATELY because his safetly and others are at risk. Doctors will not contact Motor Vehicle useless their truly believe that there is no questionable doubt that their patients are at risk behind the wheel. Doctors will also side with the benefit of the patient driving if it's questionable because they realize this is a very serious "privelege" to loss. Contact your husband's doctor IMMEDIATELY...fax him your concerns and document for future legal issues. Hiding the keys is not the answer...you must get to the root of the problem and deal head-on and directly with it. Good luck and God Bless you.

I tried for two years to get DH to the drs. It was his work that made the appointment and made him go. Thank goodness.

Good luck, I like the idea of filing down one of the car keys so it does not work.

If you can get hold of his car keys to file...why wouldn't it be best just to take the keys and hide them instead of filing them down? You might get some residue from the filings in the key slot which could be amother real problem for you. You can always tell him a fiblet that he must have hidden his keys and forgot where he put them or just tell him you have no idea what happened to his keys.

The major thing to keep in mind would be the result to you financially if he had an accident and your insurance refused to pay. This I believe should be first in your considerations of what you do.

I don't know what your health insurance is, but if your husband is the one who carries insurance on both of you through his employer, once his work gets sloppy, you might want him on disability (with insurance) instead of letting this go and him getting fired. That could cost you every cent in savings to take care of him without insurance. If you have to, you could also apply this tactic to getting him to the doctor. I didn't tell my husband ahead of time. He was always eager to go anywhere, and I just drove him to the doctor. After we got there, I told him it was for his annual physical, and he went in.

Giving up driving is the very hardest battle everyone fights. We have all been through it and they have given you the best advice. Also, I had the doctor tell my husband that he couldn't drive, and in front of me. From that day forward he let me drive him everywhere........except for the one time I left my daughter's car keys in a bowl on the kitchen counter, and he found them and drove three blocks to Krogers to shop (without a penny to his name and without a credit card!) I had a Chaperone phone for him and it buzzed me to let me know he had left the house and where he was. I called him and asked him if he was at Krogers, and he said yes. I said stay right there, I'll come and get you (I was at work - 15 minutes away). I got him, paid for his purchases, ran another errand before heading home and he pointed to the Kroger parking lot and said Debbie, and THAT is when I realized he had taken her car! I thought he had walked!!!! I didn't make the mistake of leaving ANY keys out after that!!!!

You have to put on your big girl pants and realize that even with temper tantrums of teenage boys (which is what he really is now) you have to take control, by love, and fiblets and hiding and with the doctor's help and friends and family to help you. This is a very hard thing you are about to do, and we're here for you!

Or instead of asking, it is easier all around if you just announce: 'Lunch is ready' or 'We'll have lunch after the doctor visit.' Sometimes they have a difficult time deciding between choices. But yes, sometimes you just never get around to doing something, like buying a new car. putting things off often works. Nancy, I think you are more likely to get into Heaven for keeping things calm for your husband than always being direct and honest--that only leads to chaos when someone has AD.

I visited our doctor and told him dh wasn't safe driving and then took dh in for his appt. The doctor just casually told him that it would be better if someone else drove for him. He never said dh couldn't drive so he just accepted the doctor's advice and we didn't have any problems for awhile. In his late stage he was set on going to work - we had been retired over 15 yrs. He wanted keys so I gave him keys that didn't go to anything we still owned. He did try those out in the middle of the night once when he got up, dressed, ate cereal and was going to drive to work. He never did even ask why the keys didn't work. I was sure thankful they didn't. Getting a doctor's assistance with not driving is best if you can. Also our insurance would not have been good if he had an accident. I had checked with the agent. Hard thing to do but then nothing about this disease was easy.

well there is the rub friends, when to know 'severe and uncontrollable' is present. sometimes we dont get a second chance. we know they can go from driving ok then getting lost driving the wrong way. sometimes its not a gradual loss of impairment but quite impaired quickly. you can be sure an insurance company would try to lay the blame on the caregivers for not reporting it sooner to the DMV. my opinion only. 'cognitive and functional impairments that affect driving'??. what a quagmire if a dementia diagnosis is on the horizon. exactly when they pass from driving 'ok' from diagnosis to not is the question and if we will have notice in time.

I think doctors should be required to report to the DMV anyone who has been diagnosed with MCI, after neuropsych testing. I don’t think a dementia diagnosis should be required, because in many cases (as with my DH), they refuse to go back after the MCI is diagnosed.

The state should place these people under mandatory review for driving privileges. They should be required to annually pass the written test and at least a simulated road test.

It should be the law of the land, and not vary from state to state. If a state wants their federal highway dollars they should have to comply. A federal law would remove the burden from the caregiver and the doctor, and put it on the state where it belongs. They are, after all, the ones who issue the licenses.

A few things to think of when evaluating driving.

1) How are their mechanics? My wife's control of the car was very good, but she had to stop driving.

2) If stopped by a police officer, would they be able to communicate? This has resulted in people having to stop driving. I know one person who didn't realize he was supposed to stop when the police lights came on behind him, or when the siren went off. He was followed home and didn't obey the police officer's instructions (he couldn't understand them). If his wife wasn't at home at that time he would have been tasseled. The officer had no idea what he was doing but he was making threatening gestures (which were not intended to be threatening, he didn't know how to react). That was it for driving for him.

3) Can they drive without getting lost? Some people are fine if they stay in the same area. But then we hear stories of the person who couldn't find their way home from the store a few blocks away and drive for hundreds of miles.

4) Can they read signs, including ones that we know more by shape than by words?

5) Can they multitask? My wife also had a one car accident because she *had* to adjust the heating and this distracted her enough to almost hit the curb (I intervened). If they can't react to an emergency situation or concentrate in all conditions driving is a bad idea.

6) Do they show poor judgement? My wife would get angry and drive really fast (not angry about driving, but about how her day went). I found out about this from my son a year after she stopped driving.

And we need to act before things get too bad.