Is it Time to Take the Keys? — 3 Secrets About Alzheimer’s Disease and Driving That Will Give You the Answer

NOTE: Of all the issues involved in caring for a loved one with Alzheimer’s Disease, one that can cause the most stress is when to take the keys away. When is someone with dementia so impaired that it is dangerous for them to drive? This article is a compilation of resources, blogs, and research taken from my website, www.thealzheimerspouse.com, which was the #1site on the Internet for support and information for Alzheimer’s spouse caregivers during the years I was caring for my Alzheimer’s Diseased husband, Sid.

“I HAD THE RIGHT OF WAY!”, Sid, who was driving, screamed at me after narrowly missing mowing down a group of elementary school-age children trying to cross the street — in a crosswalk.

Seething with anger, I screamed right back at him — “It doesn’t matter who has the right of way if they’re DEAD!”

As you can surmise, this incident occurred before I learned about the advice I dispensed in my previous Alzheimer’s articles on not arguing and how to effectively communicate with an Alzheimer’s Diseased person.

It also brings up one of the most important subjects and decisions related to Alzheimer’s Disease. When is it time to take the keys away?

While caring for my husband, I was bombarded with differing and opposing opinions from caregivers, doctors, Insurance agents, lawyers, and psychologists. Many doctors will advise you to allow your loved one 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 only. That made no sense to me either. Does that mean that a child or animal will not run out into the street unexpectedly between your house and the store a few blocks away? Does that mean that your loved one will actually FOLLOW the rule of local driving only?

As I was sorting through this confusing advice, I was faced with a husband who angrily and stubbornly declared that there was nothing wrong with him and he was NOT going to stop driving.

Forcing someone to stop driving involves a complex list of psychological and emotional issues. From their point of view, it destroys their already diminishing sense of self-esteem, erodes their independence, and fuels their anger because their impaired judgment does not allow them to understand the necessity for the change in driving status.

To break it down in its simplest form, there are 3 main factors at play in allowing a person with Alzheimer’s Disease to continue driving: level of functioning, individual State dementia-related driving rules, and Insurance liability.

1. Level of Functioning:

Alzheimer’s Disease affects a multitude of brain functions that are involved in driving — memory; processing speed; judgment; visual perception. When your loved one forgets where he is going, cannot react quickly in traffic, and does not properly perceive the location of road lines and other cars, driving is out of the question.

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 — it affects such tasks as remembering to put on directional signals, and 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 GPS systems, side view blind spot mirrors, and backup cameras with “beepers” as aides to keep those with dementia driving longer. Those devices cannot repair slow processing and faulty judgment as evidenced by another example from my experience with my husband.

We were in busy city traffic, and Sid decided to switch from the left lane to the right lane, which he promptly did, not bothering to look to see if a car was coming up on the right. Which it was and nearly smashed right into us. Inches kept us from impending disaster. Horn beeping, dirty looks, and an obscene gesture by the other driver invoked my inappropriate response of screaming at Sid about “looking” before changing lanes. His answer? “I wasn’t going that fast. It wouldn’t have been a bad accident.” What good are side mirrors to someone whose judgment is as faulty as his statement indicated?

2. DMV DEMENTIA RULES:

STATE’S POLICIES ON DRIVING WITH DEMENTIA:

Every State has different rules.

· In some States, a doctor is legally obligated to report a dementia 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.

· For more information on individual State laws related to driving and dementia, CLICK HERE.

Given the examples I cited above related to my personal experience with my husband’s driving, any reasonable person would assume that he would fail a driving test. Because he was so adamant about refusing to give up driving, his neurologist arranged for him to have a special driving test given to dementia patients.

These tests rely heavily on the mechanics of driving. Upon completion, the tester told me that although Sid forgot to put on his seatbelt, he drove adequately enough to keep his license. I was LIVID, as Sid was in the violent, angry, aggressive period of the disease, so not only did I have a husband behind the wheel of a car with no judgment skills, but he was subject to unpredictable violent rages of temper. Not exactly the person you want driving on the road, but legally, my hands were tied. He passed. I lost and given his adamant refusal to stop driving, there was nothing I could do about it. It was an insurance issue that finally ended his driving, which I will explain below.

3. Liability-

Click Here for a comprehensive look at insurance liability and dementia.

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. You can be sued and lose everything — your home and life savings included.

In the middle of all of this driving drama, I received a notice from our insurance company that they were leaving the State of Florida, where we lived, and would no longer insure Florida residents.

That meant that I had to fill out a form for a new insurance company — the form that asked if anyone on the policy was driving with, or had been diagnosed with a mentally incapacitating condition. For the reasons explained above, I had no choice but to answer honestly, which meant Sid was denied insurance and had to relinquish driving.

His ongoing rage over the issue drove me to seek professional advice. His neurologist, psychiatrist, psychologist, and 3 social workers agreed that he was the WORST case of refusing to give up driving that they had ever seen. No one was able to quell his rage, and we endured two full years of violent, incessant rants over the issue. Only the progression of the disease into the more mild, passive stage ended his fury.

In my experience, I have seen a wide range of reactions from Alzheimer's patients related to giving up driving. From my husband’s extreme negative case to a friend’s husband who was a retired police officer. Upon diagnosis, my friend's husband still had enough reasoning and judgment to say that he would voluntarily give up driving due to the dementia-related accidents he had seen as a member of the State Police.

Regardless of the level of cooperation of your Alzheimer’s Diseased loved one, when the driving issue rears its ugly head, it is YOUR legal responsibility to address it. You must thoroughly research and familiarize yourself with your State’s laws related to driving with dementia and you must do the same with your Insurance Company.

Even if your loved one is technically, according to the DMV, cleared to drive, and you are willing to take on the Insurance liability, you will need to think carefully about your moral responsibility.

Your loved one may still possess the technical skills to drive, but what about the judgment, reasoning, and quick reflexive motor skills needed to drive? Are you willing to endanger the lives of countless other drivers, passengers, and pedestrians by allowing your Alzheimer’s Diseased loved one to remain behind the wheel of 4000+lb. vehicle?

If you are questioning the ability of your loved one to drive safely, you have answered your own question, and the answer NO.

CLICK HERE for the Alzheimer’s Association comprehensive guide to driving and dementia.

There are currently 5 more articles in this Alzheimer Series, which can be accessed in the links below. If there is a subject you would like me to cover in a future article, let me know in the comments or contact me directly via email — [email protected]

The Top 5 Early Symptoms of Alzheimer’s Disease — It’s not always about memory

Alzheimer’s Day Care — 7 things to know before signing on the dotted line

Never Argue — The most important lesson to learn when interacting with a person with Alzheimer’s Disease

6 Basic Rules for Communicating with An Alzheimer’s Patient

An Artist’s Self-Portrait Demonstrates His Own Descent into Alzheimer’s Hell

This article was originally published in the Medium Publication, Illuminated-Curated

©Copyright 2022 Joan Gershman