People in the early stages of dementia are frequently still driving. There is usually little trouble in getting to and from familiar locations, although one slight change in direction, terrain, or time of day can cause major confusion. And most challenging of all, the person with early stage dementia does not usually notice a decline in driving skills. There is a list of reasons and excuses for their decisions on the road, none of which include any admission of fault. This is perhaps the most dangerous reality of all.
I met Mary last year. Mary, a youngish 72 year old with an active social life, was heavily involved in volunteer work at the local hospital. Her family noticed a decline in her ability to accurately handle her finances. She occasionally confused her medications. She became defensive if a family member offered her help or tried to point out her mistakes. One day Mary was leaving the hospital a little later than usual. It was nearing dark when she began her short, highly familiar trip home. At 2 a.m., her family called the police. Mary made it home a short time later, and had a perfectly logical explanation for getting lost. She said that she made a wrong turn into a neighborhood and couldn’t find an exit back out to the main road. She drove the same streets, turning around the same cul-de-sacs, for seven hours. She thought about knocking on someone’s door to ask for directions, but thought it would be rude at such a late hour. She thought about using her cell phone, but it was turned off. Her limited problem solving and insight skills demonstrate classic early dementia.
Does this story sound familiar?
How about the man who’s left side of his car was constantly being hit by other drivers, light posts, and guard rails? Always the left side, always a coincidence.
A single post on the subject of driving and dementia will barely touch on the multi-faceted decisions regarding older drivers. I will certainly be posting more and more on this topic in the days, weeks, and years to come. Just to graze the surface, though, check out these resources and tips:
American Medical Association’s Guidelines for Assessing and Counseling the Older Driver.
For a quick screen, try this:
Self assessment or caregiver assessment (Sample questions- yes or no)
- Getting lost
- Others are worried about my driving
- Cars appear out of nowhere
- Others drive too fast/honk at me
- Feeling tired after driving
- Being stopped by the police recently
- Dislikes night driving, busy intersections, left hand turns
- Recent “near misses”