Are you allowed to drive with dementia or Alzheimers?

As Australia’s population ages, the elderly want to continue driving in ever increasing numbers to maintain their standard of life, but often dementia sets in and that can create difficulties.

With around 100,000 drivers over 80 in New South Wales alone, and around 20% of people suffering from dementia, authorities have to balance an individual’s need to retain independence with the broader need for road safety. The challenge is to define at what point dementia becomes too severe to allow a driver to stay on the road.

Dementia is an umbrella term describing a range of symptoms that include a reduction in the ability to think or remember. It’s caused when the brain is damaged by a disease such as Alzheimer’s disease, or repeated concussions.

What should drivers do when they find out they have dementia?

The onset of dementia is usually slow. A person could have several years to decide how to stop driving and retain their mobility. Over the next decade we are likely to see self-driving cars become widely available, and the rise of ride-sharing services associated with them that will be  lower cost than owning one’s own car.

Why is driving with dementia dangerous?

In the initial stages of dementia, driving is not necessarily more dangerous. However, over time, dementia can cause limited concentration, vision problems, cognitive impairment (i.e. difficulty thinking and making decisions), an increase in reaction time and a loss of memory.

How to recognise signs of dementia when driving

If you have a relative and you believe they are suffering from dementia, here are some things to look out for:

• Reaction time: they seem to see things at the last minute or not react to developing hazards, or even difficulty staying in the same lane
• Ability to solve problems: they can become agitated if too many things are happening at the same time
• Reduced coordination: mixing up the wipers and indicators in a vehicle they’ve driven for years; confusing
• Confusion on familiar routes: turning the wrong way to go home, or temporarily forgetting the way home or the way to a familiar place such as the supermarket
• Getting left and right confused
• Missing traffic lights and road signs, or getting confused between the red and green lights
• Difficulty following directions from a satellite navigation unit, spoken directions, or reading a map
• Changes in mood while driving for no reason
• Difficulty manoeuvring, e.g. causing minor dents and scratches in car parking situations.

If you drive with someone that exhibits a lot of these, or one or two very seriously then you must raise it with them or their doctor. You can also contact your local licencing authority to ask for advice as the initial contact may be better coming from them if you are worried about a family member who may not take advice from close relatives.

Licensing requirements

Local licensing authorities require drivers to tell them if they have a medical condition that affects their ability to drive safely. This applies to dementia in the same way it applies to epilepsy and diabetes.

Once a driver has notified the licensing authority they may ask for a doctor to make an initial assessment and the results of this will mean the driver either keeps their licence or has to surrender it.

In the case of keeping the licence, a 12-month conditional licence will be issued usually with another assessment to renew it. Depending on the severity of the person’s dementia, they may be allowed to drive but only in limited circumstances, for example, between certain times or within a certain distance from home.

Driving without a licence or driving with dementia and not notifying the licencing authority has consequences. Insurance could be invalidated in the event of an accident, and the driver could be sued or charged with driving offences.

Difficulties for drivers

People living in rural areas are often hardest hit because of the lack of other viable transport methods.

People living alone can feel the loss of independence especially acutely.

Drivers may be reluctant to stop even if they know they should, and the only way of stopping them is to take away their keys or vehicle.

What are alternatives to driving with dementia?

• Support groups that collect a number of people for outings
• Buses, taxis, trains and ride-sharing services (where available)
• Walking – this has good health benefits
• GPS and satellite navigation – where the dementia is not severe enough for a driver to stop driving, a good GPS system can be reassuring, especially if common destinations are programmed in such as home, the supermarket and the doctors
• Online shopping with home delivery
• Family and friends can help with transport
• Get the person connected to other social groups either within walking distance or online so that they don’t feel isolated
• Purchase car with as many autonomous safety features as possible to reduce accident risk – look for autonomous emergency braking and forward collision warning
• Consider the person’s living situation and how isolated they are.

Introducing the idea of not driving

It’s not uncommon for people to have to stop driving – most people have to at some point – but it should be acknowledged that it’s hard to do. The alternatives mentioned above can reduce the feelings of anxiety a person will have over not being able to drive anymore. While most drivers who develop dementia will have fundamentally clean driving records, this doesn’t mean that they continue to be safe drivers.

There are financial benefits to selling a car if the person has ready access to public transport or can walk places. There will be no maintenance, fuel and other costs associated with the vehicle. It’s possible in some places to rent a parking space to commuters using services such as Parkhound or Kerb which could bring in some money.