beyond the video

Driving: Recognizing Trouble Ahead

An analysis of what makes people with Alzheimer's unsafe drivers.



Video summary
This video makes seven major points:

  • Driving and dementia is a controversial and emotional topic.
  • People with dementia are not always aware of their deficits.
  • One way to determine a person's ability to drive is to assess your comfort as a passenger.
  • Some people do self-limit their driving.
  • People with dementia have many deficits that may not be immediately noticeable.
  • The issue of driving and dementia is rarely solved quickly and easily.
  • Thankfully, some people with dementia accept their situation gracefully.

1. Driving and dementia is a controversial and emotional topic.
Although all of the subjects used to illustrate this point were men; the reaction of those who are told they can no longer drive tends to be the same – devastating – for both men and women. People who realize and accept that they are becoming a danger to themselves and others are rare.

2. People with dementia are not always aware of their deficits.
As Dr. Weintraub points out, many people with dementia lack insight into their condition. Even those who are aware that they are not as alert as they once were tend to believe "I just have to be careful."

3. One way to determine a person's ability to drive is to assess your comfort as a passenger.
If you avoid riding with the person, it is probably time to start examining the reasons why.

4. Some people do self-limit their driving.
Some people will limit the driving they do to:

  • basic errands, such as going to the grocery store
  • a certain radius, such as no more than 10 miles from home
  • daytime only
  • fair weather only
  • no highways or interstates

5. People with dementia have many deficits that may not be immediately noticeable.
Dr. Weintraub mentions a number of things to take note of in determining whether a person can safely continuing driving. The Hartford Insurance Company distributes a list of 28 warning signs. (Click on "Warning Signs for Older Drivers") They are:

  1. Decrease in confidence while driving
  2. Increased agitation or irritation when driving
  3. Uses a "copilot" (Passenger to tell him/her what to do)*
  4. Easily distracted while driving*
  5. Other drivers often honk their horns*
  6. Incorrect signaling
  7. Getting lost in familiar places*
  8. Car accident
  9. Failure to stop at stop sign or red light*
  10. Confusing the gas and brake pedals*
  11. Scrapes or dents on the car, mailbox or garage*
  12. Failure to notice important activity on the side of the road*
  13. Failure to notice traffic signs*
  14. Driving at inappropriate speeds*
  15. Stopping in traffic for no apparent reason*
  16. Not anticipating potential dangerous situations*
  17. Bad judgment on making left hand turns*
  18. Near misses
  19. Delayed response to unexpected situation*
  20. Moving into wrong lane*
  21. Difficulty maintaining lane position*
  22. Confusion at exits*
  23. Ticketed moving violations or warnings
  24. Trouble navigating turns
  25. Difficulty turning to see when backing up
  26. Riding the brake
  27. Parking inappropriately
  28. Hitting curbs

Those with an * are particularly common in people with dementia.

6. The issue of driving and dementia is rarely solved quickly and easily.
Some people continue to obsess about driving for months or even years after they have been advised to stop. They do not accept that they have deficits and cannot be reasoned with because their deficits preclude their ability to reason. For them driving is an emotional issue that can be partially mitigated by making sure they are helped to continue an active life.

7. Thankfully, some people with dementia accept their situation gracefully.

Applying the video to your own situation
The purpose of this video is to call attention to the fact that dementia by definition is a progressive disease which involves brain deterioration that affects a person's ability to drive. By the time we are able to diagnose a problem, significant brain damage has already taken place, but the person with dementia is frequently unaware of his specific losses and tends to think he is still a safe driver.

As family caregivers, we frequently want to continue believing that our loved one is "safe enough" because there are seldom easy solutions to helping the person to remain active and involved in his community. That dilemma is addressed more thoroughly in part 2.

Beyond the Video

Dr. Weintraub points out many people with dementia lack insight into their condition. Even those who are aware that they are not as alert as they once were tend to believe "I just have to be careful."