Driving skills are affected by dementia
Driving may be an important part of life for the person you support. It may help them to be independent as well as getting to places and meeting up with friends and family. They may drive now, or in the past, or as part of their job. Some people just enjoy the driving and going out for a drive at the weekend. You or others might rely on the person to drive you places and may worry how you will manage if they can no longer drive.
To drive safely we need quick reaction times, coordination, and problem-solving skills. As we get older, these skills deteriorate in all of us, but more so in people with dementia. When people are told they have dementia, they often worry about whether they will be allowed to drive, or whether they should still drive and if they may be putting themselves or others at risk.
Driving, dementia and the law
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When someone is diagnosed with dementia, they do not have to stop driving. However, they must tell the DVLA about their diagnosis (DVA in Northern Ireland). If the person you support doesn’t tell the DVLA about their diagnosis of dementia, they may be fined up to £1000. If they have an accident they could be prosecuted. Also, not telling may affect their insurance. If a healthcare professional feels the person you support is not safe to drive and may put themselves or others at risk, they can inform the DVLA if the person refuses.
Find out more about dementia and driving, and the steps the person should take if they want to keep driving from the Alzheimer’s Society.
Once the DVLA are notified, they will ask the person you support for information and ask their doctor for a medical report. They then make an assessment. They will inform the person of their decision. If they decide the person you support can continue to drive, they will renew their license for between one to three years.
They may ask for more information from their doctor. The DVLA can also ask for an expert independent assessment where the person with dementia attends a special driving assessment centre and is watched how they drive on a course by an instructor. Driving mobility provide information on driving assessments and can help you to find a centre.
However, the DVLA may ‘revoke’ or cancel their license straight away if they feel the person is a risk to themselves or others on the road.
A dementia diagnosis may affect car insurance. The person you support must tell their insurance provider they have dementia, as the policy may be void if this information isn’t provided. They may also raise insurance premiums.
Supporting someone to stop driving
Talking about driving can be difficult. Some people may be aware that their driving is affected but others may feel they can drive just the same as they always have. The person you support may be upset or annoyed if you mention driving. You may have your own worries about their safety, your safety, the safety of others or how you will manage if they give up driving. Even if the person you support is a confident and capable driver, it can be helpful to plan for a time when they want to drive less often or give up driving.
The person you support might understand that dementia may cause some difficulties with their driving now or in the future. They may agree to talk about driving less, think about using other transport or returning their driving license at some point, and what do with their car (if necessary). Talking about their options may help them make steps to give up driving. Direct Line insurers provide some helpful tips to help the person make their decision to keep driving or to stop.
There is also a helpful booklet to help the person you support work through their decision and weigh up the pros and cons of continuing to drive.
Please note this is a Canadian document and the law will be different.
However a UK guide is available for healthcare professionals, which may also be helpful: Driving with dementia or mild cognitive impairment – consensus guidelines for clinicians.
The person you support may become defensive, upset or angry when driving is mentioned. Sometimes it can be helpful if a professional such as their GP or specialist, or a family member whose judgement is respected broaches the subject. If you choose to talk about driving, plan out what you are going to talk to them about. Here are some suggestions to try:
- Avoid focusing on what they can’t do and reminding the person of mistakes they have made on the road. For example “you keep getting lost”, or “you almost crashed at the roundabout the other day!”
- Gently and sensitively remind them that they could be putting other people at risk, such as other road users, pedestrians or other passengers.
- Sometimes reminding the person that their insurance may be void or they could face prosecution if they were in an accident may be necessary. It is important to approach this sensitively.
- Offer alternatives and solutions. For example, offering to share the driving, driving only in familiar places, walking or taking public transport. Put a positive spin on this. “Maybe if we walk to the shops on Saturday we could get some exercise and save petrol money”.
- In some cases, even when a driver’s licence is revoked the person may continue to drive. They may simply have forgotten and need a reminder. Try to be supportive when reminding the person they are no longer allowed to drive. Sympathise with the person and explain it was not your decision. It might be helpful to mention it was the doctor or specialist who has said they cannot drive. Sometimes letting them know how proud you are of them to have made a responsible decision can be reassuring. Remind the person of their options other than driving.
- Hiding car keys or disabling the car in some way should be a last resort. However, if the person is unsafe to drive, has had their licence revoked and still insists on driving it may be necessary.
In this video families describe their journey from noticing first signs of difficulties with driving due to dementia, to having the conversations about giving up, and where they went to for support. It may give you ideas of how to approach the conversation. If you want to jump to the section on ‘starting the conversation’ move to the time stamp of 5:48 in the video.
Talk about alternatives to driving
You may be tempted to ‘co-pilot’ and help the person to drive. This is unsafe and potentially illegal. However, if you are a driver, you could drive and ask them to navigate for you. Below are some alternatives to help you to keep the person you support getting out and about. This may be to reduce some of their driving or stopping altogether.
- Ask family and friends to drive. If the person’s friends or family are going to the same gathering or activity, ask them for a lift. Travelling together can become part of the routine and can cut costs if you share the petrol. Asking a few different people spreads out who you’re getting help from and you get to spend time in the car with different people.
- Encourage the person you support to use services which are easier to get to without driving. For example changing their hairdresser, pharmacy, or exercise class so they can walk there or use public transport. It may be possible for them to go to one place that offers many services, so they only need to take one trip.
- If they use a taxi, suggest they use the same taxi company or even the same driver. They might be able to ask for the same driver when making the booking (either by phone or using the app). It might be possible to make this a regular booking.
- The person you support might be entitled to a free bus pass to use on public transport. They may have access to reduced fares on other transport options in your local area. See section 3 below for options on financial help and transport. If they haven’t taken public transport for a while, or aren’t confident using it alone, offer to practice with them to see if it’s a good option to get to some places.
- Suggest using assisted travel schemes on trains and planes. The person can get help at the station or airport, when traveling and when they reach their destination. Some people use the sunflower lanyard scheme to let people know they have a hidden disability and may need some support with their journey. Find out more about wearing a sunflower lanyard at the Alzheimer’s Society and in Talking about dementia. You can also read Cheryl and David’s story.
- Suggest using services which help with transport (see below)
- Dementia UK offer helpful tips for alternatives to driving.
Financial help and transport
Free bus pass
The person you support may be able apply for a free bus pass in England and Wales when they reach the female state pension age or if they have some disabilities. They must apply to their local council. In Scotland, if the person is over 60 or has a disability they can apply to Transport Scotland. In Northern Ireland the person can apply to NI Direct if they are 60 – 64 plus.
They may be entitled to help getting to and from NHS medical appointments. Ask their doctor for information. There is also information about hospital travel on the NHS website.
There may be voluntary organisations in your area to help the person you support to get out and about. Some national and local organisations provide these services. The Royal Voluntary Service is an example of a national service which provides transport support, however local organisations may also provide transport. For example, local day services and clubs may provide transport to and from their services.
Tell the DVLA and your insurance company
Encourage the person you support to tell the DVLA about their dementia diagnosis straight away.
Contact driving mobility
The person you support may want to find out more about having a driving assessment.
Plan for using alternative transport
Help the person plan how they will get to their usual activities and appointments without driving.
Apply for transport services
Even if you the person is still driving, they may be able to apply for a free bus pass or buy a railcard to give them options.