Dilemma with Alzheimer's Diagnosis and Driving

Changing the routine or environment for a senior with Alzheimer's/dementia is very difficult and increases the confusion.  

Seniors become more stubborn and set in their ways, and will fight with their children about the things that you observe that they probably shouldn’t be doing.

So your loved one has some cognitive decline but their doctor has not made a definitive diagnosis as of yet.  Mom is telling you from time to time about how she lost the car at the mall and couldn’t remember where she parked, or how it took her an hour to remember where she put the keys, or the best one is how she was planning to go to a destination and ended up at a totally different location.  You are only imagining how she is performing the skills of stop signs and traffic lights.  The doctor has been watching the changes and has ordered the tests necessary to make the diagnosis.  So the family has some discussions and decides that maybe it’s time for mom to stop driving her vehicle.  Well, the first approach is always having a gentle conversation regarding this issue which results in mom not even understanding what outcome you are trying to achieve.  The next discussion will have to be more direct but results in anger and mom being very upset refusing to give you the car keys.  She says “I am just fine and have no problems with driving, and you are not taking my keys away!” Every sibling has tried all approaches possible without good results.  It is the nature of the beast to think it is a personal attack against them, and that all the children want them to be just miserable….So if you can give the job to someone else the outcome may be totally different. I would like to give you a solution that may help.

You have already talked to the doctor about this issue and the doctor agrees and will speak to mom during the follow up visit.  Now the doctor who she trusts and loves speaks about the possibility of giving up driving.  The diagnosis has been made and documented in the medical record. The doctor will order a driving evaluation to be done with an occupational therapist and explains to mom that her driving will be evaluated for safety, and the results will be documented in her medical record and sent over to the doctor.  This takes the decision off the children and the doctor, and mom no longer feels like it’s a personal attack.

The test can be scheduled with an occupational therapist who evaluates driving abilities.   The therapist will assess the complex activity of driving which requires the driver to use multiple cognitive and sensory skills, and will make the recommendation to the doctor with results.   Once the doctor discusses with the patient, it is easier because the decision comes from someone else.  The doctor will then document it in the medical record and report it to the motor vehicle department.