Dementia patients who drive need close monitoring

Dear Savvy Senior:

Is there a good rule of thumb on when dementia patients should stop driving? My 82-year-old mom has early-stage Alzheimer’s disease but still drives herself around town just fine. — Inquiring Daughter

Dear Inquiring: Most doctors agree that people with moderate to severe dementia should never get behind the wheel, but in the early stages of Alzheimer’s, driving performance should be the determining factor of when to stop driving, not the disease itself.

With that said, it’s also important to realize that as your mom’s driving skills deteriorate over time from the disease, she might not recognize she has a problem. So, it’s important that you work closely with her doctor to monitor her driving and help her stop when it is no longer safe for her to drive. Here are some additional tips that can help you.

Watch for warning signs

The best way to keep tabs on your mom’s driving is to take frequent rides with her watching out for key warning signs. For example: Does she have trouble remembering routes to familiar places? Does she drive at inappropriate speeds, tailgate, drift between lanes or fail to observe traffic signs? Does she react slowly or make poor driving decisions? Also, has your mom had any fender benders or tickets lately, or have you noticed any dents or scrapes on her vehicle? All of these are red flags.

If you need some assessment help, hire a driver rehabilitation specialist who’s trained to evaluate older drivers. See AOTA.org/older- driver or ADED.net to locate one in your area.

Transition tips

Through your assessments, if you believe it’s still safe for your mom to drive, you should start recommending some simple adjustments to ensure her safety, like driving only in daylight and on familiar routes, and avoiding busy roads and bad weather. Also, see whether she will sign an Alzheimer’s “driving contract” (see ALZ.org/driving to print one) that designates someone to tell her when it’s no longer safe to drive.

You might also want to consider getting a GPS car tracking device (like Moto Safety.com or AutoBrain.com) to help you keep an eye on her. These devices will let you track where she’s driving and allow you to set up zones and speed limits that will send you alerts to your smartphone when she exits an area or if she’s driving too fast or braking harshly.

Time to quit

When your mom’s driving gets to the point that she can no longer drive safely, you’ll need to talk to her. It’s actually best to start having these conversations in the early stages of the disease, before she needs to quit driving, so she can prepare herself.

You also need to have a plan for alternative transportation (including a list of family, friends and local transportation options) that will help your mom get around after she stops driving.

For tips on how to talk to your mom, the Hartford Center for Mature Market Excellence offers a helpful guide called “At the Crossroads: Family Conversations About Alzheimer’s Disease, Dementia and Driving” which you can get at TheHartford.com/Publications- on-Aging.

Refuses to quit

If your mom refuses to quit, you have several options. First, suggest a visit to her doctor, who can give her a medical evaluation and prescribe that she stops driving. Older people will often listen to their doctor before they will listen to their own family.

If she still refuses, contact your local Department of Motor Vehicles to see whether they can help. Some states require doctors to report new dementia cases to the DMV, who can revoke the person’s license.

If these fail, consider hiding her keys or just take them away. You could also disable her vehicle by disconnecting the battery, park it in another location so she can’t see it or have access to it, or sell it.

Jim Miller is a contributor to NBC-TV’s “Today” program and author of “The Savvy Senior.” Send your questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070; or visit savvysenior.org.