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Dementia and Driving

What is dementia?

Dementia is the progressive impairment of brain function. It usually first appears as forgetfulness, then decreased problem-solving and language skills. Difficulty with ordinary daily activities often follows, then severe memory loss and disorientation.

 What is Alzheimers Disease ?

The most common form of dementia is Alzheimers Disease. Alzheimers is a disorder affecting the function of the brain. A person can appear fully alert and awake, but their memory and judgement are impaired. With Alzheimers, recent memory goes first. People tend to forget events rather than details. While we may say "Who did I sit next to at the wedding?", a person wtih Alzheimers will ask "What wedding?" No single feature distinguishes Alzheimers Disease: the total picture determines whether or not a person has Alzheimers.

 What if someone close to me may have dementia?
  If someone you know may or does have dementia, but continues to drive, discuss your fears with them.
It is important to raise the issue early, while an individual still has sufficient reasoning ability to make decisions about their driving future, such as selling their vehicle. Sometimes people with dementia will recognise their own limits and accept that they are putting themselves and others at risk. Give the person a chance to make the decision to stop driving.
There may be a reluctance to do this, possibly because the person is unable to understand fully his or her loss of skills. This reluctance can be a worry for caregivers because unsafe drivers put themselves and others at risk.
This problem must not be ignored, even if the person is only travelling to the shops and back. It may be necessary to enlist the help of the family to ensure the person does not drive.

  What are the skills needed to drive safely?

These are the skills a person must have to drive safely :
Good vision in front and out of the corners of the eyes;
Quick reactions - to be able to brake or turn to avoid crashes;
Good co-ordination between eyes, hands and legs;
The ability to make decisions quickly; the ability to make judgements about what is happening on the road.

 What are the signs of dementia?
  Warning signs
A person with early signs of dementia may show the following decline in driving skills:
Driving too slowly - this does not mean, however, that all slow drivers have dementia;
Confusion when stopping and changing lanes;
Becoming lost on a route which would not previously have confused the person;
Ignoring traffic lights and signs - confusing the colour or order of the lights or failing to notice traffic lights, stop signs or give way signs;
Judgment - not being able to make sound judgments about what is happening on the road;
Condition of vehicle - having small scrapes may indicate unsafe driving, i.e. the car hitting the side of a garage or gateway and the driver misjudging widths and distances in driveways.

 What is the effect of alcohol and some medication?
  These can alter the driving ability and reaction time of a person with dementia. This combination is dangerous and it is your duty to take action.
It is important to remember that many driving skills are automatic. A confused person may appear to be driving well when relying on habitual responses. The older driver test, therefore, may not pick up problems due to memory loss or confusion, particularly if the test is on familiar ground.
A person with dementia may have difficulties when they have to respond to an unexpected problem on the road.

  What is a memory test ?
  If you suspect a person may be showing signs of dementia give them this simple test on common traffic signs.
Ask "What does the sign mean?" and "What action should the driver take?
Suggested answers
Uncontrolled T intersection ahead: slow down, indicate a left or
right turn and apply the give way rules.
Sharp bend ahead to the right: slow down, keep left and do not cut the corner.
Pedestrian crossing ahead: slow down, look for pedestrians crossing on the road and stop if you have to.
Roundabout ahead: choose correct position for left turn, right turn or going straight through. Slow down and apply the give way rules. Indicate if you have to.
Road narrows: slow down, scan the road ahead for on-coming traffic and keep well to the left.
Railway crossing ahead: slow down, look for trains and stop if you have to.

A person who has trouble with this test or requires a long time to give an answer may need your help to seek medical advice.