When Should Caregivers Take the Keys During Alzheimer's Disease?

Alzheimer’s disease comes with a host of challenges for the individual with the diagnosis and their caregivers. Over time, the disease will affect the individual’s ability to do many activities in his or her life, but driving can be one of the more difficult ones to determine.

Driving represents independence for many people, and losing this autonomy can be upsetting. However, driving can be dangerous to your loved one and other people on the road as Alzheimer’s disease progresses.

So, who decides when it’s time to throw in the towel (or keys)? Usually, it’s the caregiver or other loved ones of the individual with Alzheimer’s disease, but studies have shown that doctors can also hold much clout in this decision. One study published in the new England Journal of Medicine found that when doctors warn patients and tell driving authorities that seniors may be medically unfit to be behind the wheel, there was a serious drop in serious crash injuries among the drivers.

Some states have rules and regulations that require doctors to report drivers who have health conditions that could affect their driving abilities, but others depend on family members and healthcare professionals to urge drivers privately, The Associated Press reports. If you are worried about your loved one’s driving ability because of Alzheimer’s disease, it is your responsibility to talk about it with them.

How to know when it’s time for the talk

It is not always clear that your loved one is unable to drive. However, careful observation can be helpful in determining when the senior becomes a risk to him or herself and others. Warning signs include forgetting how to get to familiar places, failure to observe traffic signs, driving too fast or too slow, hitting curbs and other objects, making errors at intersections and confusing the brake and gas pedals, according to the Alzheimer’s Association. If your loved one forgets the location they are driving to during the trip or comes home from a familiar drive later than usual, these may also be warning signs.

Harvard Medical School conducted a study in 2009 that looked at 128 drivers, 84 seniors with early Alzheimer’s disease and 44 healthy older adults. Through driving tests of all participants, researchers found that people with the early stages of Alzheimer’s disease became unsafe drivers about twice as fast as their healthy counterparts. The study found that while people with Alzheimer’s disease can continue to drive safely for some time, it is important for family members and caregivers to regularly assess them.

How to broach the topic

Bringing up the topic of driving can be tricky, but it’s best to do it as early as possible, according to Harvard Medical School. As soon as you get a diagnosis, bring up driving. This can help because your concern can be grouped in with other aspects of care that need to be discussed anyway.

The Alzheimer’s Association recommends caregivers and other loved ones initiate the dialogue by expressing concerns and stressing the positives about the situation. It can also help to appeal to the individual’s sense of responsibility as well as medical diagnoses. Caregivers should offer alternatives and reaffirm their support and love, offering to help with any challenges this situation could present.

How to handle resistance

Some seniors will agree with you and willingly give up the keys, but others may be a bit more resistant. The organization recommends being patient and empathetic, but still firm. Caregivers should continue to appeal to the individual’s desire to make the responsible choice.

If need be, bring in a third party – whether another family member, doctor, attorney or religious leader to reaffirm your authority and the message you are trying to get across.