Dementia and Driving: Practical Steps for Handling Driver’s Licenses and Car Keys

Aug 6

Navigating tough conversations with a loved one who has dementia, especially regarding taking away a drivers license, which is so linked emotionally to one’s independence, requires sensitivity, patience, and careful planning.

Some topics are better to address between you and your loved one, and other topics might be best left to a professional in case there is residual anger associated with the “loss”. In that way it is not directed at you and you are able to remain “on their side” in the eyes of your loved one. Only you know your loved one best and can determine which strategy(s) will be most effective.

Trust your gut! These are such emotional triggers in your relationship with your loved one. You feel awful because you know how important this step is for your loved one. You are doing the right thing to protect them!

With all of that in mind, here are some strategies to help you approach this challenging topic, with a recognition that these can help you address most sensitive topics:

Prepare for the Conversation

Choose the right time and place: Select a quiet, familiar setting where your loved one feels comfortable.
Educate yourself: Research dementia and its effects on driving to better understand the risks and concerns. As you gather information, think about what will resonate best with your loved one.
Gather resources: Compile information on alternative transportation options and support services before the conversation. For example Uber, Lyft, or other adult transport van services might exist in your loved one’s community. And for as long as they are able to navigate using these on their own, or with your help, they enable your loved one as much freedom as possible. Maybe they live in a 55+ or retirement community that provides public transportation (e.g. a bus) that you can help them learn how to use. Friends or fellow worshipers might be willing to take on a weekly outing.
Determine who to include at what stage in the conversation based on what might be most comforting and meaningful to your loved one (e.g. trusted family member, doctor, friend)

During the Conversation

Start with open communication: Use phrases like "I have something I want to talk about that is hard for me to bring up" to break the tension.
Use simple, clear language: Speak slowly and clearly, using short sentences, simple words (monosyllabic where possible) and avoid complex concepts.
Be an active listener: Give your loved one time to express themselves without interruption. And it is so important to validate their feelings. Acknowledge how difficult this topic must be for them. They have been driving for a long time and especially as an American, your car is very tied to your sense of independence. So it is not only the ability to drive by the symbol of what you are losing that your loved one is facing.
Avoid confrontation: Instead of arguing or correcting, focus on their emotions and redirect the conversation gently.
Discuss safety concerns: Explain that driving with dementia is similar to driving while impaired, affecting reaction time and increasing the risk of disorientation.
Present reasonable alternatives: Consider a driving evaluation; if they pass then they are ok to continue driving. Or offer to research transportation options together or explore ways to maintain independence without driving.

Strategies for Difficult Situations

Involve healthcare professionals: Ask the doctor to explain the need to stop driving, which can add credibility to your concerns.
Consider a driving evaluation: Suggest a professional assessment to objectively determine driving ability.
Use analogies: Compare driving with dementia to other situations where safety is paramount, such as not allowing a child to drive.
Discuss legal and financial implications: Mention that continuing to drive with dementia may result in insurance not covering damages in case of an accident. Or worse, if they get into an accident they could harm someone else.
Remember, this conversation may need to happen multiple times. Be patient, empathetic, and focus on maintaining your loved one's dignity throughout the process. Remember that you are ensuring your loved one's safety and well-being (and that of others).

I ended up asking my mom’s primary care physician (a geriatrician) to be the one who “took away” my mom’s drivers license. My mom saw hers as such an integral part of her independence; it was a symbol of her coveted freedom. It was pure self-preservation on my part, so my mom didn’t get mad at me and hold it against me for the rest of her life.

That only sort of worked. My mom was stubborn and didn’t believe me or her doctor. She had been on her own since I was seven. She had never remarried and was FIERCELY independent. So before I could get to the “why” she had to give it up, we needed to first “prove” that she couldn’t physically drive. So we went this route, at her request. She studied for hours, was determined to pass, and she failed. It drove home the point - but it did a lot to impact her psychologically and I wish I could have avoided that. She became very depressed.

Ultimately what resonated with my mom was the “why” (could harm others). And later, when she would ask about where her car was, I would gently tell her that she decided to stop driving because she didn’t want to put anyone else at risk. That seemed to calm her down again. It had been “her decision” and the reasoning was easy to understand. But the path to get there was bumpy and painful.

💡In a recent conversation with a friend, she and her family took an interesting approach to solving this problem. Rather than the combative route my mom took, or having the conversation over and over about why they can’t drive, having to take the car away (traumatic), removing THE KEYS to independence (equally traumatic) … they didn’t. Instead, the car was disabled (The movie The Sound of Music comes to mind: the Nuns removed the distributor cap and spark plug wires). So their mother kept her keys - in her purse. When she wanted to go somewhere, she would go out to her car and try to start it; and it wouldn’t work. So then her children promised to get it fixed for her. Mom didn’t remember that it had happened before and so wasn’t bothered by this cycle of events. What she did get to retain was a feeling of independence and control over her keys. Genius! I wish I had thought of doing that!

You're not alone in this journey. Together, we can face the challenges of dementia with compassion, understanding, and hope. Glya Health was started with a commitment to being a “friend in your pocket”, for the duration of this journey. We are honored to share it with you.

In solidarity,