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Assessments/Older Drivers

Dementia & Driving

Introduction

For anyone experiencing memory loss or diagnosed with dementia, driving does not necessarily have to stop. A proactive approach would be to discuss driving with their general practitioner, and comply with the Medical Fitness to Drive Guidelines.

View/Download RSA ‘Sláinte agus Tiomáint’ >>(PDF format).

Following a GP evaluation, a referral for an on-road assessment may be recommended. For more information see Driving Assessment.

For many people, especially in rural areas, driving is essential to quality of life. Driving represents independence, integrity and confidence. It also provides a means to access necessary services, social interaction with family, friends and community.

The loss of driving privilege impacts on self esteem, can result in isolation, affects a person’s independence and can contribute to other social and health issues.

It is in everyone’s interest to keep a person with dementia mobile through driving for as long as possible, provided they are safe to do so.

When a person with dementia has to stop driving, it can be very challenging for the driver, their family, carer etc. Some people have great difficulty coming to terms with the loss, and everyone manages their stress differently. It is not uncommon to have poor insight into driving difficulties.

Arranging a family conference is helpful when discussing and supporting the driver in adjusting to change. One family member should not have to accept all the responsibility in driving decisions. Also, when a family are in agreement, a person with dementia is more receptive to change.

The following is a guide to help monitor and manage driving for a person experiencing age related memory difficulties, has mild cognitive impairment or diagnosed with dementia.

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Monitoring Driving
The capacity to self assess one’s driving ability may diminish
Create opportunities to travel and observe the driver’s skills
Be aware of increased car damage
Share opinions with family or close friends and remain objective
Avail of opportunities and encourage discussions about driving, with the person
Keep a written record of driving issues

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Limiting Driving
The most effective approach to limit or stop driving involves progressive steps
Driving is best reduced over time rather than all at once, where possible
Encourage the driver to stay on familiar routes and implement some restrictions such as avoiding night driving, long journeys, high speed roads, and complex routes
Try to arrange others to do some of the driving for the person with dementia
Encourage the use of public transport

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Discontinuing Driving
No two families resolve issues identically
Once a person has been advised to stop driving, do not rush in selling the car
Allowing the person with dementia to travel as a passenger in their own car helps ease the transition from driver to passenge
Provided it is safe, allowing the person with dementia to keep car keys, licence and car often helps maintain dignity
Taking away car keys, licence, selling the car should be a last resort and avoided  Such actions are abrupt, extreme and punitive
And most importantly, encourage the person with dementia to maintain their regular social activities

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Warning Signs For Drivers

Confused on how to unlock the car
Confused or forgetting how to start the engine
Confused between the wipers and indicators
Forgetting how to use the interior controls
Incorrect signaling
Forgetting to use the mirrors safely
Incorrect sequencing of the gears affecting the progress of the vehicle
Incorrect use of the accelerator/clutch resulting in high revs, or gears grinding
Forgetting which lane to use on familiar routes
Travelling too close to the kerb or too close to parked vehicles
Driving either too fast or too slow, for the road and/or traffic conditions
Delayed reaction to road or traffic situations ahead
Confused at familiar roundabouts or familiar junctions
Unable to maintain a consistent correct position and drifting over the centre of the road or into other lanes
Failing to notice traffic warning signs or traffic lights
Getting lost in familiar places
Impulsive and not willing to wait at junctions
Increased aggression towards other road users
Stopping in traffic for no reason
Unsure regarding the right of way at familiar junctions
Delayed in deciding when to move off at junctions, despite no approaching vehicles
Bumping kerbs
Increased car damage
Road accidents, two or more in a short time period
Poor attention resulting in late braking, near misses, inconvenience to other road users
Difficulty judging space or distances
Needs instruction from the passengers when making decisions

Be vigilant in your observations and objective in your decisions. Avoid mistaking habitual driving styles with decreasing driving skills.

Arrange opportunities to travel with the driver but be discrete in your observations, as driving errors may increase if one is feeling under scrutiny.

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Legal Requirements

In Ireland, a person diagnosed with a disability, illness or medical condition that may affect their ability to drive safely, require permission from a registered medical practitioner before beginning, returning or continuing to drive. Failure to do so may render their car insurance policy void.

Drivers are also required to report to the Driving Licensing Authority when they become aware of a health condition that may affect their ability to drive safely.
For further information, View/Download RSA ‘Sláinte agus Tiomáint’ >>(PDF format).

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Frequently Asked Questions

Q. If I have a disability, do I need to inform my car insurance company ?
A. Yes. A driver is obliged to inform their car insurance company of any changes in their health that may affect their ability to drive safely.

Q. If I have a disability/illness, will I be charged extra for my car insurance?
A. No. A driver with a disability should not be charged extra, nor refused a quote solely based on their disability.

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