Ask Dr. K: Drivers with Alzheimer’s don’t belong on road

DEAR DOCTOR K: My father has Alzheimer’s disease. Is it unsafe for him to drive?

DEAR READER:

The automobile has become a part of who we are in the United States. It gives us a sense of independence and the means to go nearly anywhere. Also, in many cities, public transportation is not nearly good enough to substitute for an automobile. To lose the freedom to drive and to become dependent on taxis, buses or subways, is for many people a sad thing to contemplate.

But when you drive a car, you control more than a ton of steel moving at high speed.

Safe driving requires a complex interaction of eyes, brain and muscles. It also requires the ability to respond quickly to unexpected circumstances. One study found that the driving skills of people with even mild Alzheimer’s were significantly poorer than those of other elderly people, including those with some other forms of dementia.

Your father’s general behavior in nondriving situations can give you some clues as to whether safety is likely to be an issue. For example, if your father exhibits poor judgment, inattentiveness to what’s going on around him, clumsiness, and slow or inappropriate reactions, then those are clear signs that he should not drive.

If you feel that it is time for your father to stop driving, some experts would suggest that you try simply taking away his keys. If his dementia is substantial, after a period of confusion about where the keys are, he may simply forget about them.

Try to preserve his self-esteem. Some people agree to stop driving for reasons other than concern about their competency. For example, you might tell your father that his car needs repair, or that the license or registration has expired.

Getting objective feedback from an impartial person can help. Some people with AD will accept a written prescription from a doctor that says, “Do not drive.” If that doesn’t convince him, then his doctor may be able to have his driver’s license suspended with a written statement. If nothing else works, you may have to sell the car.