3.5 Dealing with driving

Driving skills are affected when you have dementia.

For many people, driving is an important part of their life. Driving is part of being independent as well as a way of getting to places. Some people like the activity of driving, such as a Sunday afternoon drive, or going for a drive to blow off steam.  

In order to drive safely, you need quick reaction times, coordination, and problem-solving skills. These skills deteriorate in all of us as we age, but more so in people with dementia. When people are told they have dementia, they often worry about whether they will be allowed to drive, or whether they should still drive. Click here to open a PDF checklist of driving concerns.

People with dementia can continue to drive, after passing an assessment

People who are diagnosed with mild stage dementia do not automatically lose their license. In some Canadian provinces and territories, you are legally obligated to tell the driver’s licencing authority (e.g., Department of Public Safety, Motor Vehicle or the provincial Ministry of Transportation) about medical conditions that may affect your ability to drive, including dementia or mini strokes. Your doctor is required by law to report to the provincial authorities any medical conditions, including dementia, that impact your ability to drive safely. 

• If your doctor is concerned about your ability to drive, they will complete a medical form which is sent to the provincial or territorial authorities.
• Your doctor may ask that you not drive until assessed by the licensing authority. To provide an assessment of your ability to drive, the licensing authority may also request an on-road driving assessment.
• In some provinces, a Fitness to Drive assessment is suggested which includes both an on- and off-road assessment conducted by a private occupational therapist.
• The cost of the assessment varies. If your licensing authority doesn’t think you are safe to drive, then you may find your licence revoked.  

Depending on which province or territory you live in, if you pass the on-road assessment, you may be given a conditional driver’s licence, usually lasting 6-12 months. This licence may have some conditions such as only driving during the day, within your local area, or under a certain speed. 

A dementia diagnosis may affect your car insurance.  Tell your insurance provider you have dementia, as the policy may be void if you don’t provide this information. Your insurance premiums may increase because you have a diagnosis of dementia.   

Some people with dementia decide to stop driving

Even when they are allowed to continue driving, some people with dementia decide to stop. They may worry about causing an accident, getting lost, or have less confidence in their driving skills. Some people stop driving at the request of their family. 

If you are unsure about whether you should keep driving, you can use this helpful decision aid. It’s a booklet which helps people with dementia work through their decisions and weigh the pros and cons of continuing to drive. 

Prepare for the transition from driving to not driving

Planning ahead can help you to prepare mentally and practically for when you are no longer able to drive. This will enable you to keep going out, socializing, and doing things you enjoy when you stop driving.  Together with a trusted care partner, review the ‘At The Crossroads’ Booklet. This booklet explains how to consider a balance of a driver’s safety and independence, how to have discussions and agreements about when to stop driving and how to develop a plan for after you stop driving. You can also review this resource from the Alzheimer’s Society of Canada. 

• Some people stop driving gradually. You might start by limiting you’re driving to places you go to regularly, only driving during the day, and/or only driving when traffic is not busy.
• Reduce distractions when driving by turning off the radio and not having pets in the car.
• You might use other transportation options (see below). Over time, you may reduce the distance and places you drive to (e.g., only to the store, or to a friend’s home).  Getting used to other means of transportation options can make this transition easier.   

Have an open and honest conversation about driving with someone your trust. Write a letter of agreement stating when the times comes that you are no longer safe to drive that you will stop driving. Include a list of activities which are priorities for you to attend along with a few options for getting there. Sign and date the letter and share it with others. 

Some people are told to stop driving   

Some people with dementia do not make the decision to stop driving themselves.   

Sometimes the doctor’s judgement about medical issues dictates that the person should not drive. Please note that doctors can be legally liable if they don’t act. Sometimes the person fails their on-road driving test. Sometimes family members stop the person from driving, or take away the car keys.  

Some people with dementia feel angry or sad when they are no longer allowed to drive. They feel frustrated or upset at the loss of their licence, their independence, and control. These feelings are understandable. It is very unlikely you’ll be allowed to drive again. Some people have told us they only ask family members for drives to ‘important’ appointments such as medical or financial appointments, but not to activities for fitness or socializing.

It is important that you continue going to activities you enjoy and visiting the people you love to see. Feeling isolated may lead to depression, so stay connected with others. 

There are, however, other transportation options so you can keep going out and doing the things you enjoy.