Dementia - when driving is dangerous

Dementia can affect a person’s judgement and ability to drive safely. This may be due to loss of memory, limited concentration or sight problems. When their driving ability is affected, the person with dementia may be a risk to themselves and to others.

A diagnosis of dementia does not always mean that the person is immediately incapable of driving. However, dementia produces a progressive and irreversible loss of mental functioning which can make driving dangerous.

The law in Australia
In all Australian states and territories, except Western Australia, drivers have an obligation to tell their licensing authority of any medical condition that might affect their ability to drive safely. Diabetes, some heart conditions and dementia are all medical conditions that need to be disclosed because of their potential effect on a person’s driving ability.

The licensing authority will generally advise the driver to see a doctor who will assess whether it is safe to keep driving for a period of time. If the doctor determines that dementia is affecting the person’s ability to drive, the licensing authority may place conditions on their licence. These conditions might be that they can only drive close to home, at certain times or below 100km/h.

Regular medical and driving tests may be required as dementia will cause a person’s ability to decline over time.

Individual responses
The aim of caring for someone with dementia is to support their maximum level of independence. For people living alone or in remote areas of the country, it can be especially difficult to manage without driving. Not being able to drive a car can be a threat to the independence of many people. For someone in the early stages of dementia, having to give up driving may seem like giving up altogether and losing control.

While some people will recognise their declining ability, others may not or may simply forget that they can no longer drive. For yet others, it will be a relief to be rid of the responsibility of driving.

Warning signs
To decide whether a person still has the ability to drive safely, consider the following warning signs:

• Vision – can they see things coming straight at them or from the sides?
• Hearing – can they hear the sound of approaching cars, car horns and sirens?
• Reaction time – can they turn, stop or speed up their car quickly?
• Problem solving – do they become upset and confused when more than one thing happens at the same time?
• Coordination – have they become clumsy and started to walk differently because their coordination is affected?
• Alertness – are they aware of and understand what is happening around them?
• Left and right – can they tell the difference?
• Confusion – do they become confused on familiar routes?
• Stop and go – do they understand the difference between stop and go traffic lights?
• Route finding – can they read a road map and follow detour routes?
• Steering – are they able to stay in the correct lane?
• Mood – has their mood changed when driving? Some previously calm drivers may become aggressive or angry.

• Talk about the problems openly with the driver concerned. Look for ways to help them make the decision to stop driving.
• The person may not understand why they can’t drive. It may help to empathise with the feelings of loss but respond with the same short message – the doctor believes it is safer not to drive.
• It may be best to avoid trying to have a rational discussion or argument about the issue.
• A letter from the doctor or licensing authority may help the person accept the decision.
• Try to support past routines with new forms of transport.
• Contact local councils about their transport services – community buses and transport for appointments are sometimes available.
• For older drivers, the road transport and traffic authority in each state and territory have a number of publications about driving. These are usually free.
• Arrange outings that do not require the person with dementia to drive.
• Suggest good reasons for using public transport or having someone else drive, such as it being less stressful, being able to enjoy scenery and saving on the cost of running a car.

• Your doctor
• Your local community health service
• National Dementia Helpline Tel. 1800 100 500
• Dementia Behaviour Management Advisory Service (DBMAS) Tel. 1800 699 799 – for 24-hour telephone advice for carers and care workers
• Carer Respite Centre Tel. 1800 059 059
• Carer Resource Centres Tel. 1800 242 636
• Aged Care Assessment Services – contact your regional Department of Human Services office
• Aged Care Information Line Tel. 1800 500 853
• VicRoads Tel. 131 171

• People with dementia may be a risk to themselves and to others on the road.
• Dealing with the issue of driving can be difficult for some people with dementia and their carers.
• Some people with dementia may not recognise their declining ability to drive.

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