Drivers with dementia become a risk on the road. Even in the early stages of dementia, those affected no longer react as quickly as they used to and can no longer judge distances and speeds correctly. “Personally, I would definitely advise a dementia sufferer against continuing to get behind the wheel of the car himself,” explains Dr. Horst Christian Vollmar from the Medical Knowledge Network at Witten/Herdecke University.
The more severe the dementia, the higher the risk of accidents
The risk of accidents increases with the duration and severity of dementia. Assessing the patient’s fitness to drive is therefore a responsible task for the physician providing care. However, convincing the patient not to drive the car himself in the future is not easy. “Most of the time, neither the affected person nor the relatives raise the issue of their own accord,” says Vollmar, a general practitioner. For many older people, giving up driving means a considerable loss of independence and self-esteem.
Problems driving with dementia
This is often accompanied by considerable practical problems for those affected: if the supermarket is not around the corner and cannot be reached by public transport, if the children live further away or friends meet in the neighboring town in the evening for leisure activities, shopping and participation in social life are difficult to organize.
“Especially in older couples, often only the husband has a driver’s license. If he is ill, often even the wife does not want to admit that her husband can now no longer provide a driving service,” says Vollmar. In most cases, it is also very difficult for the doctor to realistically assess whether a patient is still fit to drive.
However, a few targeted questions can help. For example, the physician should clarify together with the patient and the relatives whether the patient has recently lost his way more often, whether he has had more accidents or “near-accidents” or whether he has more often had technical difficulties with the vehicle.
If the patient loses orientation and appears significantly impaired in his reactions, he is clearly no longer fit to drive. “The doctor should first appeal to his patient’s insight,” advises Vollmar. It often makes sense to offer further assistance, he says, such as pointing out that dementia patients are entitled to recognition as severely disabled.
Notification to the road traffic office
If a patient is clearly no longer able to drive and poses a risk on the road, he or she must give up driving. This is the law. In extreme cases, a report must be made to the DMV. “Because of medical confidentiality, it is always better if relatives take over this task,” advises Vollmar.
In unclear cases, the public health officer or a special traffic medicine department can be called in. There, the patient can have an official test performed to determine whether he or she is still fit to drive. As a rule, however, he must bear the costs of these tests himself.
