Dementia and Driving Safety - DementiaHub.SG

Dementia and Driving Safety

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Driving can represent independence and freedom for a person. One of the first concerns caregivers have when a loved one is diagnosed with dementia is whether or not he or she should drive.

While it may seem like an easy and automatic activity for frequent drivers, safe driving is a complex task which requires a range of cognitive abilities,1-4 such as:

• Attention and concentration:
To focus on and switch between different driving tasks while ‘reading’ the road;

Visuospatial skills:
To keep to the right speed, distance and road position;

Problem-solving skills:
To deal with any incidents and challenges on the road, such diversions or obstacles;

Judgement and decision-making:
For example, to understand and prepare for the behaviours of other drivers;

Fast reaction time and skills:
For example, to act quickly to avoid an accident; and

Memory:
For example, to remember a route.3,4

When Should A Person Stop Driving?

A dementia diagnosis does not always mean a person has to stop driving immediately. Some individuals in the early stages of dementia or who have mild cognitive impairment (MCI) still drive.5

However, dementia is a progressive condition that affects a person’s cognitive functions. It can thus gradually affect your ability to drive safely, compromising the safety of yourself and others. When you and the people around you notice more signs of unsafe driving, driving is no longer an option and you must stop.

Signs of Unsafe Driving

1. Getting lost when on familiar routes to places you know well

2. Not staying in the lane (drift between lanes)

3. Confusing the brake and gas pedals

4. Failing to observe traffic signs

5. Making slow or poor decisions in traffic

6. Hitting curbs or rounding a bend

7. Road hogging or speeding

8. Becoming angry or confused easily and frequently while on the road

9. Being involved in minor accidents or near-misses

10. Getting more traffic fines

Deciding to stop driving is a difficult decision, but it does not mean the end of your independence and freedom.

For your own safety and that of others on the road, it is important for you to be honest and open about your condition to your doctor and loved ones. Do not withhold information from your doctor to keep your license since this may put both you and others at risk.1

Look for Alternative Transportation Options

Devise a New, Safe Driving Arrangement

If you are still able to drive, speak with your loved ones and doctor to come up with a new driving arrangement that will allow you to drive safely on the road.

Driving after a diagnosis
Source: Alzheimer’s WA

This video showcases the journey in which Tom, who is living with dementia, and his family have gone through in coming up with a new driving arrangement that still allows him to drive independently, whilst ensuring his safety and that of others on the road.

Swap Roles - Sit in the Passenger Seat

Here is an example of how a caregiver in Singapore worked together with her loved one living with dementia to make the transition from driver seat to passenger seat a more tolerable one:

Steven & Lai Quen's Story

Lai Quen is the primary caregiver to her husband, Steven, who was diagnosed with young-onset dementia at 58. In the mild stage of his dementia, Steven was still able to drive independently and safely after his diagnosis. However, when he was 64, Lai Quen noticed a significant change in his spatial awareness and mood while driving and parking the car. Even in instances when Lai Quen was in the driver seat, she had noticed that Steven’s instructions, such as ones to avoid drivers who were driving supposedly too near the car, did not seem to tally with what was actually happening on the road. This led Lai Quen to the decision that it was better for Steven to stop driving altogether. This decision was later validated by his doctor as well.

The transition from being in the driver seat to the passenger seat was an arduous one for both of them. Steven was frustrated because he could no longer perform a task he used to be able to do all the time. Concurrently, Lai Quen was stressed because she had to manage his frustrations and figure out creative ways to get in the driver seat before he did. After a period of 6 months, Steven has come to accept his new permanent role as passenger.

Now, this what the arrangement looks like:

• When Lai Quen is available, she drives Steven around. A natural conversationalist, Steven will inform her of specific landmarks to look out for as he is still rather familiar with his routes. Lai Quen encourages this as his memory of landmarks and areas around Singapore is still intact.

• However, he has the habit of giving her a series of instructions to follow while she is driving. To combat this, Lai Quen acknowledges that she hears him, will heed some of his instructions if relevant, or engage him in conversation about their surroundings.

All in all, she tries her best to involve Steven in the process of getting from one place to another, even though she holds the car keys.

Public Transport

Fortunately, Singapore’s public transport system is amongst the best in the world. You can easily get around Singapore by various modes of transport – by taxi, private-hire car, MRT, and/or bus.

To help with your transition, you can begin taking public transport more often while you are still capable of driving. For example, you can take the public transport to your neighbourhood to buy your groceries, to a community centre, or to the shopping centre.

Read: Practical Tips on Taking Public Transport for persons living with dementia.

GrabAssist

GrabAssist is a transport option by the company Grab that offers additional assistance to seniors and persons with disabilities.

Drivers under this transport option are trained to assist passengers with mobility disabilities. For example, they are able to assist with safely transferring a person from a wheelchair to the car seat.

In addition, GrabAssist Plus is another transport option by Grab, available daily from 8am-8pm. Under this option, passengers can travel without dismounting from their wheelchairs, as vehicles in this option are equipped with ramp access. Users may access this service by clicking on the ‘Value-Added’ Tab when booking a trip on the Grab app.

References

  1. UBC eHealth Strategy Office. (2011). Getting to know dementia: A patient’s guide to diagnosis, treatment, and care. https://www.fraserhealth.ca/-/media/Project/FraserHealth/FraserHealth/Health-Topics/Mental-Health-Substance-Use/Getting_to_know_dementia_a_patient_guide_to_diagnosis_treatment_and_care.pdf?la=en&hash=11C5366B58CAB0628DC4979E9E91976F1EBBF615
  2. Dementia Australia. (n.d.). Dementia and driving. https://www.dementia.org.au/resources/dementia-and-driving
  3. Alzheimer’s Society. (n.d.). Driving and Dementia. https://www.alzheimers.org.uk/get-support/staying-independent/driving-dementia
  4. Alzheimer’s Society. (2020). Driving and dementia. https://www.alzheimers.org.uk/sites/default/files/2018-10/439LP%20Driving%20and%20dementia.pdf
  5. Alzheimer Scotland. (2016). Driving and dementia. https://www.eddn.org.uk/wp-content/uploads/2018/01/Driving-and-Dementia.pdf
  6. Mayo Clinic. (2019, July 3). Alzheimer’s and dementia: When to stop driving. https://newsnetwork.mayoclinic.org/discussion/alzheimers-and-dementia-when-to-stop-driving/.
  7. Alzheimer’s Association. (n.d.). Dementia and driving. https://www.alz.org/help-support/caregiving/safety/dementia-driving
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