driving with dementia

DUI of Dementia

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Fatal crash restarts conversation on aging drivers | Local News | The Seattle Times.

When is it okay to drive while impaired?

NEVER.

And yet many drivers that are cognitively impaired are doing just that.  Justin Runquist’s Seattle Times article, attached above, addresses the wave of aging drivers that has swept onto our roads.  I’ll be the first to admit that dementia isn’t always the impairment associated with aging drivers.  Sometimes medication side effects and/or slower response times – even without Alzheimer’s or dementia – can be the cause of accidents that can harm the driver, and anyone in his or her path.

In this article, however, I address the type of DUI that does involve dementia.  As I mentioned in my two part series: Driving under the influence of dementia and Part 2 of that article, there are far too many news reports covering the risks of impaired driving – many of which end in disaster.

My dad (circa 1980's) gave up his car keys shortly before being diagnosed with Alzheimer's.
My dad (circa 1980’s) gave up his car keys shortly before being diagnosed with Alzheimer’s.

How can we possibly take comfort in denying that either ourselves or our loved ones should no longer get behind the wheel?  This type of denial is dangerous but it is possible to get around the difficulties associated with this subject without alienating yourself or others.

In my article: Driving with dementia: the dangers of denial I offer a few suggestions on how to take the keys away – or give up ones own keys – before someone else gets hurt.

For those of you who are still driving and who have considered even once that you shouldn’t be doing so – please read all the articles attached within this blog entry and then decide if you still feel comfortable driving a weapon that might kill you, or someone in your path.  And for you adult children who have felt the same uncomfortableness surrounding your own parents’ driving skills – take heed and act before it’s too late.

Driving under the influence of dementia

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It’s the not-so-new DUI that is becoming as rampant as are the increased incidences of Alzheimer’s disease in the world.

danger-147333_640Are you enabling someone in your family by not having the difficult, yet necessary, conversation about driving safety?  “She only uses the car to drive to the grocery store, eight blocks away.”  Oh, is that all?  Well then, nothing could possibly happen that might harm/kill her or harm/kill another innocent driver or pedestrian, or child on his bicycle zooming out of a driveway and into the street.  Right?

In the attached article, Driving with dementia: the dangers of denial,  I go into detail about the hazards inherent with driving under the influence of dementia, so I won’t repeat its content here, but I encourage you to take the time to give it a look-see.  I’m readdressing this issue because of what I witnessed today:

  • A car making an unsafe switch of lanes, barely missing the huge SUV in front of which she maneuvered her car;
  • Then I witnessed this SUV – certainly not understanding the circumstances surrounding this affront to his driving – quickly passing the woman and doing the same to her as had been done to him – abruptly changing back into her lane with nary a few inches to spare between his back bumper and her front bumper;
  • Now I’m behind the impaired driver who stops suddenly at an intersection (we have the green) and she puts her left hand turning indicator on, only she’s not in the left hand turn lane – she’s in the through lane and she’s risking a multiple-car pileup by her actions.  I could not move to the left or right to avoid her so I laid on the horn and fortunately, she proceeded straight ahead, not making her left turn;
  • Further down the road she managed to get into the left-hand turn lane and as I passed her, I clearly saw an impaired and confused woman in her 70’s who appeared unaware of where she was or where she was going.

I was in no position to follow her to assure that she was okay, but I did throw up a prayer that she would get safely to where she needed to be – without harm to anyone else as well – and that her family or someone close to her would do what was necessary to take away her car keys.

Denial about this issue doesn’t solve anything.  Please make the decision today to remove the keys from a person who absolutely should not be driving because of his or her dementia.

You just may save someone’s life.

Too old to drive? Tips for families of elderly drivers

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Too old to drive? Tips for families of elderly drivers.

My oh, my – such a difficult subject to broach with a family member when you know that he should put down the car keys and let others do the driving for him.  The article linked above from NBC Nightly News is a good source of tips on how to handle this very familiar problem.  I address this issue in my article: Driving with dementia: the dangers of denial.  Although dementia is usually one of the most talked about reasons for taking away someone’s car keys, there are other reasons that are just as important that must not be ignored:

  • Age-related slow reaction times;
  • Medications that might cause dizziness and/or slow reaction time; and
  • Impaired eyesight and hearing.

Not wanting to hurt a loved one’s feelings should not be the reason to avoid this subject matter.  Let’s face it, your loved one’s safety and the safety of absolutely everyone else is at stake here.  There are already so many dangers on the road with drivers talking or texting on their cellphones, driving under the influence of alcohol or drugs, doing any number of distracting functions such as eating, personal grooming, changing a tune on your I-Pod, or being distracted by children or dogs in the back seat.  Now add someone who is impaired by age or cognitive disease and the risks to others increases greatly.

If you or a loved one are facing this important and difficult step, please read the attached NBC article linked above and also take the time to look at my article, Driving with dementia: the dangers of denial  that provides encouragement for how you might take care of this very important matter of safety.

Driving and Dementia: is it a safe combination?

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Driving and Dementia.

The linked article, above, from a fellow Blogger is very much worth the read as it’s just one of many stories occurring around the world when loved ones – whether because of dementia or just advancing age – face the decision of whether or not to put down the keys to a vehicle that can cause untold damage to the driver, and all those in his or her path.

In my article, Driving with Dementia: the dangers of denial, linked here, I address this dilemma that many families encounter.  I hope both of these articles provide you with helpful information so that you are able to make informed decisions centered around the dangers of driving with an age or disease-related impairment.

Driving with dementia: the dangers of denial.

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As family members, we are desperate to believe that dad’s driving is absolutely fine.  We try to convince ourselves that even with dementia, dad presents no hazard to himself or others and we even trick ourselves into believing it.  When a precipitating, oftentimes, climactic event occurs, our best-case-scenario dream becomes a nightmare.

My family was one of the lucky ones – those in the very small minority whose loved ones come to their own decision to retire their automobile keys.  My dad decided that he wasn’t comfortable driving anymore and stopped driving cold turkey.  Boy did we dodge a bullet!  I know, however, that more often than not- male or female – your loved one will be very resistant to any suggestion that their driving experience come to an end.  And it’s not always a case of dementia causing the questionable driving behavior.  Declining hearing and/or vision, combined with slow response times, can render just about anyone a hazard to humanity behind the wheel.

Be supportive, not argumentative.

Whatever you do, acknowledge that this function of your loved one’s life equates to independence – going wherever you please, whenever you please.  Imagine being told that you have to give up that freedom.  How would you feel?  Very carefully consider what steps will be most successful in addressing this issue with your loved one.

  • Make serious efforts to preserve the dignity and pride of the person while protecting the safety of that person and others;
  • Involve your loved one in the discussion; by doing so you emphasize that person’s ability to be a part of the solution which might bring about a more successful outcome;
  • Be realistic and honest with yourselves.  Don’t take comfort in the fact that the person with dementia “only drives to the store and back” or “only drives in her immediate residential area.”  Many accidents occur during the shortest and most mundane trips;
  • If you’re the primary point person for your loved one, enlist the help of other family members and friends, and/or a respected professional – such as a doctor or lawyer – to support you in your efforts.

What does the law have to say on the matter?

Just about every state in the Nation has driving restrictions for those who exhibit questionable driving aptitude.  I’m about to provide some links to laws that are applicable in the State of Washington but I’m certain that similar statutes exist in most states.  In Washington Sate, the Revised Code of Washington, RCW 46.20.207 states that the Department of Licensing can cancel any license wherein the driver is not competent to operate a motor vehicle under RCW 46.20.031 which addresses a person’s inability to safely operate a vehicle due to physical or mental disability or disease.  RCW 46.20.305 further details the reexamination process for those who fall within this category.  This is not a laughing matter to be sure.  Not only is your loved one at risk, but everyone within sight of his vehicle is unknowingly being subjected to your loved one’s dangerous driving.  Imagine how you will feel if an innocent person dies or becomes disabled as a result of your family member’s driving.  And there are liability issues to consider.

Who shares liability in these types of circumstances?

The Western and Central Washington State Chapter of the Alzheimer’s Association has much to say on this matter.  You can request and receive, free of charge, their booklet, At the Crossroads: Family Conversations about Alzheimer’s Disease, Dementia & Driving.  In a separate article, Seattle elder law attorney, Janet L. Smith outlines our legal obligations as family members of those who drive with dementia.  Are you letting your wife or husband drive with diminished abilities?  According to this article by Ms. Smith, because Washington is a community property state, the marital community is generally responsible for any injury or damage caused by either spouse.  This article further states that an attorney-in-fact, acting under a Durable Power of Attorney, opens himself up for possible legal action should the impaired driver cause significant damage to another.  In both of these circumstances you simply need to ask yourself if you feel comfortable enough to take that risk, knowing that the driver is unfit but taking no action to prevent that person from driving.  It all boils down to a matter of conscience, and a matter of moral obligation.  Only you can decide what type of risks you’re willing to take and/or the degree of responsibility you’re willing to shoulder.

Consider the frequency and severity of these signs and symptoms of dementia-impaired driving:

  • inability to locate familiar places;
  • failure to observe traffic signs, perhaps because they may no longer understand what they mean;
  • making slow or poor decisions in traffic, such as slow response times, and making incorrect responses to traffic conditions;
  • driving at an inappropriate speed – usually too slow;
  • becoming angry or confused while driving.

Soft ways to eliminate driving opportunities.

  • Arrange an independent driving evaluation through the local AARP or your State Department of Licensing;
  • With the help of your loved one, assign driving responsibilities to family members, neighbors, and church friends;
  • Take your loved one on errands that she needs fulfilled and make a date of it – grabbing a cup of tea somewhere, or combining the errand with a lunch opportunity;
  • Plan alternative transportation such as public transportation organizations similar to those found in Washington State: Access VansCatholic Community Services, National Volunteer Caregiving Network, and Senior Services, to name a few.

Drastic ways to eliminate driving opportunities that should only be employed as a last resort:

  • gain control over access to the car keys;
  • disable the car by removing the distributor cap, a battery cable, or the starter wire;
  • arrange to sell or donate the car;
  • secure a letter from a physician declaring the person incapable of safe operation of a vehicle and present it to the Dept. of Motor Vehicles/Department of Licensing.

I can not emphasize enough how important it is to make sure that you’ve assembled a team of well-intended friends and family members to fill in the transportation gaps.  Helping Mom and Dad, or your spouse, maintain an acceptable level of independence will go a long way toward softening the blow of losing the ability to get behind the wheel on their own.

Understanding Alzheimer’s & other dementia

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There are diagnostic tools in place that try to make sense of the symptoms of Alzheimer’s and other dementia; some are conclusive, while others are simply an educated guess because knowledge of this disease is evolving day by day in the medical and scientific fields.  And for certain, no two people with the disease have the same manifestation thereof.

Whether or not an actual diagnosis is presented, you as family members, or perhaps as the patient, are struggling with this new reality and are attempting to carry on as normally as possible.

In the days ahead I am going to submit four articles addressing some of the challenges inherent with this disease.  I am not an expert – I have no PhDs and no medical degrees – but what I do offer is advice gleaned from my own practical experience and from that of those with whom I have been fortunate to be acquainted.

The four articles will be as follows:

  1. Denial: Roadblock to better health and better care.
  2. Driving with dementia: the dangers of denial.
  3. Long distance caregiving (provided in two parts.)
  4. Preserving your loved one’s dignity.
My wonderful brother Don, and our dad in June 2005, a year after dad's Alzheimer's diagnosis.

As Charles Darwin once said: “It is not the strongest of the species that survive, nor the most intelligent.  It is the one that is the most adaptable to change.”

I hope that ALL of us will have something to offer as these four articles are presented.  I covet your input and hope that you feel free to provide it.