Getting your loved one to give up the car keys can be one of the most difficult things a caregiver must do. For many people, driving has been a powerful symbol of independence from the time they were teenagers and got their first license. It can be very distressing when limiting that independence becomes necessary.
Receiving a diagnosis of frontotemporal degeneration need not mean an immediate end to driving. In time however, everyone with FTD or any other degenerative neurological disorder, will become unable to drive. The characteristic behavioral changes associated with FTD can increase risk, and highlight the importance of caregivers getting involved early. People have reduced judgment and are typically unaware of the changes they are experiencing.
A study conducted in 2007 by a team of researchers at the National Institute of Neurological Disorders and Stroke (NINDS) evaluated the driving competency of FTD patients and healthy controls in a driving simulation task. The FTD patients received more speeding tickets, ran more stop signs, were involved in more accidents, and had a significantly higher average speed than the controls (de Simonea, L. Kaplana, N. Patronasb, E.M. Wassermanna, J. Grafmana 2007).
Caregivers share in the responsibility for the safety of the person diagnosed and that of others who may be at risk if the person continues to drive when no longer safe. Caregivers need to excercise their own judgment, as well as heed the advice of their physician, when it comes to “taking away the keys.”
Guides and Resources
Evidence shows driving skills deteriorate with increasing dementia severity. A recent study found that caregivers who rate a patient’s driving as “marginal” or “unsafe” were often proven correct when the patient took an on-road driving test. Patients who deemed their own driving as “safe” were not necessarily accurate in their own assessments. The American Academy of Neurology has issued new guidelines to help determine when people with Alzheimer’s disease or another type of dementia should stop driving. The guidelines were published in the April 12, 2010 online issue of Neurology.
The Hartford Insurance Group, in collaboration with the Massachusetts Institute of Technology Age Lab, has released a guide to help people deal with the issue of driving. The guide, Alzheimer’s, Dementia and Driving, is only available online here. While geared to people dealing with Alzheimer’s, their page on Dementia and Driving includes many useful pieces of advice.
The Alzheimer Association website includes information and tips for how to approach the issue with family members. Go to www.alz.org/living_with_alzheimers_driving.asp.