SENIOR SPOTLIGHT: Dementia and driving

Maureen Wendt

I've often written about dementia and how it is different than memory loss that might be expected from normal aging. Have you ever thought about how dementia's progression can have an effect on the ability to drive?

Dementia is the decline in cognitive function due to damage or disease in the brain and can affect memory, attention, language and problem solving. It goes beyond minor forgetfulness. Higher mental functions (like memory) are affected first followed by disorientation in time and in place (like day, month, year, or location of home).

As dementia progresses, it eventually affects the ability to drive because diminished functioning in judgment, multi-tasking, reaction times and spatial skills make it difficult to physically drive and navigate a vehicle. An individual's capacity to correctly assess his/her own driving abilities decrease with people who have dementia. It is not uncommon for them to minimize the complexity of the tasks involved or overestimate their capabilities.

A variety of indicators of driving decline are often noticed by family members or friends. Driver safety experts offer the following 10 indicators of driving decline:

— Easily distracted while driving

— Other drivers often honk horns

— Incorrect signaling

— Scrapes or dents on the car, mailbox or garage

— Riding the brake

— Driving at inappropriate speeds

— Not anticipating potential dangerous situations

— Bad judgment on making left hand turns

— Delayed response to unexpected situations

— Confusing the gas and brake pedals

Some people become aware of problems and willingly "give up the keys," while others feel that driving is their link to independence and continue to drive because they fear the consequences of not driving. Research shows that it is best to reduce driving over time. Strategies for modifying driving behavior include: driving shorter distances, driving only in familiar areas, limiting driving to daytime, avoidance of difficult left hand turns, and avoidance of driving in bad weather.

Experts suggest that it is best to include the person with dementia when planning ahead for the day when driving is no longer an option. When a person with dementia stops driving, it is usually up to the family to find ways to provide the necessary transportation. Transit and aging services both agree that transportation is critical to older adults who have limited their driving or have stopped driving altogether.

Maureen A. Wendt is president and CEO of The Dale Association, a non-profit organization that provides senior, mental health, in-home care, caregiver support services and enrichment activities for adults. For more information, call 433-1937 or visit www.daleassociation.com .