Concern for dad with dementia who’s still driving; Caregivers Corner

Dear Mary,

My father has been diagnosed with dementia; my mother is his primary caregiver. I am concerned because he is still driving even though the doctor said he shouldn't.

The car has several new dings and scratches from him backing into the mailbox and shopping carts but, fortunately, he hasn't hit another car ... yet. My mother has always done what he wants so she backs down when he insists on driving. I tried taking the car away but when he got angry, my mother told me to bring it back. The title of the car is only in his name. What can I do to make them both understand he should not be driving?

Dear Reader,

Keep in mind that this is a difficult time for both of your parents; yet their safety, as well as that of other drivers on the road, is paramount. Let your father know you are concerned about his safety based on the doctor's recommendation that he not drive.

But don't get caught up in an argument. Instead, acknowledge his feelings and share alternative transportation methods with him. Be patient and empathetic. Appeal to his sense of acting responsibly. Keep in mind that the disease impairs his judgment and insight making it difficult to understand that driving is no longer safe. And if your dad was always a strong-willed individual, don't expect that to change!

Driving does not only involve procedural memory, which your father may still have, but also involves split-second decision making. As your father's dementia has progressed, his ability to make these decisions has decreased. Spatial awareness, reaction times, and problem-solving skills have all been affected.

In addition, while he may have been able to find his way to and from his destination until now, you will have no warning for which day he may go out and be unable to find his way back home. This is often the case when we see the Silver Alerts posted for missing seniors.

Maryland law requires drivers to notify the Motor Vehicles Administration (MVA) when diagnosed with any of 16 conditions, to include dementia. It sounds as if your father might be unwilling to do so, so I suggest you enlist your father's physician to notify the MVA; you can also make the report.

Once the report is received, it can still be a lengthy process involving more paperwork, a review by the Medical Advisory Board and possibly a meeting and a retake of the driver's exam. For more information on the MVA process, you can contact the Driver Wellness and Safety Division at 410-787-7759 or by email at DWSMED@mdot.state.md.us.

If your father is so sure of his driving ability, encourage him to participate in Sinai Hospital's Driving Evaluation and Training Program. The assessment consists of pre-driving and behind-the-wheel evaluations.

The evaluation includes assessment of vision, reaction time, cognition, memory, and physical function.

The driving route is designed to assess the driver's skills under normal driving conditions. A copy of the evaluation will be forwarded to the driver, the primary care physician and, if applicable, to the Motor Vehicle Administration.

For more information or to schedule an appointment, call 410-601-7360.

You can also speak with your father's auto insurance company to determine their policy and requirements for insurers who have been diagnosed with dementia.

Since the car is titled to your father, check with your mother to see if she, or someone else, has the power of attorney to remove the car temporarily or permanently. It may be helpful to speak with an elder law attorney.

You can also take some temporary measures by losing the keys or disabling the car and having the "shop" take a long period of time completing the "repairs." Make sure you have helped develop alternative transportation during the down time.

Dear Readers,

For those of you caring for someone in the early stages of dementia, The Hartford offers information and a great conversation starter about driving and dementia.

"At the Crossroads: Family Conversations about Alzheimer's Disease, Dementia &Driving" is available for download at www.thehartford.com. If you are unable to access the internet, email or call me and I will send a copy to you.

Questions and comments can be sent to Mary Chaput at the Department of Aging and Disabilities, 2666 Riva Road, Suite 400, Annapolis, MD 21401, or by contacting 410-222-4339 or agchap01@aacounty.org.

Credit: Mary Chaput - Questions and comments can be sent to Mary Chaput at the Department of Aging and Disabilities, 2666 Riva Road, Suite 400, Annapolis, MD 21401, or by contacting 410-222-4339 or agchap01@aacounty.org.