Driving is often one of the first obstacle that families face when a loved one is diagnosed with dementia. In the very early stages of dementia, many people maintain the ability to drive. Since dementia is a progressive illness, this ability will eventually wane. Deciding when that ability has diminished causes great distress in many families.
When a diagnosis of mild cognitive impairment or early dementia is made, planning for long term care including ensuring that appropriate legal documents are in place for this particular situation and discussions about driving cessation are imperative. A person in the early stages of cognitive impairment or dementia may still have the reasoning ability to understand that there will come a time in the progression of the disease that driving will no longer be safe. A person who is aware of his or her own limitations at that point may voluntarily give up driving at the first indication that they have lost some driving ability. Even when a person is not yet ready to give up driving, having a conversation at this early stage may pave the way for an easier discussion when driving is impaired.
When families wait until driving has already become impaired to start discussing the problem, they are often met with extreme resistance. Families have several options for handling this situation.
The family may be able to convince the elder to undergo a driving evaluation. This evaluation is best done by driving evaluations designed to test possibly impaired drivers. The test done by the DMV does not really test the ability of an impaired driver. Some evaluators automatically report their findings to the DMV if the client fails the test. Other evaluators keep the results confidential. In any event, the senior may respect the findings of the test in determining whether to give up driving.
Another option is having a conversation with the treating physician. Sometimes patients will listen to the advice of a physician much better than they will listen to the advice of family members. Some physicians report the driver to the DMV when they have concerns about the ability of their patient to drive. Some physicians are reluctant to get involved in this issue because this emotionally charged issue can cause long-term damage to their relationship with the patient.
When cognitive impairment is particularly pronounced and driving is an issue, the family may be able to resolve the problem by replacing the car keys with a non-working set or disabling the car. These options are generally preferable to having arguments with a person who lacks the ability to reason.
Lastly, anyone concerned with the ability of a driver may confidentially report the driver to the DMV by filing a form 72190. Section 322.126 (2), (3), Florida Statutes, provides that “Any physician, person, or agency having knowledge of any licensed driver’s or applicant’s mental or physical disability to drive…is authorized to report such knowledge to the Department of Highway Safety and Motor Vehicles… The reports authorized by this section shall be confidential… No civil or criminal action may be brought against any physician, person or agency who provides the information herein.” After receiving the Medical Reporting Form, the Department conducts an investigation to ensure there is cause to initiate a review of the driver. If cause is shown, the driver is advised they are under medical review and are asked to provide medical information from their physician to the Department. Once received, the information is provided to the Department’s Medical Advisory Board. After review, the Medical Advisory Board provides a recommendation regarding the individual’s ability to drive. This recommendation may be to:
• Require additional information from the driver;
• Require the driver to re-take the driving test; or
• Revoke/deny a license.
If a license is denied/revoked, the driver may request an administrative hearing to appeal the decision.