Driving is a complex skill that requires concentration, coordination, patience and an ability to remember routes. The brain damage of dementia will increasingly affect your capacity to drive and to safely cope with the tests and trials on the road. Eventually all people with dementia will have to stop driving, however dementia is a progressive condition. In the early stages, driving can often be completely safe and as many as one in three people with the condition can safely stay behind the wheel.
Driving and dementiaDementia impairs the memory and the ability to plan, think and perform complex tasks, so it’s easy to see that it can impact on the ability to drive. However, many people have been driving safely for decades, making it a deeply ingrained skill. The ability to drive can be automatic and instinctive and it can be well-maintained in the early stages of dementia. But being safe on the road is about more than the technicalities of driving the vehicle. Steering, changing gears and using the controls are important but so are spatial awareness, sense of direction, understanding of signs and signals, recognising road closures and the ability to stay calm and respond quickly to avert a potential accident. These can all become increasingly problematic as dementia advances.
Driving may seem effortless but it can often be stressful. When you’re struggling with confusion and forgetfulness it can be even more of a challenge. Many of us have got cross, frustrated and upset in traffic or when faced by other drivers behaving erratically or unreasonable. It can be particularly difficult to stay calm, focused and in control when your mental function is deteriorating- for this reason most people with dementia stop driving within three years of first noticing symptoms.
The DVLA and dementiaFor your wellbeing and for that of others it’s vital that you’re safe behind the wheel. But you don’t just have a moral responsibility, there is also legal requirement to inform the authorities when you are diagnosed with dementia. The DVLA have made it compulsory to tell them immediately following a dementia diagnosis. The rules are clear:
• You must tell the DVLA immediately if you have dementia.
• If you don't notify the DVLA about a condition that could affect your driving, you can receive a fine of up to £1,000.
• If you don't inform the DVLA, you risk prosecution if you're involved in an accident.
The paperwork can be downloaded from the DVLA website. If you have a driving licence for a car, motorcycle, bus, coach or lorry, fill in the form CG1. It’s a detailed questionnaire that helps the DVLA understand more about your condition, the medications you take, your level of function and your care support. The names of your healthcare team will be requested as well as your consent for them to provide your medical details. Send it back to the DVLA so that they can assess whether your condition may have affected your competence as a driver.
Sometimes the authorities may require you to undergo a practical test or have a detailed medical assessment to help them evaluate your fitness to drive – if this is the case you will usually be told to stop driving until the results are confirmed.
Can different types of dementia affect driving skills?Dementia can affect people differently. Ultimately, it becomes increasingly difficult to drive with dementia. Although most people need to stop driving in the mid stages of dementia, some have early symptoms that can make safe driving especially difficult. This can be a particular problem in dementia with Lewy bodies and frontotemporal dementia.
Visual hallucinations commonly occur in the early stages of dementia with Lewy bodies, which can make driving challenging. You will need to fill in a different form for the DVLA, called a B1 form and it is likely that you’ll have to stop driving earlier on in your disease. Frontotemporal dementia is characterised by impulsive behaviour; this can make it more difficult to respond appropriately when something unexpected happens and affect safe driving.
Staying on the roadIf the DVLA determines that you are safe to drive and you feel confident and comfortable on the road, you will be issued with a driving licence for a fixed length of time. This is often a year but the period can vary according to your function. It’s important to realise that the authorities don’t have a crystal ball and can’t fully know how your disease will progress, if you’re worried or if anyone close to you expresses concerns about your abilities, talk to your doctor immediately.
Life without a carWe live in a car-dependent society. The idea of coping without your wheels can be worrying, but there are other options. Running a car is expensive, just think of the fuel, the servicing, the tax and the insurance. Use the cash saved to stay mobile by investing in cabs, buses or care support. Sort out a transport plan so that you don't become housebound and isolated:
• Arrange regular online grocery shopping, so you won’t be caught short.
• Set up weekly outings with family or friends.
• Use your legs. If you're fit, well and close to facilities, then think about walking. However, you may need an escort if there is a risk of traffic accidents or getting lost.
• Arrange an account with a local taxi firm. Add them to the speed dial on your phone, and you'll be able to access them easily.
• Consider employing a carer that drives and has a car. They can come into your own home and offer a helping hand, as well as driving you to social events, hospital appointments and out and about so that you can stay in touch with those that you love.