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Wednesday, July 14, 2010

Dementia and Alzheimer's Series #5: Driving

There is an excellent, on-going  series of in The New York Times, called The New Old Age.  Written by Paula Span and Jane Gross, the blog series covers a wide variety of topics involved in aging and senior care.  All of the topics are important, but one that concerns us very much, at Support For Home and Senior Care Solutions, is driving.

In an April 2010 article, titled "Driving While Demented," Paula Span points out that "several studies had shown that a considerable number of those with mild dementia — 41 percent to 76 percent, depending on the study — could pass an on-road driving test."  We absolutely believe that.  It does not, however, mean that folks with dementia should be driving.  Rather, it means that we do not have good driving tests!

Every one of us who drives has "gotten away" with periods of inattention or bad judgment.  Some one else avoided the accident we might have caused or there was no one else around.  The point is, even without dementia, driving is extremely dangerous.  When families look at Dad or Mom and consider whether they should be driving, they either forget that or do not want to face it.

One reason they do not want to face it is they might then have to be the "bad guys" and take the keys away from someone who has been an authority in their lives forever.  They do not want to hurt their parent(s).  In our view, this is simply making the wrong choice.

Paula Span includes two very important points in her article, including the standard used by the American Association for Geriatric Psychiatry, as stated by their past President, Dr. Gary Kennedy:
“Our recommendation is that you stop driving once you have a dementia diagnosis.”
Less formally, he relies on “the grandchild rule”: If a patient’s children don’t want the grandchildren in the car when the patient is driving, he or she needs to relinquish the keys before hurting someone else’s grandchildren.
We think that is a good approach.  Assume that there are children who are at risk -- because they always are when we drive -- and let that guide you.

Too often, we talk to seniors with dementia and family members who think that driving is OK, as long as it is just in the local area.  Our response to that is to ask where most non-driving accidents happen: answer, at home, with the bathroom the most dangerous location.  So, being close to home does not improve our safety.  Why would it do so while we are driving?

Another reason that some families want Dad or Mom to keep driving is that they see it as therapy.  "It keeps him stimulated and sharper," we actually heard from one daughter.  With all due respect, NO!  This is part of a larger problem we will talk about in another article, which is that some families are unable to absorb that dementia is truly a disease; that their parent(s) cannot help their behavior; and that it is not going to get better simply by expecting the parent(s) to work at it.
 
Best wishes,
 
Carol Kinsel, Senior Care Solutions
 
 
 
 
 
 
 
Bert Cave, Support For Home
 
 
 

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