Driving and HD

Driving is a privilege that many people enjoy. It is also a complex task that involves paying attention, quick thinking, good judgment and the ability to think about many things at the same time. As we get older and our health changes, our ability to drive safely can be affected. Over time, every person will lose the ability to drive. For people affected by HD, this will happen earlier.

The loss of one’s driver’s licence can be stressful and difficult for the person who has to stop driving as well as his/her family, but safety has to be the priority. Talking about safe driving and planning early is especially important. Having a plan in place will help people to remain as independent as possible. The link below is for a video, called A Plan in Place, produced by an Alzheimer’s Organization in the U.S. (www.alz.org). It shows a family struggling with the realities of a loved one who has dementia coming to terms with driving cessation and putting a plan in place to give up driving when the time comes: www.youtube.com/watch?time_continue=102&v=TMMZM4OmVSg

Planning

• Monitor driving ability if possible, or look for dents or damage to a car (which might be a sign of problems).
• Look at public transit options and how close a person lives to stores and other family and friends. Consider the best ways to keep independence and quality of life for the person affected.
• Start the talk early to make sure that everyone (e.g. the person with HD, family members, friends, community members) remains safe. It’s a good idea to have more than one conversation about driving.

Having the Talk

• Do it simply and gently one step at a time, having frequent and short discussions and setting up the next time to discuss the topic.
• Ask if the person with HD has any concerns about his/her driving. Often a person with HD will not be aware of changes in his/her driving and may react defensively or angrily.
• Give facts and examples when discussing concerns about the person’s driving; show concern for the safety of everyone.
• Talk openly about the effects of HD on driving.
• Involve appropriate professionals (e.g. physicians, optometrists, nurse practitioners, occupational therapists) in the assessment process. Although there may be provincial differences, any of these professionals can provide an assessment (fees may be charged by some) of driving ability.

Changes in Driving

Have you noticed any change in driving skills? Such as…
• Problems when entering or exiting a roadway.
• Stopping in traffic for no apparent reason.
• Difficulty working the gas and brake pedals or keeping the pressure consistent for smooth acceleration or braking.
• Unsteady steering on straight roads or through turns.
• Unsafe lane changes.
• Weaving between lanes or driving over the centre line.
• Speeding through an intersection.
• Accidents and near misses in the last year.
• More traffic tickets or warnings for going too fast or too slow.
• Unawareness of activity on the side of the road.

What do other people think about the person’s driving?
• Do other drivers honk or show irritation?
• Do others (including family and friends) criticize the driving or refuse to ride with the driver?

How does the driver react/feel?
• Does the person get easily distracted while driving?
• Does the person become nervous, anxious or afraid about driving?
• Does the person have a delayed response to unexpected situations on the road?
• Does the person become angry and irritable at other drivers?
• Does the person get lost while driving?

Ways to Support a Person Who Can No Longer Drive

• Listen to the person’s feelings (e.g. loss of identity and loss of freedom, sadness, anger) about losing the driver’s licence.
• Lack of awareness may make it difficult for people with HD to see that their driving is not safe; be supportive and recognize their efforts to limit their own driving (e.g. not driving at night).
• Look for and help to arrange for other types of transportation (e.g. public transit, taxis, community services, family, friends, home delivery).
• Put a plan in place for helping the person to maintain independence and prevent social isolation.
• Help the person to get another kind of photo ID card to replace the driver’s licence.

If a Person with HD Does Not Agree to Give Up Their Licence

• If a family has concerns, follow up with medical professionals as the safety of family members and the community is very important.
• Confidential ‘reporting’ by a family member about another family member to a medical professional or motor vehicle agency can help to maintain family relationships.
• Physicians are legally required to report concerns about driving and can request a Medical Driver’s Assessment.
• The formal driving assessment, usually administered by a specialized occupational therapist, is available at some hospitals and rehab centres or some provincial transportation ministries. Depending on the province, there is usually a cost.
• Often, the objective information from the assessment about driving ability results in the person with HD stopping driving willingly.

Steps to Take if a Person Refuses to Stop Driving

Ask yourself if you would want your child to ride with this person. If not, take preventative action. Contact your local HSC Family Services team member to discuss the options available:

• File a provincial motor vehicle report.
• Take away car keys.
• Consider disabling or selling the vehicle.
• If anyone is in immediate danger, it may be neccessary to contact local law enforcement.

RESOURCES

Thank you to Michelle E. Osmond, OT(R)NL. CDE for her assistance with this factsheet. Michelle is an Occupational Therapist and Certified Driver Examiner.

Ongoing support, education and information about HD is available from HSC. You can find a listing of our family services team members here.

• Driving and Dementia Toolkit for Patients and Caregivers (Regional Geriatric Program of Eastern Ontario)
• Conversations about Dementia and Driving (Alzheimer Society of Canada)