There is significant evidence to suggest the ability to drive becomes altered in the earliest stages of Alzheimer’s disease. Losses associated with the disease especially alter visuospatial perception, judgement, memory, inhibitions and executive planning, and lead to the need for driving cessation. The responsibility for suggesting the patient stop driving usually falls on the physician who has limited objective data to make the decision. The physician’s decision often leads to resistance from the patient and family.

Driving represents a cherished American activity and is synonymous with independence and autonomy, thus loss of driving may impair social functioning, cause behavioral symptoms and lead to premature institutionalization. What is needed is a way to 1) assist physicians with knowing whether the patient is safe, 2) involve the patient in decisions about driving, 3) and empower a family member or trusted friend to assume responsibility for managing driving by the person with dementia.

Banner Alzheimer’s Institute has developed a Driving Cessation Algorithm* to provide a continuous evaluation format for all patients. The patients are told there will be a day when they become unable to drive and are asked to select a partner who will ride with them routinely to assess their driving. Patients agree that the person they select will be trusted to report back to the Institute on safety on a regular basis. Staff at the Institute may recommend a formal driving assessment as needed. Documentation is kept. The format is followed until the actual recommendation is given to stop driving and cessation occurs. Patients and families are thus not surprised when driving cessation is recommended and fewer behavioral issues are noted.

*Summary of program developed by Roy Yaari, MD and Geri R. Hall PhD. Banner Alzheimer’s Institute

This article is republished with permission from Pathways: a newsletter publication of the Desert Southwest Chapter of the Alzheimer’s Association.