How to stop a parent with dementia from driving

If you're trying to work out how to stop a parent with dementia from driving, the short answer is this: don't make it a debate between the two of you. Ask his doctor to tell him to stop, get a professional driving evaluation, or ask the state DMV to retest him. Arrange rides before the car goes. Then make the car hard to use, because he may forget he ever agreed.

For a lot of parents, the car is the last proof of being a grown man who runs his own life. Expect this to be one of the hardest fights of the whole illness. Expect, too, that he'll be angry at you whatever you say. That's all right. You're protecting him and everyone else on the road.

When should someone with dementia stop driving?

A diagnosis alone doesn't always mean he has to stop the same day. The National Institute on Aging says some people can keep driving in the early stages. But it's time to stop when he can't react quickly to surprises, think clearly and make fast decisions. The Alzheimer's Association says that during the middle stages, a person with Alzheimer's will need to stop driving.

Signs it's no longer safe, drawn from the NIA, the Alzheimer's Association and MedlinePlus:

• New dents or scrapes on the car, near misses, or minor accidents.
• Getting lost on roads he's driven for years.
• Errands that take far too long, with no explanation.
• Drifting between lanes, sudden lane changes, or driving much too fast or too slow.
• Confusing the gas and brake pedals.
• Missing stop signs or red lights.
• Getting angry or flustered behind the wheel.
• Tickets, or comments from neighbors about his driving.

If he's in between, the NIA suggests limiting driving first: short local trips in daylight, no freeways, nothing at night. Treat that as a bridge, not a plan. Driving skills keep slipping, and MedlinePlus says that even someone who passes a driving test should be retested in six months.

Start the conversation early

The Family Caregiver Alliance says a person often adjusts better when he's part of the discussion about when to stop. The Alzheimer's Association suggests involving him, giving specific examples of what worried you, and promising to do everything you can to keep rides available.

So bring it up before it's urgent, on a calm morning, with one or two dated examples rather than a list of his failures. "Last Tuesday you were gone two hours for milk" lands better than "Your driving is terrible." If he's still early on, you can make an agreement now. When the doctor says it's time, he'll hand over the keys. He won't remember the agreement later, but you'll have a starting point.

Let his doctor be the one who says no

This is the most useful step. Many parents who won't hear it from a daughter will hear it from a doctor.

1. Before his appointment, send the doctor a short note or portal message with your concerns and the dates, so the doctor isn't relying on your dad's account alone.
2. Ask the doctor to tell him directly that he shouldn't drive anymore.
3. Ask for it in writing. The NIA and the Alzheimer's Association both suggest asking the doctor to write "Do not drive" on a prescription pad or in a letter. When he asks for the keys next week, you show him the note.

The Alzheimer's Association says that involving the doctor in a family conference on driving may work better than trying to persuade him yourself. If getting him to the doctor is the problem, see our guide on what to do when a parent refuses to see a doctor.

Get a driving evaluation by an occupational therapist

If you're not sure he's unsafe, or he won't believe anyone, ask for a formal driving evaluation. The Alzheimer's Association recommends a comprehensive evaluation by an occupational therapy driving rehabilitation specialist. The specialist looks at how he actually drives and can suggest strategies that fit him. The NIA points to the American Occupational Therapy Association's national database of driving specialists, and says your state DMV or his doctor may be able to recommend someone.

There may be fees, and coverage varies, so ask what it costs and whether insurance pays before you book. A neutral report from a specialist is hard for him to dismiss as "my daughter being dramatic."

The DMV, and why your state's rules matter

Driving rules for dementia are set by each state, and the NIA says they vary. It describes the range:

• Some states automatically revoke a license when someone is diagnosed with dementia.
• Others let a person with a diagnosis take a driving test and keep driving if he passes.
• Many states require a new driving test when there's reason to think someone can't drive safely. Reports can come from police, medical staff and family members.
• A few states require doctors to report a dementia diagnosis to the DMV.

Search for your state's DMV site and "request driver re-examination" or "report unsafe driver." Check two things before you file: who is allowed to report, and whether your name stays confidential. States handle that differently, and it matters if you'd rather he didn't know it came from you.

How to stop a parent with dementia from driving: what to say

Keep it short, put the decision on someone else when you can, and offer a ride in the same breath.

More lines for the days that follow:

• When he asks for the keys: "Dr. Kim said not yet. Where do you need to go? Let's figure out a ride."
• When he says he's a perfectly good driver: "You drove for 50 years and never hurt anyone. I'd like to keep it that way."
• Appealing to him as a protector: "If something happened with the grandkids in the car, you'd never forgive yourself. Neither would I."
• When he's angry at you: "You're allowed to be mad at me. I'd rather you be mad than hurt."
• On a day he's confused and wants to go "to work": "The car's at the shop until Friday. Let's get a coffee instead."

That last one is a small therapeutic fib, used once he can't remember the real reason. Our guide on therapeutic lying in dementia care explains when that's kind.

Taking car keys from a parent with dementia

Talking may work once. Then he forgets, and he's standing at the hook by the door. The NIA, the Alzheimer's Association and the Family Caregiver Alliance all list the same fallback options:

• Hide the keys, or take them home with you.
• Swap his keys for a look-alike set that won't start the car.
• Disable the car. A mechanic can show you a simple way.
• Move the car out of sight, to a relative's house or a garage.
• Sell it, once he's stopped asking about it as often.

Before the car goes, write down how he'll get to the barber, the grocery store, church or the VFW. Family and friends can take set days. Grocery and prescription delivery cover the routine trips. The NIA suggests calling your local Area Agency on Aging, or the Eldercare Locator at 800-677-1116, to find senior ride services in his area.

Take Tom's dad, who'd backed into the mailbox twice in a month. His doctor wrote "No driving" on a prescription slip, and Tom taped a copy inside the kitchen cabinet. His dad still asked for the keys most mornings for a few weeks. Tom pointed to the note, then to the calendar, where his sister had signed up for Tuesday and Thursday drives. By spring, the questions had mostly stopped.

Questions caregivers ask

Can you legally drive with dementia?

It depends on the state and on how far the disease has gone. Some states revoke a license at diagnosis. Others allow driving as long as the person passes a test. Check your state's DMV site, and ask his doctor whether the doctor is required to report the diagnosis where you live.

What if he keeps driving after the doctor says no?

Assume he will, at least once. He may not remember being told. Take the keys out of the house, disable the car, or move it. If he's out driving and you believe he's a danger right now, call 911.

How do I take the keys from an elderly parent without a fight?

You probably can't avoid the fight entirely. You can make it shorter. Let the doctor's note do the talking, have rides already arranged, and don't re-argue the decision every time he asks. Calmly repeat the same short answer and change the subject.

For what tends to come next as the disease moves along, see the stages of dementia and what to expect.