At the Crossroads: A guide to Alzheimer’s disease, dementia and driving

Every 70 seconds, someone develops Alzheimer’s disease.¹ In conjunction with National Older Driver Safety Awareness Week, Dec. 6-12, leading researchers are joining forces to encourage families to talk openly with loved ones about driving as soon as they are diagnosed with a form of dementia.

Since 2005, The Hartford Financial Services Group (NYSE: HIG), the MIT AgeLab and the Boston University School of Medicine’s Alzheimer’s Disease Clinical and Research Program have collaborated on research to help caregivers cope with issues they face related to dementia and driving.

“Asking a person to reduce or stop driving can be a delicate, highly emotional matter,” said Jodi Olshevski, gerontologist and assistant vice president of The Hartford Advance 50 Team. “Family members delay having these conversations mainly because they want to avoid conflict and hurt feelings. It’s important, however, to be honest and involve the person with dementia in the driving transition planning process. Taking away the keys should be a last resort.”

The Hartford has worked with MIT AgeLab and Boston University to identify warning signs for drivers with dementia, as well as to provide tips for balancing independence and safety, including:

For People with Dementia:

• Confide in a friend or family member about what driving means to you.
• Work with your family to create a transportation plan that meets your needs.
• Consider a written agreement, such as the “Agreement with My Family about Driving” included in the At the Crossroads guidebook, as a way to balance your independence and safety.

For Caregivers:

• Allow a relative with dementia to express how he or she feels about not driving.
• Initiate conversations about driving and transportation needs early and often.
• Observe the driving of the person with mild dementia.
• Keep a written record of observed driving behavior over time.
• Share observations of unsafe driving with the person with dementia and other family members.
• Create opportunities for you or others to drive the person with dementia.
• Ask professionals outside the family to raise questions about driving safety.
• Get information about driving evaluation services in your state or region.

“Family members must constantly weigh the need to respect a person’s desire to drive with the need for safety,” said Dr. Robert Stern, associate professor, Boston University, and co-director of BU’s Alzheimer’s Disease Clinical and Research Program. “It’s not just about getting lost. Although memory problems are seen early on in dementia, difficulties don’t necessarily make someone an unsafe driver. It is clear, however, that all dementia patients will eventually lose the ability to drive safely, due to problems with judgment, multi-tasking, slowed reaction times, impaired spatial skills, and other cognitive deficits.”

To help persons with dementia and their caregivers make important decisions about driving safety, The Hartford and the MIT AgeLab offer the guidebook, At the Crossroads: A Guide to Alzheimer’s Disease, Dementia and Driving. The guidebook, which provides clear, practical advice on how to assess driving behavior and features a Warning Signs Worksheet to note dates and incidents of good and poor driving behavior, is free online at http://www.safedrivingforalifetime.com. The website offers other free publications; interactive tools, such as a crash risk assessment; warning signs to watch for; a driving wellness action plan; and an interactive blog community.

According to Lisa D’Ambrosio, Ph.D., research scientist at the MIT AgeLab, people are better able to respond to appeals to safety during the early stages of the disease. “It’s important to take advantage of this early stage to discuss options for when a person must limit and eventually stop driving.”