Alzheimer's Society

If someone has been diagnosed with dementia, they may be able to continue driving for some time. However, they must fulfil certain legal requirements. When the person's condition deteriorates to the point where they are unsafe on the road, they must stop driving. Many people find this very difficult to accept. This factsheet explains the legal situation, and gives some tips on stopping driving.

Can a person with dementia still drive?

A diagnosis of dementia is not in itself necessarily a reason to stop driving. What matters, from both a legal and a practical point of view, is whether or not an individual is still able to drive safely.

For experienced drivers, driving may seem to be a largely automatic activity. In fact, driving is a complicated task that requires a split-second combination of complex thought processes and manual skills. To drive, a person needs to be able to:

• make sense of and respond to everything they see
• 'read the road'
• follow road signs
• anticipate and react quickly to the actions of other road users
• take appropriate action to avoid accidents
• remember where they are going.

Many people with dementia retain learned skills and are able to drive safely for some time after diagnosis. However, as dementia progresses it has serious effects on memory, perception and the ability to perform even simple tasks. People with dementia will, therefore, eventually lose the ability to drive. The stage at which this happens will be different for each person with dementia.

What if someone is unsure of their ability to drive?

If someone with a diagnosis of dementia is unsure of their ability to continue driving, they can take a driving assessment. To do this, they need to apply directly to an assessment centre, and pay a fee. For details of assessment centres, see 'Useful organisations' at the end of this sheet.

An assessment is not like a driving test. It is an overall assessment of the impact that the dementia is having on a person's driving performance and safety, and it makes some allowances for the bad habits that drivers get into.

Giving up driving

Many people with dementia choose to stop driving because they begin to find it stressful or they lose confidence. A person should consider stopping driving if:

• they feel less confident or more irritated when they drive
• they feel confused if there are roadworks, for example, on a familiar route
• they feel worried about having an accident.

A person who feels like this will need support and understanding from their carer and family members. They may feel bad about stopping driving if they are accustomed to being independent, or if they have always driven their partner or family around. However, it is better to travel safely on public transport than risk an accident in a car. If the person with dementia decides to stop driving, they should return their licence to the Driver and Vehicle Licensing Agency (DVLA) − see 'Useful organisations'.

Continuing to drive

If someone receives a diagnosis of dementia and wants to continue to drive, they must, by law, inform the DVLA. Notification of the diagnosis should be sent with the person's full name, address, date of birth and the driver number on the driving licence, if known, to the Drivers Medical Group (see 'Useful organisations').

The DVLA will send the person a questionnaire that seeks permission for the DVLA to obtain medical reports from the person's GP and/or specialists. Once the person returns this questionnaire, the DVLA will contact their consultant (or, if no consultant details are provided, their GP). Based on the medical information it receives, it will make a decision as to whether the person can continue to drive. The DVLA may also ask the person to take a driving assessment.

A person with a diagnosis of dementia would be breaking the law if they did not tell the DVLA about their diagnosis, and could be fined up to £1,000. If a person with dementia does not inform the DVLA about their diagnosis and continues to drive against advice from their doctor, the doctor may inform the DVLA if he or she feels that public safety or road safety would be at risk. Other people, such as family members, neighbours or police officers, may also contact the DVLA in writing and ask it to carry out a medical investigation if they are concerned about a person's fitness to drive.

A person with a diagnosis of dementia must also immediately inform their car insurance company. If they do not, their policy may become invalid. It is a criminal offence to drive without at least third party cover.

When the DVLA decides that the person can continue driving

If, following its medical enquiry, the DVLA decides that the person can continue to drive, they will issue a new driving licence that will be valid for a limited period. For someone with dementia, the licence duration is usually for one year, although in very early cases it may be longer, up to a maximum of three years. The person's condition will be reviewed at least once a year. It is also a good idea for relatives, or others close to the person with dementia, to tactfully monitor the person's driving skills on a regular basis.

Reducing the risks

Someone with dementia can take steps to minimise their risk through driving. Short drives on familiar roads at quiet times of day generally present fewer problems than long, unfamiliar journeys or journeys in heavy traffic.

People on certain types of medication, such as night sedation or drugs for anxiety, depression or other psychiatric disorders, may find that their driving ability is affected. If this is a problem for you or someone you know, ask the GP or consultant whether anything can be done.

When the DVLA decides that the person must stop driving

If, following its medical enquiry, the DVLA decides that the person cannot continue driving, the person must return their driving licence to the DVLA. However, there is an appeal process. A formal appeal must be lodged with the Magistrate's Court within six months in England and Wales, but within just 21 days in Scotland. This means that people in Scotland need to act very quickly in order to formally appeal.

Tips: encouraging someone to stop driving

Giving up driving is not always an easy decision to make. Someone with dementia may be very reluctant to stop driving even if the DVLA has concluded that they are not safe to drive. They may need some encouragement from carers, family members or friends.

• Acknowledge how difficult it may be for the person. They may have relied on driving as their main means of transport for much of their life, and may feel unhappy about losing some of their independence. Giving up driving will seem especially hard if physical problems make it difficult to use public transport, or if cuts in local public transport make it difficult to get about without a car.
• Encourage them to take charge of their new transport arrangements − perhaps by getting details and timetables of local transport services, or opening and managing their own taxi account.

Point out some alternatives to driving. For example:

• They could get a taxi to take them to the supermarket once a month. They could set up an account with a taxi firm they trust and like, and order taxis in advance.
• They could get a shoppers' bus to the supermarket and back.
• If they have a computer, they can order all their shopping online and have it delivered to the house.
• They could ask the hospital about a driver to take them to hospital appointments.
• They could pay their bills by Direct Debit so that they don't need to visit the bank or post office so often.

Point out some of the benefits to not driving. For example:

• The person will no longer have to look for parking spaces or pay for parking permits.
• They will no longer have to pay for petrol and car insurance, freeing up a significant amount of money each month.
• They won't have the stress of remembering routes and finding their way.
• Public transport can be sociable. They may like to chat to people on the bus.
• They may get more exercise if they decide to walk instead.

If the person refuses to stop driving

Some people who have been assessed as being unsafe still refuse to stop driving, even if those around them have tried to encourage them to stop, and have pointed out alternatives. This can be a very difficult and upsetting situation. Unfortunately, there are no straightforward solutions. The best action to take will depend on the individual involved.

If someone you know is in this situation, call the Alzheimer's Society Dementia Helpline or talk to others on Talking Point (see 'Useful organisations', below).

Your local Alzheimer's Society branch will always be willing to talk to you and offer advice and information to support your needs.

For more information, Dementia Catalogue, our specialist dementia information resource, is available on the website at alzheimers.org.uk/dementiacatalogue

Useful organisations

Alzheimer's Society

Devon House
58 St Katharine's Way
London E1W 1JX
T 020 7423 3500
   0845 300 0336 (helpline open 8.30am-6.30pm weekdays)
E info@alzheimers.org.uk (general information)
   helpline@alzheimers.org.uk (helpline)
W alzheimers.org.uk

The UK's leading care and research charity for people with dementia and those who care for them. The helpline provides information, support, guidance and referrals to other appropriate organisations.

Alzheimer's Society Talking Point

W http://forum.alzheimers.org.uk/

Online discussion board run by the Alzheimer's Society for carers to exchange messages with others who may be in a similar situation.

Drivers Medical Group

Driver and Vehicle Licensing Agency (DVLA)
Swansea SA99 1TU
T 0870 600 0301 (Monday to Thursday 8am-8.30pm, Friday and Saturday 8am-5.30pm)
E eftd@dvla.gsi.gov.uk
W www.dvla.gov.uk/medical.aspx

Driver and Vehicle Licensing Agency (DVLA)

Swansea SA99 1TU
T 0870 240 1651
E drivers.dvla@gtnet.gov.uk
W http://www.dvla.gov.uk/
   www.direct.gov.uk/motoring

Driving assessment centres

Cornwall Mobility Centre
Tehidy House
Royal Cornwall Hospital
Truro
Cornwall TR1 3LJ
T 01872 254 920

Derby DrivAbility
Kingsway Hospital
Kingsway
Derby DE22 3LZ
T 01332 371 929

Disability Assessment Team (DART)
Ditton Ward
Preston Hall Hospital
London Road
Aylesford
Kent ME20 7NJ
T 01622 795 719

Hertfordshire Action on Disability Mobility Centre (HAD)
The Woodside Centre
The Commons
Welwyn Garden City
Hertfordshire AL7 4DD
T 01707 324 581

Kilverstone Mobility Assessment Centre
2 Napier Place
Thetford
Norfolk IP24 3RL
T 01842 753 029

Mobility Advice and Vehicle Information Service (MAVIS)
Crowthorne Business Estate
Old Wokingham Road
Crowthorne
Berkshire RG45 6XD
T 01344 661 000

Mobility Centre
Regional Neurological Centre
Hunters Road
Newcastle upon Tyne NE2 4NR
T 0191 219 5694

Mobility Service of the Disabled Living Centre (West of England)
Vassall Centre
Gill Avenue
Fishponds
Bristol BS16 2QQ
T 0117 965 9353

Northern Ireland Driving Assessment Service
Northern Ireland Forum Centre
Disability Action
Portside Business Park
189 Airport Road
Belfast BT3 9ED
T 028 9029 7880

Queen Elizabeth's Foundation Mobility Centre
Damson Way
Fountain Drive
Carshalton
Surrey SM5 4NR
T 020 8770 1151

Regional Driving Assessment Centre
Unit 11, Network Park
Duddeston Mill Road, Saltley
Birmingham B8 1AU
T 0845 337 1540

Scottish Driving Assessment Service
Astley Ainslie Hospital
133 Grange Loan
Edinburgh EH9 2HL
T 0131 537 9192

Wales Mobility and Driving Assessment Service
North Wales Disability Resources Centre
Glan Clwyd Hospital
Bodelwyddan
Denbighshire LL18 5UJ
T 01745 584 858

Wales Mobility and Driving Assessment Service
South Wales Disability Resources Centre
Rookwood Hospital
Fairwater Road
Llandaff
Cardiff CF5 2YN
T 029 2055 5130

William Merritt Disabled Living Centre and Mobility Services
St Mary's Hospital
Green Hill Road
Armley
Leeds LS12 3QE
T 0113 305 5288

Wrightington Mobility Centre
Wrightington Hospital
Hall Lane
Appley Bridge
Wigan WN6 9EP
T 01257 256 409

Factsheet 439

Last updated: July 2008
Last reviewed: July 2008

Reviewed by: Dr AM White MB BCh, Medical Adviser, Drivers Medical Group, DVLA