Making decisions and managing difficult situations

5. Driving

A diagnosis of dementia does not mean a person has to stop driving straight away. However, they will eventually have to give up driving voluntarily or be required to stop at some point as the condition progresses.
How this is handled requires careful consideration. The safety of the person with dementia, their passengers and the general public must be prioritised.

Discussing the issue while the person is still able to make decisions enables families to agree on a course of action before things worsen. It is important to involve the person with dementia in the decision, and focus on the condition, rather than on the individual, as the reason for stopping driving.

The law

A person that receives a diagnosis of dementia and wants to continue to drive must, by law, inform the Driver and Vehicle Licensing Agency (DVLA) in Great Britain or the Driver and Vehicle Agency (DVA) in Northern Ireland. They should also inform their car insurance company of the diagnosis or the policy may become invalid.

If someone receives a diagnosis of dementia and refuses to tell the DVLA/DVA, carers should make all efforts to encourage them to do so. As a last resort, the person’s GP may inform the DVLA/DVA without the person’s consent, following guidelines issued by the General Medical Council. A GP may also help with explaining the medical reasons behind how dementia affects driving.

If the person wishes to keep driving, the DVLA/DVA will request a report from the person’s GP or consultant. They may also require the person to take a driving assessment at an accredited mobility centre. This may be helpful in getting professional guidance and evidence about whether the person needs to stop driving. It removes the responsibility from the carer and this might help to reduce conflict about the decision, because the person with dementia cannot blame them for the outcome. Also, the person may accept the news or be more easily convinced if they hear it from a professional.

It can be a difficult situation if the person continues to drive in spite of medical advice or after having their licence cancelled. This is because they may lack insight into their condition or are in denial about their diagnosis. Families and carers should make all possible efforts to encourage the person to stop driving immediately, for legal and safety reasons. Parking the car out of sight can remove a visible reminder. Some carers also resort to hiding the car keys.

Things for carers to think about

  • Is the person becoming less confident behind the wheel?
  • Have they had near misses or minor bumps or scrapes since being diagnosed with dementia?
  • Do you or other passengers feel unsafe when the person is driving?
  • Can you help them stay independent in other ways?
  • How would you feel if they had an accident when driving?
  • Can you enlist the help of a professional such as the GP (to help encourage them to stop)?
  • Would it be helpful to seek formal testing at a driving assessment centre?