2. Legal requirements
UK law on driving and dementia is clear. A licence holder who is diagnosed with dementia must contact the relevant licensing agency promptly, or risk a fine of up to £1,000. In England, Wales and Scotland this is the Driver and Vehicle Licensing Agency (DVLA). In Northern Ireland it is the Driver & Vehicle Agency (DVA).
The doctor who has diagnosed the person's dementia should talk to them and anyone attending the appointment with them about driving. The doctor should make it clear that the person needs to tell DVLA/DVA.
A driver with a diagnosis of dementia should also immediately tell their car insurance provider. If they do not, their policy may become invalid. It is a criminal offence to drive without at least third-party cover.
Some licence holders will want to continue driving if they can. How to contact DVLA/DVA and what happens after is explained in the section 'Continuing to drive'.
In some cases the doctor will tell the licence holder that they should stop driving immediately. The person may need to stop driving permanently, perhaps because their dementia is more advanced, they lack insight, have poor visuospatial awareness or are having hallucinations. Or the doctor's advice to stop may only be as a precaution until further assessments are carried out. In either case, medical advice like this should always be followed even if it takes up to several weeks for DVLA/DVA to make a final decision.
Many people diagnosed with dementia will decide for themselves that they wish to stop driving. Sending your licence back to DVLA/DVA under these circumstances is called 'voluntary surrender'. It is covered in the section 'Giving up driving'.
Driving and mild cognitive impairment
Mild cognitive impairment (MCI) is a condition in which the person has subtle problems with memory, perception, reasoning, judgement or attention. They do not have dementia, although some people with MCI will develop dementia over time. For more see the page: What is mild cognitive impairment (MCI)?
MCI can sometimes affect a person's ability to drive. But this is much less common than in dementia. Guidance from DVLA/DVA is that a licence holder diagnosed with MCI does not automatically need to tell the licensing agency, unlike a person diagnosed with dementia.
The exception, which is likely to be only a small minority of people, is if MCI is affecting their driving. The person's doctor or family members will probably be good judges of this. The driver will need to notify the DVLA/DVA if there are any concerns. As with dementia, if notified, the DVLA/DVA will then take up medical reports and make a decision as to someone's fitness to drive.
If the person does not tell DVLA/DVA
Occasionally a person diagnosed with dementia does not tell the authorities about their diagnosis and continues to drive. They might not accept their diagnosis or they may not realise how much their dementia is affecting their driving.
Not informing DVLA/DVA puts the person at risk of a fine and prosecution, as well as the danger of driving without insurance and possibly having an accident. In these circumstances, the doctor should try to persuade the person to stop driving and to notify DVLA/DVA (or get their permission to let the family do this).
If this does not work, doctors should disclose relevant medical information to the licensing agency if they believe the person's continued driving poses a serious risk to others. This is according to guidance that is issued to doctors. The doctor does not need the person's permission to do this, but they should tell them afterwards in writing that they have done it. This is often a very difficult issue for both parties.