3. Continuing to drive
The first step for someone who is diagnosed with dementia and wants to continue to drive is to tell DVLA/DVA about their diagnosis straightaway. This should be sent including the person's full name, address, date of birth and, if known, the driver number on the driving licence. The details should be sent to the Drivers' Medical Group (part of DVLA) or DVA (see 'Other useful organisations' for both).
DVLA/DVA will send the person a questionnaire with a permission request to obtain medical reports from the person's GP and/or consultant. This questionnaire can also be downloaded directly from the GOV.UK website (see 'Other useful organisations'). Once the licence holder has returned it, DVLA/DVA will contact their consultant (or, if no consultant details are provided, their GP).
Based on the doctor's report, medical advisers at DVLA/DVA will make a decision as to whether the person can continue to drive. There are three possibilities at this stage.
- DVLA/DVA may decide to renew the person's licence, usually for one year for someone with dementia.
- Alternatively, they may decide to cancel or 'revoke' it immediately (see 'DVLA/DVA decides that the person must stop driving').
- In a minority of cases, DVLA/DVA may feel that they need more information, such as more medical details, or they may require the person to take an on-road driving assessment before making a decision (see 'Driving assessment').
In all cases, DVLA/DVA will write to the licence holder to tell them.
DVLA/DVA will ask someone to take a driving assessment if they are unsure whether the person is safe to continue to drive. This will be at one of 17 accredited driving assessment centres around the UK, or at one of their satellite centres (see Forum of Mobility Centres under 'Other useful organisations'). DVLA/DVA will refer the licence holder to a centre close to them.
Some people pay privately for an assessment at a centre, for example because they have been issued with a licence but need some advice or tuition. Private fees paid then vary but most are about £70-90. In cases where DVLA/DVA have asked for the assessment then the agency will always pay.
The licence holder should go to the centre with someone else in case they need to be driven home. They will need to take their driving licence and any glasses they wear to drive.
The driving assessment is not like a driving test. It is an overall assessment of the impact that dementia is having on a person's driving and whether they are able to drive safely and in comfort. The assessment is done in a supportive way and makes some allowances for the bad habits that many drivers develop. Staff will work with the person to help them continue to drive if this can be done safely.
The driving assessment is carried out by a specialist occupational therapist and an advanced driving instructor. Overall, it can take about two hours and includes the following steps.
- An interview that covers the licence holder's medical and driving history, and any current driving problems. The person will then do a short pen-and-paper test of mental abilities.
- Reaction time and limb strength (steering, braking) will be tested on a special static 'rig'. This is the set-up of a car with a steering wheel and foot pedals that is linked to a computer. Eyesight is also checked. By this stage a few people will be found not to be safe to drive.
- The main part of the assessment - and the best measure of driving ability - is an on-road session in a dual-braking car. This is a vehicle that has a brake on both the passenger and driver's sides. Some centres have a private roadway that the person drives around first. This helps them get used to the car and allows staff to check that they are safe to go on the public road. The main assessment is a drive on local public roads following a pre-set route. The person drives with the advanced driving instructor who acts as a front passenger and the occupational therapist as an in-car observer.
- Back at the centre at the end of the assessment, staff will tell the driver what they have found. Where appropriate, they will suggest strategies and adaptations to help the person to continue driving with greater safety and confidence. If the person is assessed as not being safe to drive, staff will give information and advice about other alternatives. (In this case, someone else will need to drive the person home). Where DVLA/DVA have asked for the assessment, the centre will send a report direct to them, although the licence holder can ask the agency for a copy.