Driving licenses at risk for those with dementia: Potential license revocation?
In the journey of dealing with dementia, one crucial aspect that caregivers and individuals affected by the condition must consider is driving. The National Aging and Disability Transportation Center suggests preparing a travel kit for people with dementia, containing essential items such as clearly visible identification, fare cards or money, the destination's address, a list of emergency numbers, prescription medications, a cell phone, eyeglasses, a change of clothes, water, snacks, a jacket, and an easy-to-carry activity [1].
Driving safely requires skills such as focus, problem-solving, reaction, memory, decision-making, and visuospatial skills [2]. However, dementia causes cognitive impairment that often worsens over time, making it harder for a person to practice these skills for safe driving [3].
When a person receives a diagnosis of dementia, they or a caregiver should speak with the doctor about activities such as driving [4]. In some states, a person may need to take a behind-the-wheel driving re-examination after receiving a dementia diagnosis [5]. In the United States, a person's driving license may become invalid if they have moderate or severe dementia [6].
Laws and regulations for revoking driving licenses of individuals with dementia vary across U.S. states. Common practices include medical reporting, evaluations, and DMV review processes. For example, North Carolina’s DMV Medical Review Unit conducts periodic medical reviews and requires updated medical documentation as needed [7]. Oregon’s DMV sends formal cancellation notices about 60 days before license recertification is due if medical or vision information is not submitted or indicates impairments [1].
Physicians cannot directly revoke licenses but must report medical concerns to the DMV, which triggers administrative review. The DMV holds hearings and makes final decisions on suspension or revocation [3]. Some states allow family members, caretakers, or concerned individuals to report unsafe drivers to state licensing authorities if cognitive decline or dementia is suspected to impair driving [8].
It's essential to note that these laws differ by state. For instance, in Washington State, reports from family or concerned individuals initiate investigations or driving evaluations [5]. In contrast, in Oregon, individuals must submit Driver Medical Reports or Certificates of Vision [1].
The loss of driving may represent a loss of freedom or other issues that can be hard to accept for a person with dementia [9]. Caregivers should contact their state's DMV for information on the laws surrounding driving and dementia.
In cases where a person with moderate to severe dementia may pose a threat to their own safety or that of others if they were to drive, the caregiver could consider hiding the keys to the car [10].
In summary, the legal framework across states generally involves mandated or voluntary medical reporting, DMV medical review programs, required medical form submissions, and administrative proceedings for license suspension or revocation based on medical fitness to drive. Exact procedures, timelines, and roles of family or doctors differ by state.
[1] National Aging and Disability Transportation Center. (2019). Toolkit for Transportation Providers Serving Persons with Dementia. [2] Mayo Clinic. (2020). Dementia. [3] American Bar Association. (2014). ABA Commission on Law and Aging, Commission on Mental and Physical Disability Law, and National Conference of Bar Examiners. Driving and Dementia: A Guide for Lawyers and Judges. [4] Alzheimer's Association. (2020). Dementia and Driving. [5] Washington State Department of Licensing. (2020). Reporting an Unsafe Driver. [6] National Highway Traffic Safety Administration. (2015). Understanding Dementia and Driving. [7] North Carolina Division of Motor Vehicles. (2019). Medical Review Unit. [8] AARP. (2018). Driving and Dementia: A Guide for Families. [9] Alzheimer's Association. (2020). Dementia and Driving. [10] Alzheimer's Association. (2020). Dementia and Driving.
- Seekers of information on driving with dementia should be aware that laws vary by state, requiring medical reporting, DMV evaluations, and potential administrative proceedings for license suspension or revocation.
- Individuals with dementia and their caregivers should consider the various providers of mental-health and health-and-wellness services in their states, like the National Aging and Disability Transportation Center, to prepare for safe travel.
- As establishment of a person's cognitive fitness to drive may become questionable due to dementia, caregivers should seek guidance from healthcare professionals on activities like driving and make necessary adjustments.
- Along with possible loss of mobility and social interaction, individuals with Alzheimer's and other dementias may also experience emotional distress and mental-health challenges as they confront the reality of giving up driving.
