People with dementia want to be part of the cessation process and family/friend carers require assistance from healthcare providers. Accordingly, fostering an approach that emphasizes early planning for cessation, whenever possible, allows everyone a chance to adjust to the inevitability of cessation. An emphasis on planning also promotes ongoing communication providing you with continuous opportunities to manage the therapeutic relationship. Encourage an inclusive and supportive approach by using the following planning tools directly with the person with dementia or by recommending them to their family/friend carers.
Agreement and video
As a way to broach the topic of planning ahead for when the person with dementia can no longer drive, consider recommending these resources:
- Agreement with my Family about Driving produced by The Hartford. It is an agreement that outlines the person with dementia's wishes regarding when they can no longer make the best decisions about driving for their safety and the safety of others. It also acts as a helpful reminder if the person with dementia doesn't remember that they are not supposed to drive anymore.
- Video produced by the Alzheimer's Association of a woman with dementia planning with her family for when she can no longer drive.
Warning Signs Checklist and video
Presuming the person with dementia does not need to imminently stop driving, you should advise family/friend carers to directly observe the driving of the person with dementia and monitor them for warning signs. They cannot rely on the person with dementia to recognize when their driving is unsafe. However, for family/friend carers to provide valuable information, they need to directly observe the person with dementia driving in the recent past. Recommend these resources:
Alternative Transportation Plan
Driving is certainly a convenient way to get around and yet it is not the only way. To help ensure that the person with dementia is still able to get around and is as independent as possible, work with them - or recommend that their family/friend carers work with them - to develop an alternative transportation plan. It's important to involve the person with dementia so that they feel respected and have a sense of control. Follow these steps:
1. First, identify all the things the person with dementia likes to or needs to do on a daily, weekly, monthly and yearly basis like grocery shopping, socializing, going to the gym, birthdays and anniversaries. To help, download one of these worksheets produced by The Hartford or recommend them to family/friend carers:
2. Next, brainstorm ways to get errands done without driving. For instance, the person with dementia may be able to change certain routines. Instead of visiting the bank, the family/friend carer could set up automatic bill payments. Other ideas include:
- Meal delivery services (e.g., Meals-on-Wheels)
- Delivery services and online ordering (e.g., groceries, prescriptions, books, newspapers)
- Services offering home visits (e.g., hairdressers, doctors, laundry pick-up)
3. Then, brainstorm ways for the person with dementia to continue doing the things they like to do without driving. However, keep in mind that relying too heavily on just one family/friend carer to do all the driving or make all the driving arrangements, can be highly stressful and should be discouraged. Instead, try to share the driving responsibilities by using different forms of transportation.
Using a variety of driving options also decreases the person with dementia's isolation and expands their social circle. Beyond family and friends, possible transportation options depend on the person with dementia's specific situation such as whether they live in urban or rural areas. Ideas include:
- Family and friends
- Members of a place of worship
- Carpooling
- Public transit - but if the person with dementia tends to get lost, they need someone to take them to the transit option and meet them at their destination.
- Taxis and ridehailing (e.g., Uber, Lyft) - but if the person with dementia tends to get lost, they need someone to meet them at their destination.
- Community organizations that offer driver services
- Retirement residences with van service
- Delivery services and online ordering (e.g., groceries, prescriptions, books, newspapers)
- Services offering home visits (e.g., hairdressers, doctors, laundry pick-up)
- Meal delivery services (e.g., Meals-on-Wheels)
4. In addition, share these alternative transportation options for the province or territory where the person with dementia lives.
Transportation Cost Calculator
To help allay anxiety around costs associated with alternative travel options like taxis, recommend this transportation cost calculator produced by The Hartford. Once the costs associated with owning and operating a car are factored in - such as gas, repairs, and insurance - many people with dementia and family/friend carers are surprised to learn that it may be less expensive to just rely on taxis/ridehailing.
- Primary Care Physician: Primary Care Physician: "We often talk about using family members, trying to problem-solve.
Going through some education about if you don't have a car and you're saving the amount on insurance, then that can be put toward the taxi, and you can still save money, that kind of thing.
Input from authority figures
Explain to family/friend carers, that in addition to healthcare professionals talking to the person with dementia and/or giving this
letter to them that is provided by the Regional Geriatric Program of Eastern Ontario, other authority figures may also be helpful in reinforcing the cessation message. For example, a religious leader, the family lawyer or a familiar police officer.
Last resort strategies
If nothing else is working, advise family/friend carers to:
- Park the car in a location that is not immediately visible to the person with dementia.
- Gift the car to a family member as part of an agreement that the family member will provide a certain number of drives, or assist the person with dementia in selling the car.
- Place the car keys in a location that is not visible or use a steering wheel lock.
In many provinces and territories, family and friends of people with dementia, as
well as concerned citizens can report unsafe driving to the drivers' licensing authority. For more information, please click on the
region where you live below.
Most provinces and territories require mandatory and/or discretionary reporting by healthcare professionals of all health conditions that affect driving, such as dementia. This licensing information section provides more about reporting under the heading: Requirements for healthcare professionals to report dementia diagnosis.
Please note, in some cases, although the link below provides this information, it also includes other
information. You will have to browse through the link.
In other cases, because this information is not available, we have included a link to the closest relevant information on the licensing authority website. This way, you can follow-up directly with the authority to find out more.
These links were available as of September 2022.
As a health condition
that could affect driving ability, most provinces and territories require mandatory
and/or discretionary reporting by healthcare professionals of all health conditions that affect driving, and of course, dementia is one of these. For more information,
please click on the region where the person with dementia lives below.
Please note, in some cases, although the link below provides this information, it also includes other
information. You will have to browse through the link.
In other cases, because this
information is not available, we have included a link to the closest relevant information on the licensing authority website. This way, you can follow-up directly with the
authority to find out more.
These links were available as of September 2022.
To determine if a person with dementia can continue driving and if so, to what extent,
the drivers' licensing authority in most provinces and territories may request
that a person with dementia take a comprehensive driving evaluation. It is sometimes called something else such as a functional assessment. It
typically includes two parts: an in-office evaluation and an on-road driving
evaluation. For
more information, please click on the region where the person with dementia lives below.
Please note, in some cases, although the link below provides this information, it also includes other
information. You will have to browse through the link.
In other cases, because this
information is not available, we have included a link to the closest relevant information on the licensing authority website. This way, you can follow-up directly with the
authority to find out more.
These links were available as of September 2022.
Most provinces and territories
have a process for appealing licence suspensions. For more
information, please click on the region where the person with dementia lives below.
Please note, in some cases, although the link below provides this information, it also includes other
information. You will have to browse through the link.
In other cases, because this
information is not available, we have included a link to the closest relevant information on the licensing authority website. This way, you can follow-up directly with the
authority to find out more.
These links were available as of September 2022.
You can provide support for the person with dementia and their family/friend carers by helping them come up with an alternative transportation plan. Here are some specific ideas to consider based on where the person with dementia lives below.
Alberta
Click on each organization's name below. After reviewing, when you
close the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
British Columbia
Click on each organization's name below. After reviewing, when you
close the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Manitoba
Click on each organization's name below. After reviewing, when you
close the organization's web page, it will automatically take you back
to here. These links were available as of September 2022.
New Brunswick
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Newfoundland and Labrador
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Northwest Territories
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Nova Scotia
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Ontario
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Prince Edward Island
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Quebec
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Saskatchewan
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.
Yukon
Click on each organization's name below. After reviewing, when you close
the organization's web page, it will automatically take you
back to here. These links were available as of September 2022.