Whenever I read or hear about a Silver Alert, the emergency system that is activated when a senior citizen is lost or missing, I wonder if this is the first time that the person has wondered off on foot or in the car or if this has happened before and this was just the first time that the episode escalated to this degree. We’ve all heard people say, “John really shouldn’t be driving, he always gets so confused.” Or “John is a terrible driver. One of these days someone is going to get hurt.” But John may never willingly give up his car keys and no one in his world either knows how or is willing to tackle one of the biggest issues of aging.

Getting lost is a common and early sign of dementia. Routes to places that a person has gone to for years, the grocery store, the hairdresser, the golf course, are now unfamiliar. Landmarks that always served as reminders of directions lose their meaning.

For a long time after we moved to Tucson, I thought Deena’s complete inability to recognize where we were was a function of her constantly looking at her phone while I drove. It was only later that I realized she didn’t recognize Old Spanish Trail, a road we took dozens of times a month, because she couldn’t recognize it because of the dementia.

I’ve heard some caregivers say that wondering off and getting lost wouldn’t happen to their loved one because the car is equipped with GPS. I think that theory assumes a lot of things. First, it assumes that the person with dementia will remember to and knows how to input the address of the location that they are headed.

Second, it assumes that the driver will be able to remember and execute the directions that the GPS system gives. “Turn right in ½ mile.” “Turn right in ¼ mile.” And finally, “Turn right in 600 feet.” But what are the chances that the driver will remember 600 feet later that she/he was supposed to turn right? And if you miss the turn, the directions get more complicated and confusing, with a high potential for a disastrous outcome.

Maybe because Deena never really liked to drive, this was simply never an issue for us. The neuropsychologist, on the day that we got the initial Alzheimer’s diagnosis, told Deena that she shouldn’t drive. Her test results showed a significant decrease in Executive Functioning skills and a high level of anxiety.

The neuropsychologist explained it to Deena this way: If Deena was driving down the road without other traffic or distractions, she could probably manage safely. But if, as she approached a traffic light, an ambulance come up from behind her requiring her to move to her right, where a bicyclist was riding in the bike lane, she could be overwhelmed by the multiple tasks that would need to be accomplished in rapid succession, resulting in a potential disaster.

Deena heard that and understood it. The last thing she wanted to do was to put anyone in a dangerous situation. And the fact that the decision was based on the test results made it easier to accept. Only once in the next 3 ½ years did she complain about not being able to drive. And that was more in the context of her desire to be as free to come and go as she thought I was.

So, I got lucky on this issue. But I know many caregivers who haven’t been so lucky. Repeated conversations on this topic can result in anger or denial with no progress towards resolution. So here are some ideas that I’ve seen be successful in taking the keys away from someone who shouldn’t be driving.

  1. Enlist another family member, a son, a daughter, a brother, to have the conversation with the person with dementia. This person should be someone that is trusted by the person with dementia and whose opinion is respected and listened to.
  2. Suggest that you both enroll in a senior citizen’s safe driving class offered by AARP or the AAA. You’ll both have your driving evaluated and may even save on insurance premiums when you complete the class.
  3. Raise the issue of driving with the person’s primary care physician or neurologist. In many states, doctors are mandated reporters and must submit a report to the state’s DMV when, in their professional opinion, a person’s driving poses a risk to themselves and others. This should result in the person with dementia receiving a notice that they need to be retested in order to maintain their driver’s license.
  4. If a physician is unwilling to intervene, make an anonymous call to your local DMV and report the person’s driving. This should also result in the need for the person with dementia to be retested.
  5. As a very last resort, if the person’s ability to drive is significantly compromised, take and hide the keys.

I know that some of these ideas seem extreme, maybe even downright deceitful. But sometimes, desperate times require desperate actions. This could be one time where life requires us to make a hard decision, take an unpopular action. But doing the right thing, even in the face of strong opposition, is always the better choice.