Events & News

Cognitive decline: When to give up the car keys


Melba and Reggie got into the car. She was driving today. They chatted as they started out on their shopping trip. She sped up the ramp to the freeway, gaining speed as they went. Reggie spoke up.

            “I don’t suppose I should tell you …” He hesitated.

            “Tell me what?” she prompted.

            “I’ve almost had three accidents this week, and all of them were my fault. I just didn’t see the cars. One was at a stop sign.”

            Melba spared a quick glance at her aging husband, then return her attention to the traffic flow. What could she say to ease his angst? Why was he telling her this now? Was he glad that she did most of the driving these days? He insisted she do al the driving when they traveled any distance, especially in large cities because he just couldn’t handle the heavy traffic. He hated city driving.

            “I’ve always felt safe when you’ve been driving,” she said, “except when you run up behind other vehicles. That won’t get you to your destination any faster.”

            She recalled that her mother had said the same thing about her dad and everyone in the family had known he drove where he was looking – and often gawked at things along the road that caught his attention. Still, he had avoided crashes. And so had Reggie. But there was the other thing that Reggie often mentioned these days … his memory was faulty. He admitted when he couldn’t remember things and other times just flat out said, “My memory is getting worse.”

            Melba swallowed hard. She would watch over Reggie and hope she didn’t miss the red flags. As her mother had progressed into dementia there had come a time when they had to take away the car keys. Mom had been furious. “I’ve driven all my life!” she had insisted, outraged that anyone would take away her right to drive. She didn’t want to hear that it was a privilege, not a right. And if she were in an accident and a child was killed because of her, she would never be able to live with herself. Anyone who ever has dealt with dementia knows you can’t win an argument with Alzheimer’s. It hadn’t been easy, but they had taken her mother’s car keys. And then disabled the car so she couldn’t slip away when no one was paying attention to what she was doing.

            When you think about what an impaired driver is, it may not occur to you to consider cognitive impairment. But Donna Stressel writes in “Cognitively Impaired Driving” that “more drivers are driving cognitively impaired due to natural declines in attention and visuospatial skills as well as the deleterious effects of prescription medication on judgment and psychomotor skills.” (Cognitively Impaired Driving,” Donna Stressel.)

            “Cognitive impairment is defined as decline in at least one of the following areas: short-term memory, attention, orientation, judgment and problem-solving skills, and visual-spatial skills,” says an article, “Older Drivers and Cognitive Impairment,” in JAMA. Such changes, the article advises, can affect abilities to drive any motorized vehicle including lawn mowers and golf carts.

            But, how do you know when it’s time to give up your driving privileges or take the keys away from a loved one who can no longer drive safely? Schedule a doctor’s appointment and share your concerns. It may be that a medication you are taking is contributing to the problem. It may be that you will undergo some cognition testing at the Bureau of Motor Vehicles or with a specially trained occupational therapist who can  evaluate your driving and make recommendations.

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