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tzeigler61 Asked April 2022

Do you tell your father he has Dementia or just a memory problem?

My father has had this issue for about five years, and just officially was diagnosed through the proper testing that he has Dementia. They have said we need to remove his driving privileges.
Does anyone have advice on how my mother and I should sit down with him and explain the outcome of his testing? If he doesn't relinquish his driving, we will need to contact the DMV and they will come out and evaluate his driving.

Geaton777 Apr 2022
Ditto to the diagnosis conversation being given by the doctor to your father in the presence of the MPoA and your mother. If father doesn't bring up the driving issue to the doctor, someone else in the room should ask it.

freqflyer Apr 2022
tzeigler61, it depends on your Dad's personality and how you think he would react.

Personally, I would just start out with saying that you and Mom had noticed that his "reaction time" while driving is not as quick as it was in the past, and that is normal as one gets older. But you both are worried.

Your Dad might resist, as he's of that age group where it was always the man of the house who did all the driving.

Another writer here, lealonnie1, had a brilliant idea of having someone else to drive "to get more practice as license renewal is coming up". Would your Mom be able to do that? Or would that start a major battle between them?

You might wind up doing all the driving for them. Set boundaries!!! I didn't do that and found myself using up all my work vacation days, sick days, and days without pay, and dealing with a Manager who didn't understand the situation. It became so very stressful, that I dreaded to drive them anyway.

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Cashew Apr 2022
I was lucky in that my Mom had a stroke and lost her driving ability before the vascular dementia set in.
However, when she is having a problem or trying to do something and not being able to...I find it easier to explain to her that she has brain damage. Because dementia is NOT a memory issue. It is BRAIN DAMAGE. She can usually handle that pretty well.
There seems to be too much of a stigma to dementia as if it is a personal failing or something. Instead of the death of an organ. No different than kidney failure.

lealonnie1 Apr 2022
Driving is a sticky wicket when dementia is involved. Here is a suggestion for a way to ease an elder out of driving, that comes from a booklet called Understanding the Dementia Experience which I will link you to later:

DRIVING
The issue of driving is extremely difficult. Sometimes during testing, a physician will find that the person's spatial skills are such that they need to cease driving immediately. Other times, the family may want to curtail the person from driving because when they sit in the passenger seat while the person with dementia is doing the driving, they find their driving unsafe. One method of gradually ceasing the driving has been found to work well. A lady asked her husband once a week or so if it could be her turn to drive (her license renewal was coming up). She gradually increased the frequency of asking for her turn until she was doing the driving 80% of the time. Then she started to automatically head for the driver's side of the car whenever they walked toward the car, without saying anything. After about six to eight weeks, her husband always went to the passenger side and never again expected to be the driver. This non-confrontational approach is positive, but not always possible.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580


Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The "Do's"
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

The booklet also discusses ways to broach the subject of the diagnosis with your loved one.

Wishing you the best of luck.

JoAnn29 Apr 2022
I am with Alva here. With my Mom the Neurologist told Mom. He sat in front of her and looked her in the eye and told her then explained what she may experience and it was nothing to be afraid of. When asked if she could go back to driving, he said no and explained why. When we got home the car was put up for sale and her keys taken away. The car sold shortly afterwards. Out of sight out of mind.

To me, its the Doctors responsibility to tell a patient he/she has Dementia. It is his duty to contact DMV that his patient should no longer be driving. Why, because your Dad will believe his doctor before he believes you.

Midkid58 Apr 2022
After mother had her hip replaced, she was determined to go back to driving. YB made her pass a 'test' for him before he planned to take her to the DMV. He put the parking brake on really tight and told her she had to show him how she planned to get her walker in the car, start and back the car up and drive down the street.

After a length of time it dawned on her that she was incapable of moving without the walker and she could not even open the car door.

As mean as that may seem, it took the onus off of YB to tell her she couldn't drive. He told her if she could rehab to the point she could get in the car and show him she was once again a safe driver, he'd let her be tested at the DMV.

It never happened. She never drove again.

It wasn't a big dramatic moment, it just sort of 'happened'--she has been ferried around by friends and family since then. Since COVID she has gone nowhere, like so many elderly. It's sad, her life was so small before COVID and now it's non-existent.

Very recently she was dxed with Parkinson's. She actually seemed perfectly fine with it. She told everyone and doesn't seemed perturbed by this news--even though this is what daddy died from. It's very early stages. I don't want her to suffer...but I truly don't KNOW how to feel about this. Of course she KNOWS she has this. I think the days of keeping a person's health issues ' a secret' from them is over and quite ridiculous. At least, for her, it gave her a reason as to why she began falling more and more and why she can't write legibly. Her level of dementia is different from day to day. She seems content, and there's nothing we plan to do that's different from now. She tells EVERYBODY that she has Parkinson's---she's funny that way.

AlvaDeer Apr 2022
I as a nurse and as a Sister of a brother who was diagnosed with probable early Lewy's dementia, believe in honesty. I would consider telling him WITH the doctor, then discussing with him when he is ready. My brother always said that he wasn't necessarily happy to know what he HAD, and what might be COMING at him due to it, but he was happy to know there were reasons for how he was seeing the world so differently than once he did. We could sit long and long, when we visited and discuss things.

del356 Apr 2022
I don't envy you.

Different circumstances, but I just laid it on the line with my mother. She'd been a terrible driver, anyway...the road belonged only to her. I flat-out but respectfully talked to her about driving and refused to get in the car with her.

She. was. mad.

But, with time to think, she got over it.

She ended up handing me her keys.

Especially with your father's diagnosis, he needs to know the dx and the danger to himself and others by driving.

He'll get mad or frustrated or depressed or all of the above.

Have a doctor talk to him. Couldn't hurt more than anything else will, I suppose.

You're not giving him the benefit of knowledge and to act responsibly if you don't tell him the truth about his dx. A memory issue seems less troublesome in someone's mind than dementia. Be gentle and understanding and honest.

Geaton777 Apr 2022
I think he deserves to know his own diagnosis. You need to be prepared for how he might react, though. He may get angry or be in denial. He may have anosognosia (an actual condition where someone is unaware of their own mental health condition or that they can't perceive their condition accurately).

I would address the driving thing very discretely, as it will just throw gas on this fire and make it harder for him to emotionally work through his diagnosis. FYI I don't agree that a doctor who has not witnessed his driving will just tell you to stop his driving. But, if his memory is that bad then secretly start arranging for others to take him places, make the keys "lost" and figure out other non-confrontational ways to get someone else to drive him places.

The DMV will not "come out and evaluate his driving". You will go onto the website and anonymously report him as a dangerous/impaired driver. They will mail him a letter instructing him to come out and get retested (this test depends on the state: maybe an eye exam, maybe behind-the-wheel). DO NOT SHOW HIM THIS LETTER. Do not tell him. Do not take him to the DMV for any testing. Just let his license expire on its own. If it turns out he insists on getting into the car and driving, even with an expired license, then the car needs to be physically removed from the premises permanently "for extensive repairs". Don't name a shop or he might call it. Good luck!

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