How do family doctors effectively persuade a dementia patient to hand over the car keys and accept the fact that they cannot drive anymore?

This post is from August 2023.

my mom had mild dementia, got lost coming to my house! Then an accident fortunately nobody was hurt. Her PCP prepared me a letter I sent it to the DMV. The DMV required she report for evaluation or have her drivers licenses revoked.

She was not aware that I sent the note to the DMV.

She hid the note thinking it would go away! I followed up with her Auto Insurance and they cancelled her policy once her DL was suspended.

It was the safest thing to do! She never realized I was behind it all. She eventually let me sell her car, she knew no insurance no need to have a car payment. It meant more work on me taking her to doctors, beauty appts, groceries!

I just could not imagine her lost and us not finding her in the cold of Winter.

Sometimes the grown children have to do what's safest! Does not make it easy! Tough Love.

When my husband got to the stage I thought he should quit driving, I feared his forgetting to stop at a stop sign, and the fact he took the right of way when his light was red. I took his keys, and any extras I had in a drawer, and my own set of car keys, and hid them in our small safe, of which he didn't remember the code , and got them out only when I intended to use the car. I was afraid of my own safety. It wasn't long after that that I 1) found a facility I could take him to, 2) slowly talk with him about his driving, and 3) locked the keys in the safe (mine as well as his) and only took them out (mine only) when I intended to drive. Nor long after that, I had to place him in a facility for both our safety. I found him putting the house key in the car door lock (didn't fit); could have broken a key in the lock and then how would I get it out if it got stuck; and what would I do if he took the keys in the middle of the night if I didn't hide them. He also was trying to put the house key in the ignition!!! I actually feared for my safety if he got the keys, and his, too. Don't understate the abilities of a person with dementia. They are strong, strong minded, and sure of themselves, but NOT. I tried parking the car down the street instead of in our carport, but that was quite inconvenient, not to mention I was afraid of someone forcing the lock and driving my car away, you know what I mean!!! The caregiver's safety is at risk if a demented loved one is allowed to drive. Then what will happen to the patient? So, fight like hell to keep keys away from the patient, all at the same time be loving, attentive, changing the subject, like peeling an orange and apple, and sitting down for a snack, to get the mind off "going for a drive.

It's best to have an alternative to driving

i’m only 65 now, but I’ll tell you, I’m going to move to someplace that has great bus service. I don’t even want the bother of cars much longer!

@mj1929

I'm afraid I love that! They may have saved lives, who knows.

Bizarrely, in the state my mother lived in when she was 95, as long as her eye doctor said she could see they gave her a license renewal! I couldn’t believe it! I’ve been behind her while she was driving when she was in her 80s, and she almost ran someone off the road. Fortunately or unfortunately depending on your point of view, she now has macular degeneration, so she absolutely can’t drive. Frankly, I am relieved in a dark way.

Seems the DMV will be the one to deny him a license. If so, then take his keys away and make other plans for transportation.

We showed the doctor pictures of the house in the condition it was in. He revoked her license immediately. She has a non driver's license now.

Giving up driving was emotional for my DH but it was most definitely the right thing to do. We are grateful it was just a curb and flat tire that opened his eyes that it was time.
Although caregiving has many similarities, when it’s your spouse we carry an additional burden. Time seems to stop. I wish you comfort during this painful chapter. It’s really hard.

At first my daddy was all for not driving then one day he says to me ... I am going for a drive. I told him he could not ( I had already taken the car keys off the key ring) that he did not have any insurance. He said so what and I told him without insurance if you kill someone then they will sue us for this beautiful house and we will need to live on the streets -- He accepted that and never said another thing about driving.

My mother wasn't inordinately stubborn about giving up the keys, but she had macular degeneration and it was getting worse. She was giving us the "I only drive to the church" (past two schools on the way).

However, the last time she had to renew her license she failed the vision test, and it turned out the examiner had put in a Chinese test, not an English one. I often wonder if they did that intentionally, but either way, she failed and they wouldn't let her retake it.

That was the end of her driving, and no one complained about it.

KPWCSC: Although I stand by my observation, you make some good points, worthy of consideration for sure. It seems to me that you have chosen to take a strongly proactive stance at 73. (I was still commuting to work 2 days/week then and had not even begun to question my abilities, as perhaps I should have.)

So far, I have no memory issues--except occasionally where I put something or exactly why I came into a room. My 22 Y/O mini-SUV is a stick shift, which requires attentiveness and a certain amount of coordination to drive; it should become apparent when I can no longer manage. I drive generally within a 5-mile radius on well-known roads, during daylight hours and in decent weather.

My vision is good with glasses, and I wear hearing aids so that I will hear road sounds, including sirens. In January DOL renewed my license for 8 years (which BTW I think is way optimistic!). For now, I think I'm a competent driver--although not under all the conditions I was 20+ years ago. Does anyone else cringe at the many young people who blow through stop signs and red lights, tailgate and cut sharply in front of other drivers these days as they give the 3-finger salute?

When my time to stop driving comes, I hope I can keep our car as long as possible. The agency I use for the VA caregivers for my husband will not allow their caregivers to use their own cars to transport clients, but can drive the client's car to provide transportation. I know several Uber drivers and wish others would join me in urging Uber to allow their drivers to be requested by passengers instead of being at the mercy of whoever Uber sends. I wouldn't mind using the service if I could ride with someone I know and trust.

If the car needs a key fob to start it, the battery can be removed from the key fob and the car won’t unlock or start. I know of a case where this was done, and the driver just thought the car was broken. And it never got fixed! LOL

I'm 84 and I voluntarily gave up my license 2 years ago. I noticed I had short term memory loss, had not yet gone to a neurology for tests, but knew with this kind of memory loss, I was an accident waiting to happen. I pictured myself not stopping for a red light, and barging into a car taking his/her right of way. It literally made me sick to think I could actually cause someone's death or badly be injured because I "forgot" I had the stop sign or red light. At that point I had NOT had any incidents that I forgot what to do. BUT, I thought of the day my memory would give out for a second and I would lamblast a car that took their right of way . I am just appalled that people wait till it is too late to think of "what if" and don't stop driving. I was literally petrified of losing my short term memory at a traffic light. I gave up that right on MY OWN, my family did not know I did that. I was diagnosed with short term memory loss a few months later. Take the license away from that person NOW before a family member gets sued for not taking care of their loved one before a tragedy happens.

Contrary to some opinions, I think that many older adults will "self-select" and stop driving if they are no longer able to drive safely. My spouse (93) voluntarily stopped driving at night 10 years ago and stopped completely several years ago. I (86) have voluntarily stopped driving at night and on the freeway. I still drive locally during the day. As much as I will deplore losing my transportation and thus my independence when the time comes--and it will be a hard call since I've equated the two since I was 16--I would not willingly risk the lives of others and our own financial stability.

When my husband went on oxygen the DMV wouldn't renew his license. He had already given up driving but had hoped to maybe try again. I saw an infomercial on tv about portable O2 machines and the person was driving. If this is your situation, please check with your state regulations. Just a FYI.

ConnieCaretaker: My father didn't live long enough to have to give up his DL, passing away from CAD at age 50. My mother, a legally blind woman, exclaimed "That is the last time that I back my auto into my driveway." That was well before she turned 94 and passed away from an ischemic stroke.

Disable your DH's auto by any means possible.

I wish I would have had this site before my mother passed from Alzheimer’s in 2020. I could not get any docs to tell her she shouldn’t drive. It was left for me to do myself and was very painful. She loved her car and asked about it until 5 weeks before she passed. She could barely talk but asked where her car was. I’m glad many of you have found solutions to this dilemma. The docs her in FL would not help with the driving issue.

Having gone through this myself I wrote to the Medical Board part of the DMV and asked them to evaluate my MIL. I gave SEVERAL specific instances, diagnoses, etc. They wrote her and reigned her in, and she was REQUIRED to take the written and driving test. She couldn't get past the written test. Our eldercare attorney also reminded us that if she is driving with a diagnosis of Alzheimers/ dementia , and we knew it, and she had a wreck, that a " greedy" attorney could not only go after her $$$ but go after our $$$ because we did not stop her from driving. They would subpoena medical records. You HAVE to do what it takes for the safety of everyone on the road. Driving is a priviledge not a right. What if she ran a stop sign and t- boned her daughter and killed her grandchildren? When you are dealing with Alzheimers/ dementia things happen. My MIL left the scene of an accident. I became the " bad person" but that's okay. Mom is safe and so are the streets. Her needs are met.

I literally just got home from a week with my mom and I finally have all 4 cars keys. I reported her to the DMV in July. Since I have the USPS mail app I could see the letter did come to her mailbox. Then I saw a 2nd one arrived. When I got there on Monday of this week, she finally got her mail (she has lost so many mailbox keys, I made 6 earlier this year). The mail was in there for at least a week when I looked at the mail dates. Anyway, hallelujah there was a letter from the DMV stating her license was suspended starting 9/12. I told her she must have ignored the previous letters and since she didn't respond, they suspended the license. I did call to find out about it and apparently she missed an interview as well, thankfully. I told her I would look into it....NOT. She thought she got a ticket that got her into trouble. And there were also 2 unpaid hospital co-pays. That said, when we left this morning to drive home, I had the 2 remaining keys with me. I can't tell you what a relief it is bc she was never going to give up the car. Unfortunately the car is still there but would cost her a fortune for a key and I reminded her that she is not allowed to drive. Last night she was in rare form and blurted out well at least I never killed anyone. I didn't even comment. I've been trying to figure out how to do this and her lack of responsiveness didn't for me. It's a tough one for sure. And her medical records has dementia on it.

I live in SC

I found this website that gives info on different state laws.

https://adsd.nv.gov/uploadedFiles/adsdnvgov/content/Boards/TaskForceAlzheimers/State%20Regulations%20Dementia%20and%20Driving.pdf

A hospital system in our state offers a program that doctors can refer patients. They are tested with simulators and if they don’t pass that way they aren’t even taken out for a road test.

https://prismahealth.org/services/rehabilitation-and-physical-therapy/outpatient-rehabilitation/driving-rehabilitation

I am 87. I LOVE LOVE LOVE to drive and cherish the independence it gives me. Many who ride with me have told me I'm an excellent driver. I told my (younger) brother: "They'll take my car keys out of my cold, dead hands!" He replied: "It often happens that way."

You posted under Alzheimer's and Dementia so I am assuming that is the case. I assume also that you are the POA for your husband. He is apparently cooperative enough that he will show up for testing at the DMV?

The DMV test will be done. If your worst fears are borne out then he will likely lose his license. It will then, as JoAnn say, be up to you to disable or sell the car. Sorry you are facing this, but whether your eyes are closed or open in the car, your husband may well kill someone if he is an unsafe driver. My brother had to come to a severe accident for his full diagnosis to come to the fore, and luckily only he was hurt, not others.

No doctor is likely to whip away a license or even report, which is sad. I did experience once a case where an impaired (eyes) senior was asked by the doctor "Are you carrying your license" and replied he was. Doctor asked "May I see it" and my brother's ex handed it to him. He held on to it and said "You cannot drive. I am taking your license". I assume he turned it in to DMV? My brother's ex went to DMV to change license to senior ID, so SOMEthing sure happened. That was in CA. I have never otherwise heard of such an instance.

We went through this in December. Even though my SM's license was revoked, she continued to drive. We took the keys to her car to our home because we feared not only for her safety, but for others on the road- especially pedestrians. We let her believe they were lost. Occasionally she would ask me if I had them- I could honestly say no, because I didn't. Eventually the lease ran out. Without a valid license, she had not options. That one was out of her hands- thank goodness, because there are so many other things to deal with.

You might just have to take the keys.

Hello. I’ve been in your boat, (as others have too), trying to keep my Alzheimer’s-ridden mom out of the driver’s seat. I contacted her doctor before a visit, so she could encourage her not to drive. She reinforced to my mom that my mom had a “chauffeur” (me). Luckily, my mom’s older car stopped working. I have a chapter entitled “Car Ma, Karma” in a book I wrote about taking care of my mom called, “My Mother Has Alzheimer’s and My Dog Has Tapeworms: A Caregiver’s Tale.” I told my mom that she could just relax and I’d take her anywhere she wanted to go. Her car not working sealed the deal. Maybe you could stress the advantages of just being chauffeured around.

Hello Connie C! Good luck with this! I'm pretty sure someone will be telling your husband he cannot drive and taking his license. I'm also pretty sure you are going to go thru some long hard moments over this. Since you are there with him, riding now, and living with him, you are going to hear about this. Probably long and hard.

Are you going to do the driving now? If so, you need to keep the keys with you all the time for a while. You will need to stand by the locked driver's side door and refuse to budge. Take him around to the passenger side with the remote in your hand , unlock the doors and if he bolts for the other side of the car, hit the lock remote and wait . Smile and ask if he's ready to be chauffeured, won't he enjoy looking out at the scenery, and "NO YOU ARE NOT DRIVING......I AM! If YOU don't want to ride, we're NOT GOING!" End of story, over and over again until he understands.

Stay strong and try to understand how he feels. If he's anything like my guy, and it sounds like he is, this is going to be a rough few months for both of you. I kept a vision in my head of kids I know, I didn't want them to meet my husband by accident! I didn't want him running down a mom with a stroller, an old lady with groceries! You get the idea. He's sure "he's okay" as apparently he has been driving that way for quite a while. He knows "it's everyone else", he knows you're "crazy" if you think he "can't drive"!

My heart goes out to you both, I myself dread the day I can't drive. It's such a loss of independence and happens quickly with dementia. Your patient can still do lots of things and will argue this constantly for a while. Bluntly, he's gonna be damn mad! I will be thinking about you, you can stand the onslaught! Don't kid yourself and give in, it just makes it harder the next time! Good luck, my thoughts and prayers are with you, as they are with every single caregiver trying to do this job we never asked for, never trained for, and never ever wanted in any close personal way.

Encourage him to take the test in order to prove others wrong and that he can still drive.

Pray for the one in the car " testing" him.