Safe Driving is our Collective Responsibility


Safe Driving is our Collective Responsibility

By David W. Hart, Ph.D.

The privilege to drive a motor vehicle is deeply rooted in the values that most Americans hold as preeminent: freedom and liberty.  The ability to pick up and go whenever and wherever we like is as American as apple pie.  Especially in the expanse of Los Angeles County, where running errands, meeting appointments, and visiting with friends and family can encompass miles of roads and highways, driving is perceived as crucial to our pursuit of happiness and living our best life.

 

Yet, it likely goes without saying that driving is not our constitutional or human right.  Driving is a privilege that requires cognitive and physical capacity to safely operate a vehicle.  The key concept here is safety.  Sadly, individuals with Alzheimer’s disease or a related neurodegenerative brain disorder experience progressive and insidious impairment of cognitive functions required to drive safely.  Memory loss can impact an individual’s ability to recall the rules of the road; visual spatial disorientation can lead an individual driver to become lost in familiar surroundings; lack of judgement may affect moment by moment decision making; and a decrease in the speed at which an individual processes sensory information can be the difference between a foot on the break or the accelerator.

 

The law does require physicians who diagnose patients with dementia to submit a confidential report to the county health department if the cognitive impairment is severe enough to impair driving ability (California Health and Safety Code Section 103900).  This information is then forwarded to the Department of Motor Vehicles (DMV), which is then authorized to take action.

 

Whether or not physicians report their patients to the county health department, all of us as a community, including people with dementia, have a collective responsibility to ensure the safety of our roads.  The question must be: Am I (or my loved one, neighbor, patient, etc.) able to confidently get behind the wheel and not risk an accident that could injure me, a passenger, or fellow traveler on the roads and sidewalks?

 

A dementia diagnosis of any kind does not immediately require cessation of driving.  On the contrary, many patients with a recent diagnosis of dementia in the very early stages, maintain the physical and cognitive ability to safely drive.  Some patients living with dementia maintain insight regarding their declining ability to drive and make adaptations including driving within a specific perimeter, driving only during the day, and avoiding congested highways.  Alternatively, I have several clients who have maintained their independence by accessing other transportation options, including Access, Uber, Lyft and GoGo Grandparent.  In an effort to be prudent and maintain accountability of all parties, I recommend prescribed occupational therapy through driving rehab programs available at USC and the Center for Optimal Aging at Little Company of Mary San Pedro or to schedule quarterly evaluations by a professional driving school.

 

Unfortunately, many families care for patients who have limited or altogether lack insight regarding their ability to drive.  These families and spouses are forced to take action against the will of their loved one and process can become messy and uncomfortable.  The following is a list of questions that you might ask to objectively discern ability to safely drive:

  • Have you noticed a change in your ability to drive?
  • Do other drivers honk at you?
  • Have you ever become lost while driving?
  • Have you had any fender benders within the last year?
  • Do loved ones feel unsafe driving with you?
  • Have you received a traffic citation within the last year?
  • Have you noticed impairment in other activities of daily living, including challenges with dressing, grooming, financial organization, or severe short term memory loss?

 

If you answer yes to any of these questions, there’s likely cause to take action of some sort, depending on how severe your answers are.  Possible recourse might include making a confidential report to the DMV’s Safety Division for immediate evaluation (within 30 days).  In extreme circumstances, families are often forced to disable or remove the vehicle entirely from the home.  These interventions may seem excessive but maintaining the status quo may lead to a possible accident that can have tragic consequences.

 

You are not alone and there is help available for those who need it.  Following is a list of resources that you might find useful:

 

California DMV Driver Safety Office – El Segundo

390 N. Pacific Coast Highway, Suite 2075, 90245-4470

(310) 615-3500

 

California DMV – Dementia DMV Evaluation

www.dmv.ca.gov/driversafety/dementia

 

Dementia and Driving

www.thehartford.com/resources/mature-market-exellence/dementia-driving

 

GoGo Grandparent – Use Lyft or Uber without a smartphone

www.gogograndparent.com

 

Finally, you’re welcome to join my caregiver support group on the 2nd and 4th Wednesdays of the month from 1030a-noon to learn more about solutions to driving safety.  Please contact me directly for more information.

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