Thoughts of not being able to drive can be extremely emotional for individuals with HD and their loved ones as they move towards making very difficult decisions about when to limit or stop driving. The loss of driving often means loss of independence or freedom for an individual with HD which can trigger feelings of depression, isolation and anger. It will likely cause disruption to the family routine as well as emotional stress to both the individual with HD and family members. It is likely that all individuals with HD will have to stop driving for their safety and the safety of others at some time.
The deterioration in concentration, processing information, executive functioning, decision-making, and slower muscle response, all effect an individuals with HD’s ability to drive safely. Some people with HD may decide they no longer want to drive because they are concerned about safety but others may be reluctant to stop driving as they may not be aware of a decline in their driving skills. Therefore, family and friends may be the first to recognize issues/concerns about their driving safety.
All individuals with HD should carry HDSA’s “I Have HD” – Wallet Card (PDF) to show police if pulled over to avoid misunderstandings about HD.
Strategies to Address Driving Concerns
Early and Frequent Discussions
For most individuals with HD giving up car keys is a gradual process. Knowing what to expect and preparing can make the process less painful for the individual with HD and the family. It is important that when talking to someone about driving issues or concerns that you are respectful in remembering driving often means independence and the thought of not driving can trigger some people to feel defensive and like they are losing a piece of their freedom. Avoid alienating or calling them bad or dangerous drivers as that may cause additional conflict. Planning early in a cooperative and supportive manner can often lead to less conflict when the day comes for the individual with HD to stop driving.
Early in the disease process the family should discuss a plan about how to approach issues/concerns in regards to safety.
- How will family let the individual know they have concerns
- Who in the family will be discussing the issues and safety concerns
- Explore community resources and/or medical professionals that can assist with safety conversations when needed
- How and who will help the individual with transportation once they stop driving
Strategies to Increase Driving Safety
- Slowly reduce how far the person drives by staying around town and on familiar roads
- Drive during low traffic times, on less busy roads (avoid freeways) and only during day light hours
- Avoid/eliminate distractions while driving
- Turn off radio
- Limit conversations in car
- No eating or drinking
Signs of Unsafe Driving
- Not staying in the lane or drifting into other lanes without signaling
- Troubles moving from accelerator to brake, etc.
- Seems to miss/ignore stop signs or traffic lights
- Difficulty merging on/off freeways
- Inability to react to sudden changes in traffic patterns or sirens/flashing lights
- Trouble seeing other vehicles, bicyclists or pedestrians
- Getting lost when driving to familiar places
- Forgeting things like using their seat belt, turning on headlights, adjusting mirrors, etc.
- Traffic tickets/stops/warnings or accidents, fender benders, etc.
Strategies for Families when Individuals with HD are Resistant and/or Uncooperative in Stopping Driving
- It may be more helpful to have people outside the family discuss driving with the individual with HD
- Utilize community resources for official behind the wheel driving evaluations, etc
- Report any unsafe driving to Department of Motor Vehicles or Police – anybody (family, friends, neighbors, medical professionals) can report safety issues as appropriate
- In severe situations, family members may need to hide the car keys or disable the car to prevent the HD person from driving
- Utilize an objective person to evaluate and discuss driving concerns as appropriate
- Doctor, nurse, social worker, church members, neighbors, friends, etc
- Private companies, as well as the local Department of Motor Vehicles, can formally evaluate driving skills
- Age, Dementia and Driving
- Department of Licensing – State of Washington
- Seniors and Driving: A Guide – this guide discusses:
- Causes of Driving Difficulties with Age
- Warning Signs of an Unsafe Elderly Driver
- Professional Assessments of Driving Safety
- How the DMV can help ensure an older adult drives safely
- How to Have “The Talk” About Giving Up The Keys
- Ways to Help a Senior Transition From Driving
- Transportation Options for Seniors Who No Longer Drive
- Top Ridesharing Options for Seniors
Adapted from an article by: Lisa Kjer-Mooney, LCSW