Medical Driving Evaluations

Driving with Alzheimer’s and Other Forms of Memory Loss

Posted by Joan Cramer on Aug 29, 2019 8:04:12 AM
Joan Cramer
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When someone is diagnosed with a form of memory loss, it can be frightening. Every area of life can be impacted, not least of which is their ability to drive. They may suffer from delayed reactions, lack of concentration, or impaired judgment. Whether it is the result of dementia, age, trauma, or medical problems, the inability to think clearly, focus on the road and recall information can pose real safety issues to drivers.

Overview of Alzheimer’s, dementia, and other forms Memory Loss

Memory loss can be grouped into three main categories. The most well-known, though not the most common cause, is dementia, which includes diseases such as Alzheimer’s. Altogether there are almost 5 million people with some form of dementia. More common, with almost 11 million sufferers, is age-associated memory loss. There are also a variety of potentially reversible forms of memory loss that account for significant though smaller portions of the population.

Dementia and Alzheimer’s

Dementia is a term that is broadly applied to any disease or disorder that results in cognitive impairment or memory loss, especially those that are progressive and permanent. Alzheimer’s disease, which is responsible for between 60% and 80% of all dementia cases, is by far the most common diagnosis under this umbrella.

Alzheimer’s, which is caused by clumps of damaged proteins in the brain, typically first manifests itself after the age of 60. It has a gradual onset and often slow but continuous progression. This usually starts with memory loss, trouble learning new information, difficulty completing routine tasks, or changes in behavior or personality. Over time, the victim may lose language skills, reasoning, the ability to recognize loved ones, or process sensory information. There can eventually be hallucinations and paranoia, and a total loss of the ability to communicate and care for one’s self. Though it does not directly lead to death, it causes the brain to severely deteriorate, which can cause many complications that shorten its victims’ lifespans.

The second most common form of dementia is vascular dementia, which is often the result of a stroke or hardened arteries from aging and is responsible for up to 20% of all dementia diagnoses. It can have a more sudden onset, and while it often includes memory loss, its exact symptoms depend on the area of the brain that has lost circulation.

The remaining forms of dementia are extremely rare and vary in the age and speed of their onset and the severity of their symptoms. Some of them, such as Parkinson’s dementia, come with additional challenges beyond memory loss that can complicate or shorten their victims’ lives. (HYPERLINK TO PARKINSON’S ARTICLE)  It is not uncommon for individuals with dementia to have more than one type of dementia at a time.

Age-associated memory loss

Nearly 40% of senior citizens will experience some form of age-associated memory impairment in their life. Around two-thirds of these cases are non-dementia related. Often, their memory loss is much milder and lacks the other debilitating effects that are common with dementia. It may involve simple forgetfulness, misplacing items, difficulty making sudden decisions, or forgetting facts that you recall a short while later. This age-associated memory loss is the result of a combination of decreased blood flow in older brains as well as a decline in the amount of hormones and proteins that repair brain cells and stimulate their growth.

Potentially reversible causes of memory loss

Many forms of illness and injury can result in memory loss. In most of these cases, action can be taken to treat the cause and restore some or all of the memory function.

Sometimes memory loss can be the result of metabolic issues, such as hypothyroidism, or from the deficiency of key nutrients such as vitamin B-12 and D3. In these cases, medication or vitamin supplements to treat the underlying cause can alleviate memory loss.

There are also times when simply being overly stressed or anxious can lead to memory problems. An overwhelming season of life or a traumatic event can leave one with emotional issues that need to be worked through, and until they are, the victim may experience confusion, difficulty concentrating, and forgetfulness.

Some medications on the market, including narcotic pain killers, antianxiety and antidepressant medications, certain hypertension medications, and antiseizure medications can affect brain chemistry or the responsiveness of the central nervous system and result in memory loss. For some drugs, memory loss can be worsened if consumed with alcohol. Alcohol consumption itself, as well as the use of street drugs, can impair cognitive function and inhibit memory. In many of these cases, this diminished memory function can often be improved by changing medications or stopping the consumption of the offending substance. This is best done under the supervision of a physician, as there may be potentially dangerous withdrawal symptoms.

Finally, problems with the brain itself can cause memory loss. This could come in the form of a mild injury, such as a concussion, or from infections, swelling, or tumors in the brain. In these cases, some form of medical care can often treat the root cause and brain function may be restored in time.

Sometimes, however, even for these generally treatable causes of memory loss, the damage can be severe enough that it can lead to permanent cognitive deficits.  

How can Alzheimer’s and Memory Loss affect my ability to drive?

Regardless of the source of memory loss, it can harm one’s ability to drive.

Milder struggles can include difficulty remembering routes and locations. As memory loss worsens, a driver may also struggle with recalling the meaning of road signs or the rules of the road. They may fumble with the radio or the windows as they struggle to recall how to operate them, which can distract them from the road. Additionally, vehicle features change and develop with technology advancements. Memory loss can make it difficult or impossible to learn these new features and how they work. This can lead to confusion and lack of confidence behind the wheel. 

In more severe cases of memory loss, especially those associated with Alzheimer’s and other forms of dementia, victims may also struggle with coordination. Tasks such as steering while shifting a manual transmission can become overwhelming. Making quick judgment calls at intersections or in response to traffic and road conditions can become more difficult. Some may even struggle to remain alert and oriented to their surroundings or find themselves confused and unable to cope with the demands of being behind the wheel.

With Alzheimer’s and other forms of dementia, the progressive nature of the illness means that a person’s ability to drive can deteriorate with time. They may start out with only minor deficits, but either quickly or slowly develop more serious issues that can lead to increased restrictions on their driving, or even retirement from the road altogether. More severe cases may experience hallucinations and have behavioral issues that make it too dangerous for them to stay behind the wheel. As their brain deteriorates, this may also affect other functions in the body, rendering them physically unable to drive as well.

Finally, memory loss can affect people’s ability to take their prescribed medicine as prescribed. Some drivers have reported accidentally double dosing their medication, while others will unknowingly forget to take theirs at all. This is obviously a big problem as it relates to driving and can lead to very risky situations on the road. 

What can I do at home to improve my ability to drive with Alzheimer’s, Dementia, or Memory Loss?

Studies have shown that brain-training activities can help to improve memory function in those with Alzheimer’s, dementia, and other forms of memory loss. This often takes place in the form of games and puzzles that focus on reasoning, memory, recognizing patterns, and quickly processing information. Playing a musical instrument, speaking a second language, or doing crossword puzzles and sudoku can also help sharpen memory skills.

It is also important to get adequate sleep, exercise regularly, and eat a healthy diet. Avoid junk foods and simple carbs, and increase nuts, fish, and other natural sources of omega-3 fatty acids. Check with your doctor about taking B and D vitamins.

Also, do your best to minimize stress and anxiety. Take up habits such as stretching and deep breathing to relax, listen to calming music, and enjoy some time out in nature.

Before you go out on the road, use a tool like Google Maps to familiarize yourself with the roads you will have to drive on. Do your best to only drive on familiar roads in places where you are very confident with how to get around. New and unfamiliar roads can be very frightening to a person struggling with memory. 

How do I know when it is time to stop driving?

The answer to this question is not straightforward. It largely depends on what type of memory loss you have, how severe it is, and whether it is progressing. In cases of reversible memory loss, it may just mean a season of inactivity while you undergo treatment, followed by a full return to driving. Or in mild instances of age-associated memory loss, there may be very few restrictions and no need to stop driving any time soon. In other cases, especially those of more severe Alzheimer’s and dementia, driving may no longer be safe, and there is no hope of ever returning to the driver’s seat.

With memory loss, and especially Alzheimer’s and dementia, the very nature of the disease can make convincing the victim that they need to stop driving a difficult task. They may not understand why you want them to stop, or even that they have a problem. In their minds, they may see themselves as healthy and independent and may feel threatened both by the possibility of losing their freedom and by the suggestion that they are unfit to keep their keys. For this reason, it is important to talk to them about their future driving as soon as they are diagnosed with a problem and while they are still capable of participating in the conversation at a rational level. If you already see red flags, be sure to document information about their driving abilities, behaviors, and specific incidents, as these facts may be useful in convincing them that they are no longer fit to drive.

You can also file a report with the Connecticut DMV or have the police or a physician file a report documenting why they feel they are unfit to drive. This will trigger a process that can suspend their license until they meet the minimum requirements to safely drive again. You can find their contact information at https://www.ct.gov/dmv/cwp/view.asp?a=813&q=507054 or call them at 860-263-5723 for more information.

The best course of action if you are concerned about how memory loss is affecting your driving or that of a loved one is to schedule a consultation with a Certified Driver Rehab Specialist. They will be able to evaluate your condition and determine whether you or your loved one can safely stay behind the wheel.

What does Next Street Look for when assessing dementia, Alzheimer’s, and memory loss patients?

We work with each patient on an individual basis to determine what may be needed for them to continue to drive or to help them make the transition into retirement from driving. We evaluate the patient’s cognitive functions and reaction speed, as well as assess vision and physical health. We may also give them a behind-the-wheel evaluation.

Possible driving outcomes

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In situations where the patient only has mild cognitive impairments, such as occasional forgetfulness, they may be able to continue driving normally. If they have a progressive condition such as Alzheimer’s, however, they will still need to be monitored and reevaluated as time goes on.

Driving with restrictions

Sometimes, memory loss patients may still be able to drive, but with certain limitations, such as only driving during the day, or only from their home to nearby, familiar locations like the grocery store. They may need to undergo specific training to help them overcome some of their challenges or correct bad driving habits.

Retirement from driving

In more severe instances of memory loss, like those seen in later stages of Alzheimer’s and dementia, the patient may no longer be able to safely operate a motor vehicle. In this case, Next Street can help you to develop a transportation plan. Depending on the severity of their condition, they may be able to get rides from family, make use of ride services like Uber, Lyft, or Metro Taxi. It is possible that they may need more specialized considerations with drivers and vehicle attendants equipped to handle their unique challenges and behaviors.

It is possible that your loved one may adamantly refuse to give up driving, even when all the facts show that they should. If it has been officially decided that they should no longer drive, you may need to take additional steps with Alzheimer’s and dementia patients, such as moving their car, hiding the keys, or disconnecting the battery.

No matter what challenges lay ahead, we will do our best to help you plan and move forward in confidence.

 

 

Topics: aging, health, elderly, memory loss, alzheimers, driver rehab, driving evaluations, medical

Driving is Important

We Are Here to Keep You Safe Behind the Wheel

Our Driver Rehabilitation program works with patients whose change in health may affect their ability to safely drive. We have a team of Certified Driving Rehab Specialists that will work with patients on evaluating your driving abilities. We also have a team of professional instructors to help you gain or regain the skills you need to drive. We created this blog to talk about the various diagnoses we experience and how they may affect your experience behind the wheel. 

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