There is a time for everything,
and a season for every activity under the heavens:
2 a time to be born and a time to die,
a time to plant and a time to uproot,
3 a time to kill and a time to heal,
a time to tear down and a time to build,
4 a time to weep and a time to laugh,
a time to mourn and a time to dance,
5 a time to scatter stones and a time to gather them,
a time to embrace and a time to refrain from embracing,
6 a time to search and a time to give up,
a time to keep and a time to throw away,
7 a time to tear and a time to mend,
a time to be silent and a time to speak,
8 a time to love and a time to hate,
a time for war and a time for peace (Ecclesiastes 3:1-8).
I am asked the same question almost every time I lead Discussing Dementia 1 or 2. The question is all about driving. To misquote Shakespeare: “to drive or not to drive, that is the question”.
My dear mother lived with both vascular and Lewy Body dementia. As she aged, and as the symptoms of her dementia increased, it soon became apparent that her driving was becoming erratic. She would brake late and hence brake heavily. She never got lost, though she did get confused about where she was going, and how to get back home. She always hating reversing the car, and her lack of confidence gradually increased. We became more and more concerned about her driving, but it was a sign of her independence and freedom, and she wasn’t willingly going to surrender it. We were intending to speak to her GP about it, but thankfully she had a small bingle while reversing the car in a car park. There was little damage to either vehicle, but Mum was shaken. She decided that it was time to stop driving, and so with great relief she gave up her licence.
The writer of Ecclesiastes puts it well: “There is a time for everything, and a season for every activity under the heavens”. There is a time when people should have a licence to drive a car, and a time when they shouldn’t. The old adage contains more than an element of truth: “I have been driving for 60 years and I’ve never had an accident!” That may be true, but I could well ask: “Yes, but how many have you caused?”
I commute five days a week on the M1 motorway from the Central Coast to Sydney, which is 3 lanes wide. Besides an actual accident and the resulting traffic jam (sometimes up to 8 km long), the worst thing I encounter is a driver in the middle lane doing well below 110. Some of them are quite oblivious to the drivers who, in frustration, are overtaking them on both the left and the right. The sign “Keep left unless overtaking” doesn’t seem to apply, probably because they ARE driving on the left of the right-hand lane! I have lost count of the number of near-misses caused by this poor driving. Surely there is a time when people’s driving needs to be tested once again, and it’s not when they’re in their 80s.
So what’s wrong with people living with dementia still driving? In the early phases it’s usually alright. However, as my Mum’s story shows, there are two important factors to consider. The first is that people may become lost. If they’re on foot it’s easier to find them because they usually can’t walk too far. If they’re in the car it’s a different matter altogether. The more confused they become, the more lost they feel, the more likely it is that they will make a bad decision. When I am not sure where I’m going I set my navigator, and it politely tells me where to go. If I’m in the wrong lane I may quickly change lanes, or else quickly turn off the road – hopefully having checked for other traffic and using my indicators. The confusion or anxiety of feeling lost doesn’t make for good decision-making.
The other vital factor is that as we age our brains do not work as quickly. Our reaction times slow down. Dementia can slow down our reaction times considerably, as a damaged brain needs to compensate. So, when I see that the car in front of me suddenly brakes, I need to suddenly brake also. If my brain takes longer to notice the other car’s brake light, and my brain takes longer to instruct my leg and foot to brake, the result can be disastrous. If the road is wet and slippery, and you haven’t left enough room to brake, applying the brake may not be able to prevent a bingle. Hopefully you’ll collide with less speed and hence cause less damage.
So, the problem with driving is not just that people living with dementia get lost. It’s the fact that eventually their reaction time may become too slow in order to drive safely. The car is a wonderful piece of machinery, but like many inventions it is only as good as its operator.
So, what do you do if you’re concerned about someone’s driving? Speak to them first. Try, try, and try again. They may accept the need to stop driving – just like my Mum. If they don’t, and their driving has become unsafe, it’s time to call in the GP. Let the GP be the one to remove their licence. You can then say that it was the GP who did it, not me! You also need to be practical. Hide the car keys! If the car is no longer needed, then sell it. It’s impossible to drive a car which isn’t there. (As an aside, it is usually cheaper to catch taxis than to own and maintain a car. That wouldn’t work for my commute on the M1, but for short trips to the shops it’s ideal. Let someone else drive).
Because driving is such a big issue, the NRMA has produced both a booklet and brochure. I have included them below. They are well worth reading:
My friends, there is a time for everything. There may well be a time when we need to stop driving. It’s better if, like my Mum, we decide that for ourselves. As we age, and as illness takes its inevitable toll, we need to be realistic. As the Serenity prayer puts it so well, we need to “accept the things we cannot change”.