You have probably seen the television commercial in which a woman loses her keys and her husband finds them in the refrigerator. The message being conveyed is that misplacing things in unusual places is one of the ten early warning signs of Alzheimer’s; but another implication is that this woman is looking for her keys because she is planning to drive her car. The question of whether or not to drive after experiencing signs of Alzheimer’s is not the focus of the commercial, but maybe it should be. At least four other early warning signs identified by the Alzheimer’s Association also affect the ability to drive:

• difficulty completing familiar tasks
• confusion with time and place
• trouble understanding visual images and spatial relationships
• and decreased or poor judgments.

In spite of these possible driving impairments, caregivers often avoid addressing this situation because of the emotional side of the issue.

A friend has frequently confided in me that her father’s driving scares her. She describes several close calls when another alert driver saved the day. Yet, she cannot bring herself to confront him about giving up his keys because, “He would be so upset.”

Opinions differ concerning driving and Alzheimer’s. Some say that in the early stages, short trips in familiar surroundings may be safe. But no one knows when “familiar” may suddenly become “strange.” I would choose to err on the side of caution, especially after reading accounts of numerous accidents and lost motorists – even some that resulted in death.

Caregivers are usually the best judges of a loved one’s ability to drive safely. Consider these warning signs which may indicate driving skills are deteriorating:

• Confusing the brake pedal with the gas pedal and vice versa
• Getting “lost” while driving to a familiar place
• Ignoring traffic signs
• Changing lanes improperly
• Running off the road or hitting the curb
• Driving extremely slow or stopping in the street for no reason
• Forgetting to signal
• Driving on the wrong side of the street
• Parking inaptly (such as stopping halfway into a parking space)
• Expressing inappropriate emotions while driving, such as extreme agitation
• Inability to foresee or react to a dangerous situation

When the time comes to limit or prohibit driving, it is imperative that alternative transportation be provided. This will ensure that your loved one’s usual activities will not be restricted and he will not feel a great loss of independence. Respond to relatives or friends who ask, “What can I do to help?” by suggesting they serve as chauffer for medical appointments, church services or pleasure outings.

Explaining your safety concerns to your loved one may or may not achieve compliance. If she balks at the idea that she should no longer drive, a conversation or written directive from a doctor, lawyer or car insurance agent may help. Refusal to cooperate may necessitate disabling or removing the vehicle.

While it is certainly not a pleasant task to tell your mom or dad or spouse that it is no longer safe for them to drive, their safety and the safety of others should be the first concern. It may be challenging to stand firm in your decision; but the consequences of giving in and allowing someone to drive who can no longer do so safely could result in a much more difficult or even tragic situation.