Similarly, you could suggest walking as an alternative and as a way to get some fresh air and exercise, When having these conversations, it is important to stay calm so the person with dementia doesn’t feel they are being told to stop driving, but they are aware of your concerns for their safety. As the disease progresses the ability to drive safely is eventually lost and at that point current regulations demand that driving stops. If the DVLA decides that a person is no longer able to drive, their licence must be returned to the DVLA and the person must stop driving. The first step for someone who is diagnosed with dementia and wants to keep driving is to tell DVLA/DVA about their diagnosis straightaway. This is an assessment to look at your ability to keep you, your passengers and other road users safe. A driving assessment will be arranged for drivers diagnosed with dementia (Image: … 5.3 Prior to any assessment of dementia or cognition (and especially within a memory clinic setting) it is good practice that a person is notified that there could be implications for their future driving.2 Some people choose to have an assessment without DVLA/DVA asking them to. The content below is reflective of our leaflet. A DVLA driving assessment can be completed at one of 17 accredited driving assessment centres around the UK. For people with early dementia, this may be up to three years. This version is the Nottingham Assessment for Drivers with Dementia. The Dilemma - You have been the GP to an elderly couple for over 20 years. Talking to others about this and making some changes to their usual arrangements can make it much easier to stop driving when the time comes. It is better at identifying those who are safe, than unsafe on the road. It’s an overall assessment of the impact dementia is having on a person’s driving and whether they’re able to drive safely and in comfort. You may be able to appeal. Regular assessments during office visits may help your doctor identify a decline in abilities that indicate a greater risk. Dementia UK, • Developed in the context of a specialist driving assessment centre. Most people in the early stages of dementia are physically capable of controlling a car. If the DVLA decide the person is able to continue driving, they will issue a new licence which is likely to be valid for one year. 296645. Following a diagnosis, it is often better if the person with dementia decides to stop driving themselves, as this not only reduces any risks to them and others, but also helps them to maintain their sense of control. Online groups and discussions boards may also be a useful way of sharing experiences. The assessment is not a driving test, but is an overall assessment on the impact of dementia on the person’s driving. The assessment will be at one of 20 approved driving assessment centres around the UK, or at one of their related ‘satellite’ centres (see Driving Mobility centres under ‘Driving – other resources’). This MedCase discusses driving assessment for a patient with mild dementia using the 2014 Clinical guideline on Dementia and Driving Safety 1 and the Hui Process, 2 a four-step approach to building relationships with Māori patients and whānau. There are two components: a cognitive assessment conducted with the patient, and an informant questionnaire (only considered necessary if the results of the cognitive section are equivocal, ie score 5-8 inclusive). It may also be helpful for the person with dementia to discuss these feelings with other professionals or people who have been through the same thing. Introduction. The assessment is not a driving test, but is an overall assessment on the impact of dementia on the person’s driving. A driving assessment will be requested. Back at the centre, the assessors tell the driver what they have found. may also ask you to complete a driving assessment at a DVLA driving assessment centre. It can be difficult to know what to do, what decisions need to be made, who to tell, what support is available and what happens next. It is a good idea for those close to the person with dementia to stay aware of their driving skills. There are two components: a cognitive assessment conducted with the patient, and an informant questionnaire (only considered necessary if the results of the cognitive section are equivocal, ie score 5-8 inclusive). These assessors will make allowances for ‘poor driving habits’ which people have developed over time, as their priority is looking at overall safety, reaction time and limb strength. It is not only the person with dementia who can be affected by their ceasing to drive. Registered as a company limited by guarantee and registered in England No. For example, there is no need to find a parking space and you may save money on tax, insurance and fuel. Many clinicians use the adage that if the son or daughter of a person with dementia is happy for their own kids to go in the car alone with the grandparents, then everything is probably fine. Although decisions regarding possession of a driving licence in the UK are made by the Driver and Vehicle Licensing Agency (DVLA), psychiatrists have a duty to advise patients who are unfit to drive to cease driving and to inform the DVLA of patients who pose a risk to the public by continuing to drive when advised not to. www.bps.org.uk, Counselling Directory This is not a driving test but an assessment of ability to continue driving; The person’s licence is cancelled and they … This can be done without the person’s permission, however, this is best avoided if possible. If they decide that you have to stop driving, you will have to return your driving licence. Assessing driving ability in people with dementia is a serious challenge. It will usually be valid for one year. The person’s eyesight is also checked. There is a charge for this service. If a person wants to keep driving after being diagnosed with dementia, they must take certain steps and let DVLA/DVA decide. It may also be worth finding local dementia groups such as memory cafes, in which the person is able to talk about this experience with others who are in a similar position. It can be very worrying for families if the person they care about continues to drive as there can be concerns about the person’s safety. I know that some areas of the UK have driving courses where people with the illness can go for an assessment, to see if they are competent to drive, and that to me is a brilliant idea. Giving up driving can be very difficult for a person with dementia and can often cause a lot of frustration and feelings of loss, particularly if they have driven their whole life. Some carers feel this is an indication that the person’s dementia is progressing. 3. Dementia UK is a registered charity in England and Wales (1039404) and Scotland (SCO47429). A person may do this if they have a valid licence but want some extra advice or teaching. The DVLA will talk to your medical team and may, if it feels it is necessary, ask you to attend a driving assessment at a mobility centre. How to keep driving after a dementia diagnosis. Two leading experts on dementia and memory loss examine the impact that diagnosis can have on people who drive. Ongoing dementia assessment. It can also mean a lot of change for their partner, or another person who cares for them. The driving assessment isn’t like a driving test. Dementia and driving You must tell DVLA if you have dementia. In this case, someone else will need to drive the person home if they came to the centre by car. If the person with dementia is the main or only driver in a family, this change can be challenging for everybody. DVLA/DVA will refer the driver to a centre near their home and will pay for the assessment. A diagnosis of any form of dementia does not necessarily prevent anyone from driving. We hope that you found this resource helpful. There are two different types of driver assessments: Detailed driving assessments for people with a medical condition or disability which affects their driving, or who are returning to driving after an accident or injury, are provided by mobility centres. When someone who drives receives a diagnosis of dementia, one of the first concerns they and their family often have is whether they can continue to drive. A thorough assessment is likely to require two visits along with collateral history from family members. The person with dementia must also bring their driving licence and any glasses they need for driving. Dementia is important in relation to driving. Many patients continue to drive after dementia has been diagnosed, 1 2 3 4 5 w10 however, and withdrawal of their licence should not be undertaken lightly. E-mail: info@dementiauk.org. 2. If you live in England or Wales, this questionnaire can also be downloaded from the GOV.UK website . Driving is something that many people take for granted; it can represent independence and a sense of freedom. So when a person is diagnosed with dementia, they may start to worry that they will no longer be able to drive, due to a loss in coordination and spatial awareness, or difficulty recalling directions. DVLA/DVA may: In all cases, DVLA/DVA will tell the person in writing. Ongoing dementia assessment After you've been diagnosed with dementia, the GP should arrange to see you from time to time, to check how you're managing. Practice dilemma - Driving with dementia. After that, your competence will be reviewed at least once every 12 months. Watch how four families deal with different issues related to dementia and driving. People can self-refer or be referred by a … Call the National Helpline. People can self-refer or be referred by a … Once these have been received, the DVLA will make a decision as to whether the person can continue to drive, choosing from one of three options: 1. If at any point, the licence holder decides that they want to stop driving and give up their licence, then they need to write to the DVLA to inform them. The assessment is not there to ‘catch people out’ and is usually very supportive. To help a person with decisions about driving: 1. We’ll send you a link to a feedback form. This version is the Nottingham Assessment for Drivers with Dementia. To help us improve GOV.UK, we’d like to know more about your visit today. Dad has had his licence rescinded - he's furious! A request for further information, either via medical details or by an on-road driving assessment It may be easier to stay safe on the road if they: Even if DVLA/DVA decides the person can keep driving, it may be helpful for them to plan ahead for when they must stop completely. It may also be good to hear this from other members of the family, or family friends, or the person’s GP, It may be beneficial to suggest alternatives to driving, and some of the benefits of this. Driving can be part of maintaining independence and an active life. Overall, it can take about two hours. The wife is disabled by arthritis and the husband has been slowly developing dementia. It is not just dementia that impacts on driving; many other conditions can also have an effect on a person’s ability to drive. NICE guideline [NG97] Published date: 20 June 2018. Registered office at Alzheimer's Society, 43-44 Crutched Friars, London, EC3N 2AE, Alzheimer's Society is a registered Charity No. Driving is a complex task, requiring the use of various skills, including navigation, spatial awareness and speed of reaction. Keep up-to-date with our progress making Admiral Nurses available to all families who need them. Dementia; Dementia: assessment, management and support for people living with dementia and their carers. The driving assessment takes about two hours and generally includes the following steps: The person with dementia answers questions about their medical and driving history, and any driving problems they may have. Dementia UK provides specialist dementia support for families through our Admiral Nurse service. Driving “I did my driving assessment and I passed… I felt 10 feet tall. www.dementiauk.org/better-communication, Driving Mobility Centres Driving Assessments for people with Dementia. 2. The loss of a driving licence can present other opportunities for people with dementia and their partner, for example, finding more local groups and going on walks together as opposed to driving. This part happens in a dual-control car, which has a brake on the passenger’s side as well as the driver’s side. 2115499. The DVLA will conduct a reassessment every year; however, it is a good idea for people close to the person with dementia to monitor their driving skills throughout the year and speak to the person’s GP if they are concerned. It will take only 2 minutes to fill in. However, there are many steps that you must follow upon being diagnosed to determine whether driving is still an option. A study highlighted the negative consequences of stopping people with dementia from driving.w11 Stopping driving can limit access to family, friends, and services and is an independent risk factor for entry to a nursing home.w12 Traffic medicine has evolved significantly since the 1990s, with more emphasis on preserving mobility. Admiral Nurses give families the compassionate one-to-one support, expert guidance and practical solutions they need to face dementia with more confidence. The DVLA will always write to the licence holder with their decision. It is better at identifying those who are safe, than unsafe on the road. This is not a driving test. Clinical assessment is required. Begin the conversation as soon as possible and involve the doctor 2. DVLA/DVA will then send the person a questionnaire and a request to get medical reports from their doctor. www.dementiauk.org/helpline, Alzheimer’s Society Confusion Over Colors, Words, or Road Rules. Results >8 or <5 on the GPCOG patient section were assumed to be cognitively intact or impaired, respectively. These guidelines, endorsed by the BGS, set out the responsibilities of clinicians to their patients and provide a framework for thinking about the management of their driving safety. Need help? We’ll send you a link to a feedback form. • Performance on tests compared with the overall decision by the centre on participants fitness to drive. Help us improve GOV.UK. Close. Brain scans are often used for diagnosing dementia once the simpler tests have ruled out other problems. Renewal of the person’s licence In Northern Ireland it is the Driver & Vehicle Agency (DVA). don’t go for long periods without driving – to keep their skills and stay confident, keep to short and familiar routes at quiet times of the day – so they are less likely to get lost or stuck in heavy traffic, drive in daylight – with good road and weather conditions, drive without distractions, like the radio – for better focus. The Dementia Drivers' Screening Assessment (DDSA) is a neuropsychological battery designed to assist in this process. Prices vary but the average cost is between £70–90. • People (n= 543) with a range of neurological conditions, including dementia (n= 53), assessed on a battery of cognitive tests. www.dementiauk.org/changing-roles-and-relationships, Dementia UK leaflet on Dealing with stigma Most mobility centres provide an aftercare service for people who have stopped driving (see Sources of support). Although family and caregivers can watch for signs of unsafe driving, a proactive strategy would be to get a comprehensive driving evaluation by an occupational therapy driving rehabilitation specialist. driving@hertsability.org.uk; Herts Ability Opening Hours: Mon - Thu 9am - 5pm Fri 9am - 4:30pm ; Dementia. The assessment of driving risk can be difficult for clinicians, not least because there is ... 1.2 As our population continues to increase in age, so too will the prevalence of dementia in the UK, which is estimated to reach over 1 million by 2025 [2]. Your doctor may ask for feedback from the person with dementia and a caregiver separately to assess risks. Involve the person with dementia in the planning and decision-making 3. Formal dementia driving assessments are available, but who decides when a patient should be referred for one of these? If you have a medical condition or disability which may affect your driving, you should take an assessment at a Mobility Centre, rather than just a simple driving assessment or refresher training. 2 Dementia UK Driving and dementia When someone who drives receives a diagnosis of dementia, one of the first concerns they and their family often have is whether they can continue to drive. Discussions about Driving in our online community, Talking Point... We will remember your selection for future visits; you can change your choices at any time, Five things you should know about dementia, Equipment, adaptations and improvements to the home, Using technology to help with everyday life, Take part in Dementia voice opportunities, Make your organisation more dementia friendly, Risk factors and treatments - we discuss evidence, All-Party Parliamentary Group on Dementia, When DVLA/DVA decides that a person with dementia must stop driving, Giving up driving after a dementia diagnosis. She said: “It can be difficult to maintain a balance between enabling a person with dementia to live independently and ensuring the safety of that person and those around them. The person should also have regular check-ups with their doctor to see how their dementia is progressing. There are several different tests. People with a diagnosis of dementia often want to continue driving. The assessors will work with the person to help them keep driving if this can be done safely. His wife doesn't drive, but knows it's time to discuss finding alternative transportation. It will take only 2 minutes to fill in. 'Driving with Dementia or Mild Cognitive Impairment' - created by Newcastle University and the National Institute for Health Research (NIHR) - helps medical teams with the appropriate assessment and management of people living with the condition. Some centres have a private road that the person drives around first. UK law on driving and dementia is clear. Talk about the safety of the driver and others 4. This is in case the assessment finds that the person is unsafe to drive. Stroke Drivers Screening Assessment, to be purchased. A driving assessment can help to clarify the effect that dementia is having on your driving - this information can help the licensing agency when they are deciding whether you can continue to drive. These tests are known as cognitive assessments, and may be done initially by a GP. Although stopping driving can be a challenging time, it does not mean that you and the person you care about cannot live a fulfilling life. Appeal to the person's sense of responsibility 5. You are here: Home / Get support / Diagnosis and next steps / Driving and dementia. Driving and dementia: a clinical decision pathway Kirsty Carter1, Sophie Monaghan2, John O’Brien3, Andrew Teodorczuk1, Urs Mosimann4 and John-Paul Taylor1 1Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK 2London and Maudsley NHS Foundation Trust, London, UK 3Department of Psychiatry, University of Cambridge, Cambridge, UK A driver (or ‘licence holder’) who is diagnosed with dementia must tell their licensing agency straightaway. A common one used by GPs is the … Stroke Drivers Screening Assessment, to be purchased. If you are concerned about any other conditions that a person has, it is important to visit your GP, or write to them, if you are caring for someone from a distance. People with symptoms of dementia are given tests to check their mental abilities, such as memory or thinking. It is important to acknowledge this is how they may be feeling and allow them to talk about this openly, even if you are unable to provide a resolution. It is possible to appeal against a licence being revoked. Dr Alison Evans, of Alzheimer’s Research UK, backed the idea of a driving assessment. The assessment is not like a learners’ driving test. Licensing decisions made by the DVLA are usually based on medical reports. The following are some tips to help ease the practicalities of losing a licence: It is not just practical factors that can make losing a licence hard. A diagnosis of dementia can be a big shock – for the person with the condition, and their family. The person drives with the advanced driving instructor in the passenger seat and the occupational therapist in the back. Evaluating driving safety in patients with mild cognitive impairment (MCI) or dementia can be challenging. The NZTA guidelines specify that patients with dementia should not drive “where cognitive impairments may affect an individual’s ability to drive safely”.2This decision is straightforward in cases of moderate or severe dementia, when driving must be stopped, but is more difficult in cases of mild dementia or MCI, as safety cannot be inferred from cognitive test results or dementia stage. London If the assessors decide that the person is not safe to drive, the information and advice they receive will be about other options. These skills can be affected by dementia, depending upon the type of dementia someone has and the part of the brain that is affected. Stopping driving can be seen as a loss of independence and it is important to ensure that the person with dementia feels respected throughout, Try to drive in daylight and during quieter times on the roads, Try to keep driving to familiar routes with short distances, Reduce distractions such as turning off the radio and limiting conversations, Try to have a passenger in the car to help with navigation, Find local services such as peer support groups which are nearby, to help reduce any social isolation caused by stopping driving Invite friends and family over to your house to prevent the need to travel, Set up an account with a local taxi service and order taxis in advance, Find local voluntary agencies which may be able to assist with transport services, Order shopping online to reduce any burden of travelling. Many people with dementia are able to continue driving for some time. Government advice on dementia and driving It might mean the friend or family member being called upon to drive them around more, or accompany them on public transport. The effect of dementia on the person’s driving should be considered at these check ups or at other healthcare appointments, where appropriate. 7th Floor EC3N 1RE, Tel: 020 8036 5400 There is a charge for this service. Here is some information on the legal requirements, as well as some practical suggestions to support both the person with dementia and their family. Tel: 020 8036 5400 only drive when they feel fully awake and well. If you have a full or provisional driving licence, this assessment is for you. This is a car with the steering wheel and foot pedals linked to a computer. Alzheimer’s, vascular, mixed, Lewy body and frontotemporal dementias. This includes notifying the DVLA, your insurance company and GP. A formal petition must be lodged with the magistrate’s court within six months; however, during this time the person is still not allowed to drive. In the UK, drivers with dementia have to be referred to mobility centres for assessment of their driving skills, as there are no specialist assessment centres for dementia.There are only16 such centres in the UK (only one in the north-east original papers Naidu & McKeithDriving, dementia and the DVLA Table 2. In these cases, the person must get in touch with the centre directly and pay for the assessment. www.dementiauk.org/staying-healthy, Dementia UK tips for better communication The aims of the strategy include: • improving diagnosis, assessment and care for people living with dementia • ensuring that all people living with dementia have equal access to diagnosis If DVLA/DVA decides that a person with dementia can keep driving, they will send them a new driving licence. It may also be emotionally difficult, if the person with dementia blames the person who cares for them for taking away their car. Use a standardized cognitive assessment tool such as the 10-point cognitive screener (10-CS), the 6-item cognitive impairment test (6CIT), the 6-item screener, the Memory Impairment Screen (MIS), the Mini-Cog, or Test Your Memory (TYM). This is the main part of the assessment. While giving them the annual flu jab, you realise that his dementia has progressed and he no longer knows your name. Cognitive assessment is central to the diagnosis and management of dementia and should be performed in all people with suspected dementia [Sorbi, 2012]. People with a diagnosis of dementia often want to continue driving. Because symptoms of dementia are likely to worsen over time, individuals who pass a driving evaluation should continue to be re-evaluated every six months. 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