Dementia, Driving and the Law
Dementia is characterized by symptoms such as memory loss, disorientation, and changes in visual and spatial perception. These symptoms may result in patients getting lost, forgetting the 'rules of the road", or having slowed reaction times. Individuals diagnosed with dementia become progressively impaired in their ability to drive. While patients with early dementia may not seem to have these problems, eventually motor coordination, powers of concentration, and exercise of appropriate judgment may become affected by the disease. Driving performance is likely to worsen during times of crisis at all levels of impairment.
The UC Davis - Alzheimer's Disease Center is required by law to report all patients with a diagnosis of Alzheimer's Disease and Related Disorders to the Department of Health. Reporting Alzheimer's Disease and Related Disorders: Guidelines for Physicians, published by the California Department of Health & Human Services, reads as follows:
"CALIFORNIA PHYSICIANS ARE REQUIRED TO REPORT ...ALZHEIMER'S DISEASE AND RELATED DISORDERS to their local county or city health departments. Local health departments send the reports in turn to the State Department of Health Services which forwards them to the Department of Motor Vehicles (DMV). The reports are used by the DMV to evaluate the driving competence of reported patients. The purpose of reporting and of evaluating the driving competence of potentially unsafe drivers is to make California's roads and highways as safe as possible for the public and for the patients themselves....Failure to report dementing disease or lapses of consciousness may lead to physician liability if the patient becomes involved as a driver in a motor vehicle accident."The diagnosis of a dementing illness is submitted in a confidential report to the local health department after the final conference is held with family.
Diagnosis of a dementing illness does not mean automatic suspension of a license. DMV determines whether patients have the capacity to continue to drive safely. Below is an example of the procedure DMV follows when evaluating a driver.lness is submitted in a confidential report to the local health department after the final conference is held with family.
- a computer search is conducted to locate the patient's name, verify if a current license exists and examining the driving record
- DMV sends the patient a letter with an appointment date for a reexamination interview. Patients can reschedule this if necessary, but the letter states that if they simply do not appear of fail to respond, the license will be suspended
- DMV includes a medical release so the information can be requested from the patient's primary physician. This is taken into strong consideration as part of the reevaluation process
- The patient goes to DMV for a written test, and a face-to-face interview focusing on memory for recent events. Patients who do well up to this point are then given a driving test. Patients who do poorly on the written and verbal tests may have the license suspended based on the DMV interview, the medical information and the patient's driving record
- The driving test is somewhat different for these patients. The first thing observed is whether the patient can find his car. The examiner gives a series of commands rather than one direction at a time. Patients are also taken on the road for a bit longer than usual to see if fatigue becomes a problem
- If the patient passes the driving test, generally the license is not suspended. The record is marked to automatically generate the next appointment for license renewal evaluation, often within a year
- A patient may also pass the exam but have restrictions imposed on the license, such as driving in a restricted radius, certain times of the day or to specific destinations only.
- The license will be suspended for patients who do not pass the exam. The DMV usually tries to notify a relative when this actions is taken. An appeals process is available.
- The DMV can provide a California identification card to those patients who will no longer have a driver's license.
Patients and families who have questions or want further information can call their local DMV for the number of their Regional Driver Safety Office; or contact Drivers control Policy Unit at Sacramento's DMV 916-657-5691.
Laws around driving for patients with dementing illness are subject to change.