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 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.
- 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.
.
