Question: My brother-in-law is a retired physician. The family is convinced he has some form of dementia, yet he refuses to see a doctor. He repeats himself, is forgetful, exercises poor judgment and frequently gets lost. The problem is driving. His family wants him to stop, but he refuses. They have turned to me for guidance. Any advice?

– M.H.

Dear M.H.:

You and your family are faced with a very difficult situation. Driving represents independence, freedom, competence and control. Any one of these is difficult to lose.

Much of the information about dementia warns against driving, but doesn’t describe when or how a transition should occur.

The publication “At the Crossroads: A Guide to Alzheimer’s Disease, Dementia & Driving,” published by The Hartford Financial Services Group Inc. and the MIT Age Lab, provides some guidance. Much of the following information is from that publication, available online at

Changes that occur with dementia are different from normal changes that occur with age.

For example, normal changes in eyesight and slower reaction time can affect driving skills of older adults. These changes usually are gradual, allowing older adults to slowly modify the way they drive. For example, they may avoid night driving, driving on freeways during rush hour or driving long distances.

Older adults without dementia usually can assess and regulate their driving without any family intervention and continue to drive safely.

The situation is different for those with dementia. Alzheimer’s disease, a form of dementia, is gradual and unpredictable. “It can affect cognitive functioning such as judgment, reaction time and the ability to solve problems,” according to “At the Crossroads.”

People with dementia typically cannot assess their abilities – they often overstate them, while minimizing the complexity of driving.

Here are some comments older adults with dementia have made to justify their continued driving:

“Just because I got lost doesn’t mean I can’t drive.”

“I make sure I look where I am going.”

“I’ve driven many years and haven’t had an accident yet.”

A diagnosis of dementia is not automatically a reason to remove driving privileges.

However, it is important to pay attention to early warning signs such as incorrect signaling; trouble navigating turns; moving into the wrong lane; confusion at exits; hitting curbs; difficulty parking; getting lost in familiar places; driving at inappropriate speeds; a car accident; confusing the brake and gas pedals; and stopping in traffic for no apparent reason.

The Hartford report suggests keeping a list of warning signs, the date observed and comments. That’s your data, which can lead to a plan.

Finding a balance is important.

One extreme is family members allowing the individual to drive for months even though they believe it is unsafe. The other extreme is family members overreacting to driving errors such as going through a stop sign, getting a fender bender or having difficulty parking. The individual may have had bad driving habits long before suffering from dementia.

Incidents that occur just once or twice are no reason for the person to stop driving. However, it may send a signal to observe and assess if they occur repeatedly.

One goal is to help people with dementia limit or stop driving while preserving their dignity.

Those with mild dementia can use senior transportation services.

For transportation within Los Angeles County, contact ACCESS at 800-827-0829. Rides of distances less than 20 miles are $2.25 each way; over 20 miles costs $3 each way.

Also consider Beach Cities Transit, at 310-376-3990; or the Senior Taxi program for Torrance residents 65 and older, at 310-618-2536.

Next week we’ll discuss family relationships and advice from experienced caregivers.

In the meantime, everyone drive safely.

Helen Dennis is a specialist in aging, with academic, corporate and nonprofit experience. Send her your questions and concerns in care of the Daily Breeze, 21250 Hawthorne Blvd., Torrance, CA 90503, or e-mail to

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