Including driving, walking and more
People with dementia may have different risks and comfort levels with driving and other forms of transport. Here are some things for caregivers to consider for helping a person with dementia stay safe, as well as mobile.
Driving and dementia
Does a diagnosis of dementia mean a person has to stop driving? This is one of the first and toughest issues many people living with dementia face. It can also be an issue for their families and friends.
Some people in the early stages of dementia can continue to drive safely. But because dementia symptoms usually get worse over time, it’s important to be aware of any changes in driving habits.
Of course, not everyone drives to get around. Many people walk, cycle, ride public transit, or use taxis and rideshares. And dementia can impact those, too.
Watch for these warning signs
As dementia progresses, a person’s thinking, memory, sight and orientation can decrease. This may lead to driving challenges, or safety issues like: Going too fast or too slow, stopping in traffic for no reason, being confused about when to change lanes, getting lost on familiar roads, driving in the wrong direction, using improper signalling, ignoring traffic lights and signs, thinking “green” means stop and “red” means go, confused about pedestrian signs and signals when walking in an intersection, refusing passengers like family and friends. Extra things to look out for:
• Becoming nervous or irritated about driving
• Not being able to make sound judgments on the road – for example, not braking in time, driving too fast in inclement weather
• Difficulties judging walking speeds and the speed of oncoming traffic
• Worsening eye, hand, and leg coordination and reflexes
• Increased traffic tickets or warnings
• Misjudging widths and distances, resulting in an unusual number of small dents or scrapes on the vehicle.
Note: Certain types and combinations of medications can further impair the person’s reasoning and judgment.
What to do if you’re concerned
• Know that you are not alone. There are places you can reach out to for help.
• Talk to your family doctor. Physicians are legally responsible to report patients who have a medical condition that may impair their driving.
• Raise the issue of driving early to help encourage the person with dementia to participate in decisions about driving.
• Driver testing and licensing rules vary by province and territory. Check with your provincial Ministry of Transportation for current rules.
• Discuss your concerns with family or friends with similar experiences.
• Contact your local Alzheimer Society. Staff can help you solve challenging issues and point you in the right direction.
Tips for getting into and out of a car
When travelling, take steps to prioritize safety and emotional comfort. A person living with dementia may find it hard to get in and out of a car. Over time, perception problems may develop. Making it hard for a person to see changes in depth. As a result, a person might need more help getting into and out of a car or other vehicle.
Other helpful ideas include:
1) Parking your vehicle on a flat surface, a fair distance from the curb. Leave enough room for the person to step onto the street.
2) Moving the front seat back as far as possible. The front seat of the car is often more accessible than the rear seats.
3) Clothing may stick to car seats made of cloth. Try covering the car seat with more slippery material, such as a sheet of plastic.
4) Ensure the person’s feet are outside of the car and firmly on the ground; guide the person to sit sideways on the seat.
5) If a person tries to remove a seatbelt while driving, turn the seatbelt inside out so that the buckle is not easily accessible.
By foot, bike or wheelchair
Walking or wheeling is a great way to stay physically active, maintain independence and connect with others. It is also important for a person living with dementia to feel as safe as possible when they are out walking, biking or rolling. It might be wise to join a walking group or find a walking buddy—this is also a great way to meet new people and stay connected. Here are some helpful tips.
Avoid hazards such as:
• Roads with high volumes of traffic and multi-lanes
• Areas with traffic driving at high speeds
• Neighbourhoods that do not have a proper sidewalk or have uneven ground
• Challenging weather conditions—such as heavy snowfalls, icy sidewalks or strong winds
• Construction zones or closed roads
• Walk in familiar places—establishing a walking routine can be helpful
• Consider using a tracking or locating device
• Always carry some form of identification, along with the name and number of a person that could be contacted in a crisis
• Keep a list of important addresses, names and contact numbers on the person with dementia
• Use a map, possibly on a smartphone, to follow familiar walking routes and to avoid busy roads
• Check the current weather before leaving for your walk
• Wear appropriate clothing, such as a hat, gloves and winter boots when it is cold and a sun hat, light clothes or sunglasses when it is hot
• Choose a walking route that has access to benches, rest areas, public washrooms, etc.
• Find a walking route with lots of green space, a calming environment and easy-to-read signage—loops can be great for this.
Tips for travelling
We all enjoy a change of scenery and a break from routines. However, as dementia progresses, changes in abilities can make it difficult to get away.
Careful planning will help you manage changes in surroundings and routines. Here are some suggestions to make the trip easier:
• Consider a holiday package, where everything is organized for you.
• Include the person with dementia in your planning. Give them a copy of the trip itinerary for their reference.
• If you are planning to visit friends and family, tell them about the changes since your last visit.
• Learn as much as you can about the place you’ll be visiting, so you can anticipate what you’ll need.
• Think ahead about activities that may need to be adjusted.
• Carry recent photographs, details of what the person is wearing, and preferred places of interest. This will help during a search if one is needed.
• Be sure to keep a copy of the name and number of your hotel in a familiar spot in the person’s purse or pocket, so they can ask for help if needed.
Simplify
Aim for as few changes in routine as you reasonably can. Try to get a direct flight. And, if you’re travelling by car for a long distance, consider extending the time to get there and driving shorter distances each day.
Ask for help
• If possible, have an additional person travel with you to help.
• Make sure that your travel agent is aware of any special needs. Inform the airline that you are travelling with a person with dementia.
• You may want to request early boarding, a wheelchair, transportation upon arrival, help getting on and off the plane or with stowing carry-on baggage.
• If you are staying at a hotel, let the staff know about your needs and explain some of the possible difficulties you think you might encounter.
Source: The Alzheimer Society of Canada. No matter where you live in Canada, you will be able access education, resources and support that can address your needs. alzheimer.ca
Useful links and resources
Conversations about dementia and driving. Alzheimer Society of Canada. In this information sheet, learn how dementia can affect a person’s driving abilities and get strategies to help people living with dementia, caregivers and healthcare providers have conversations about driving cessation.
Living safely: “A By Us For Us” guide. Schlegel-UW Research Institute for Aging. The guide offers many safety tips and strategies related to driving, living at home, being out in the community, personal identification and use of technology, health and medication, physical safety, and financial safety.
Safety when out and about: “A By Us For Us” guide. Schlegel-UW Research Institute for Aging, the Alzheimer Society of Ontario and Finding Your Way™. This guide offers tips and strategies for staying safe in the community.
