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Decisions About Driving for Persons With Neurodegenerative Conditions

      The information/education provided in this document is intended to be useful for all individuals currently experiencing or diagnosed with a neurodegenerative condition. Neurodegenerative conditions are conditions that result in progressive degeneration and/or death of nerve cells. Common neurodegenerative conditions include Alzheimer disease, Parkinson’s disease, multiple sclerosis, Huntington disease, and amyotrophic lateral sclerosis.

      How does my condition affect my driving capabilities?

      • You may have to give up driving sooner than your friends and family. If you continue driving, you may have more difficulties with critical on-road driving skills.
      • You may see accelerated decline in vision or attention that often occurs with aging.
      • Your motor functioning (eg, reaction time, hand-eye coordination, joint mobility, muscle strength) may be affected.
      • You may have difficulty keeping a constant position in the lane, driving in traffic, or concentrating while driving.

      Can I still drive after my diagnosis?

      • A neurodegenerative condition does not automatically lead to loss of driving privileges.
      • You probably will be able to drive in the early stages of your condition. Some individuals will be discouraged from driving soon after diagnosis. Others may be allowed to continue driving for many years.
      • You should discuss continuing to drive with your doctor, who will determine whether or not you meet the medical criteria of fitness to drive.
      • Your doctor will continue to monitor your ability to drive and may refer you to a driving rehabilitation specialist for a detailed assessment of your driving abilities. This assessment may involve tests of thinking, vision, and physical functioning and an evaluation of your on-road driving skills.
      • Your driving rehabilitation specialist may suggest modifications to your car that will enable you to drive better. These modifications may include a left accelerator pedal in case your right leg is weak, hand controls when both of your legs are weak, spinner knobs to facilitate steering, or lifts for entering and exiting your vehicle.
      • You should obtain medical clearance for driving soon after your diagnosis. Disclose your condition and medical clearance form to your insurance company to avoid any issues with liability in case you are involved in an accident.

      How do I know that I am at an increased risk for unsafe driving?

      Check all items that apply to you, or ask a family member to do it for you. If you check ≥1 box, you are at an increased risk for unsafe driving.
      • Do you have difficulty remembering where the car key is?
      • Do you have unexplained scratches on the body of the car?
      • Do you have blurry vision during driving?
      • Do you frequently forget the driving destination?
      • Do you get lost along a familiar route?
      • Do you get confused between the gas and brake pedals?
      • Do you have difficulty moving your leg freely between the gas and brake pedals?
      • Do you stop abruptly?
      • Do you veer off the lane?
      • Do you drive at an inappropriate speed (too fast or too slow)?
      • Do you fail to observe road signs and traffic lights?
      • Do you have difficulty executing turns and lane changes?
      • Do you have difficulty driving while conversing or listening to the radio?
      • Do you get multiple tickets for traffic violations within a span of 6 months?

      How do I know if I should stop driving?

      If you check ≥1 of the items subsequently listed, you need to stop driving immediately and seek other modes of transportation.
      • Have you been involved in ≥2 near-miss situations, fender benders, or other crashes within a 6-month period?
      • Have you had ≥2 incidences of becoming drowsy or falling asleep behind the wheel within a 6-month period?
      • Have you been told by your doctor to stop driving because of your medical condition?
      • Have you been told by a driving rehabilitation specialist to stop driving because of poor test results?

      What can I do to remain a safe driver?

      • Discuss your driving with your doctor, other health professionals, and loved ones. Those around you may notice changes in driving behavior and skills before you do. Listen to them because they are looking out for you.
      • Go for a yearly check-up of your driving skills. Go more often if you observe rapid changes in your thinking skills or reasoning and if you experience daytime sleepiness, fluctuations in your symptoms, hallucinations, serious side effects from your medication, or if you observe that your medication has become less effective.
      • Ask about restricted licensing in your state. Many states issue restricted driver’s licenses that allow you to continue driving in daylight conditions, familiar areas, or on secondary roads with lower speed limits.

      How do I prepare to stop driving?

      • Find ways to reduce your need to drive. Have prescription medicines, groceries, or meals delivered to your home.
      • Start by reducing your driving during rush hour traffic, on roads with heavy traffic, at nighttime, during inclement weather, and in unfamiliar areas.
      • Explore the following alternative modes of transportation:
        • o
          Rides from family and friends.
        • o
          Taxi cabs.
        • o
          Public transportation.
        • o
          Transportation services for seniors and persons with special needs.

      Where can I find additional information?

      • Visit the Association for Driver Rehabilitation Specialist’s website (http://www.driver-ed.org) or phone your local community rehabilitation hospital for a driving rehabilitation specialist.
      • Perform the 15-question self-rating exercise designed by AAA to help you examine your ability to drive safely (available at: http://seniordriving.aaa.com/sites/default/files/Driver65.12.13.pdf).
      • Visit the webpage of your state department of driver services or motor vehicles to learn more about your state’s regulations for driving with a medical condition.
      • Look in the phonebook under the headings “transportation” or “community services” to find transportation services for seniors and persons with special needs. You can also locate local agencies that provide transportation for people with special needs by searching the Eldercare Locator (http://www.eldercare.gov or 800-677-1166).

      Authorship

      Decisions About Driving for Persons With Neurodegenerative Conditions was developed by Abiodun E. Akinwuntan, PhD, MPH, DRS, and Hannes Devos, PhD, DRS, Department of Physical Therapy, Georgia Regents University, Augusta, GA.

      Disclaimer

      This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.
      This Information/Education Page may be reproduced for noncommercial use for health care professionals to share with patients and their caregivers. Any other reproduction is subject to approval by the publisher.