Supportive care for people who need it

Car ownership and driving are highly correlated with independence and life satisfaction in older adults. In a study in Australia, older adults rated driving as the second most important activity of daily living task, behind use of transportation but ahead of leisure, reading, and medication management. As we age, we face unique challenges as driving is a highly complex task that requires a variety of skills, including physical, cognitive, behavioral, and sensory‐perceptual abilities. But because of age‐related declines in health and physical and cognitive function, driving becomes more difficult for older adults.

However, there is mounting evidence that driving cessation in older adults may also contribute to a variety of health problems. Of special note is the apparent effect of driving cessation on self‐reported depressive symptoms. Data from five studies including one in Australia indicate that driving cessation nearly doubles the risk of greater depressive symptoms in older adults. The strength of the association between driving cessation and self‐reported depressive symptoms is generally consistent across studies and in part arises from increased isolation. But this can be partially solved by planning and taking control of the decision to stop driving.

Dementia Australia recommends starting early on finding alternatives to driving and supporting drivers by helping them reduce the need to drive and having other options for getting around.

Things to try:

  • Offer to support the person by driving them to appointments, social gatherings and to access shops and services.
  • Encourage the use of buses, trains or taxis when possible.
  • Encourage walking when possible. You may find GPS technology can be helpful.
  • Investigate community transport available in your area. Check with your local council.
  • Encourage the use of home delivery services for food, medical prescriptions and your local library.
  • Ask family and friends to assist with transport, either by driving the person or accompanying them on other transport.

In addition to the social issues of driving, drivers need to be aware that all drivers are required by law to tell their local licensing authority of any medical condition that might affect their ability to drive safely. Dementia, diabetes, heart conditions are just some of the conditions that need to be disclosed because they may affect a person’s driving ability.

Once notified, the licensing authority will ask that the driver’s doctor makes an initial assessment of the driver’s medical fitness. After this, a formal driving assessment may be required. Based on the results of these assessments the licensing authority will decide if the person can continue to drive.

If the person with dementia can continue to drive, they will be issued a conditional licence. Conditional licences are valid for a maximum of 12 months; after that the driver will be reassessed. Sometimes restrictions are also placed on the licence holder. These restrictions might be that the person can only drive close to home, at certain times, or below certain speed limits.

If a person with notifiable medical condition continues to drive and they have not notified their licensing authority and insurer, or if they continue to drive after their licence has been cancelled or suspended, there can be serious consequences. If the driver is in a crash, they could be charged with driving offences or be sued. In addition, their insurance company may not provide cover.

As a family member or friend when should you be concerned about your loved one’s ability to drive? The list suggested by Dementia Australia below is by no means exhaustive but does highlight when you need to get your family member or friend to be checked by a Doctor for their driving safety:

  • Vision – Can they see things coming straight at them and from the sides? Can they see and respond appropriately to traffic signs and signals?
  • Hearing – Can they hear the sound of approaching cars, car horns and sirens and respond appropriately? Do they pay attention to these when in the car?
  • Reaction time – Can they turn, stop or speed up their car quickly?
  • Problem solving – Do they become upset and confused when more than one thing happens at the same time?
  • Coordination – Is their coordination affected? Do they get the brake and accelerator pedals mixed up?
  • Alertness – Are they aware and understand what is happening around them?
  • Can they tell the difference between left and right?
  • Do they become confused on familiar routes? Do they get lost or take a long time on familiar journeys?
  • Do they understand the difference between Stop and Go coloured lights?
  • Are they able to stay in the correct lane?
  • Can they read a road map and follow detour routes?
  • Has their mood changed when driving? Some previously calm drivers may become angry or aggressive.
  • Are there new bumps and scratches on the car?

Assisting with transport, showing the older person how to use public transport, organising home delivery services, providing companionship are just some of the ways Perth Care + Companion Company can provide assistance to you and or your family member who is starting to take steps to retire from driving or who has had to stop driving.

Information sourced from

  1. Assessing fitness to drive, Ausroads Publication 2016
  2. Driving Cessation and Health Outcomes in Older Adults, Journal American Geriatrics Society, Feb 2016
  3. Driving, Dementia Australia fact sheet 2015
  4. Department of Transport WA web site 2019