Why is driving and dementia a problem in Nova Scotia?

Answer: This issue is mediated by many factors:

INDIVIDUAL

  • Effects of dementia
  • poor judgment about risk of motor vehicle crash
  • difficulty with multi-tasking
  • slowed reaction time
  • poor coordination
  • Gender
  • Men are less likely to voluntarily limit or stop driving, and are more likely to think of themselves as being better than the average driver.
  • Insight
  • Lack of awareness of memory and thinking problems (dementia) and the complex tasks involved in driving leads to overestimation of driving ability. “I’ve never had an accident in 50 years of driving, why should I stop now?”
  • Knowledge of alternatives
  • Drivers may not be aware of other forms of transportation available, especially the willingness of family members or friends to provide rides.
  • Finances
  • Although many people with dementia are worried about the costs of finding alternate ways of getting around, it may actually cost less to stop driving when the costs of insurance, registration, car maintenance, gas and other operating expenses are considered.
  • Meaning attached to driving
  • Many drivers see their role as “driver” as an important part of their identity.

CAREGIVER

  • Willing copilot
  • Family members and caregivers may encourage unsafe driving by sitting in the passenger seat and providing instructions or cues. This is called co-piloting.
  • Gender
  • Women are more likely to agree to act as co-pilots.
  • Provides access to working vehicle
  • Disabling the car or moving it out of site may help discourage unsafe driving.
  • Knowledge of the risks
  • Caregivers may not know just how risky driving with dementia is.
  • Fear of burden of care
  • Women may wish to avoid taking over the role of driver.
  • Positive relationships
  • Having positive relationships with family or friends makes it more likely that a person will not drive after they have been asked to stop.

HEALTH CARE SYSTEM

  • Doctors’ knowledge
  • There is no formal training for doctors to help with assessing the medically at-risk driver.
  • Lack of guidelines
  • It is not clear which tests provide the most consistent information to doctors who assess medically at-risk drivers
  • Doctors’ reporting
  • In Nova Scotia, doctors are not required by law to report potentially unsafe drivers to the RMV (compared to most other provinces where reporting is mandatory).