Bob DeMarco repeats himself on Alzheimer’s Reading Room. In his article Driving with Alzheimer's Can Mean Death he discusses key questions about driving. “Should persons diagnosed with Alzheimer’s Disease (AD) be prohibited from driving as soon as their AD has been identified” he asks. The point of the article raises much for thought and consideration by all of us affected by this disease.
The consequences of either driving or not are both beyond dreadful. Hanging the AD tag on a person changes so much. The person so classified is stereotyped into an entirely different social slot. No longer employable, no longer self autonomous, he/she becomes a person needing help, support and special concern. Everything shifts within every social group from family to outside group activity.
People do not know how to relate to a person with this disease. To do so means first overcoming the stereotype that the person is no longer functional. That done then it becomes a question of what to do with the person.
Too often, perplexed by how to do it, procrastination about doing it sets in, nothing gets done, embarrassment intrudes and the person becomes “no longer around.”
The next step for the one AD Afflicted is isolation, left out!
Wheels are so helpful in reducing this. The person with AD can maintain some autonomy, maintain activity with cohorts and take on new activities. Taking the bus allows only so much. When getting around from place to place without being able to drive turns into an effort it is let go, not done.
Marginalizing us is the worst. That gets us down the chute to later stages quicker than anything. This not only erodes our quality of life, it causes us to become a burden to others because of the accelerated time we have the need of incurring the cost of care.
ON THE OTHER HAND!
One injury to one person self or others is too much to allow a person to remain behind the wheel when the risk of their driving increases. With AD it does. Like driving while intoxicated so many subtle skills go out the window increasing the danger of driving.
In my case it was self evident. I could not see and articulate the danger in what I saw; I could not multi-task sufficiently to handle the multitude of incidents suddenly presented to the driver requiring action to deal with them.
A simulated driving test told me this. My wife told my doctor when I couldn’t hear her telling me this. The test demonstrated the practical difficulty I was having with driving. A later Neuro-Psychometric test validated the reason for the problem: namely, low scores in executive function, multi tasking and visual perception.
Bottom line I quit driving. That was that, nearly four years ago.
Liability is another factor. If there is an accident look out for sharp lawyers. Let
one of my former colleagues get there jaws clamped on AD and any knowledge it would instill that your driving skills put you at risk, that could make a case.
Whether or not it would be dispositive (providing a final resolution of an issue, having control over an outcome) I would not say. It would be a strong factor in establishing liability. It certainly is a charge that would be submitted to the jury to decide was this a cause of the accident and resultant damage and injury.
I have many friends with AD able to drive with whom I willingly ride. Thank God for them, I get around. One is not good with directions. I am. We make a perfect team, pilot and navigator.
I talked about this issue once before in TO DRIVE OR NOT TO DRIVE, THAT IS THE VEXING QUESTION a comment I posted on 1-10-10. In it I was commenting on an earlier article by Bob DeMarco about driving.
Read both in conjunction if you find this subject worthy of review.
If we consider revoking driving privileges when AD is diagnosed quickly diagnosis will be avoided by us, by our families, by our doctors, by society at large. The individual short term price is just too high! The long term cost is conversely higher if diagnosis is avoided or delayed. Early Stage resulting from Early Detection provides the opportunity to keep people functioning longer at substantially reduced social cost for care.
My conclusion is this:
I am not prepared to say “just cuz you got it, you shouldn’t drive” Nor am I willing to see driving rights revoked just because you have been diagnosed with AD. We should not require this anymore than prohibiting anyone over the age of 70 to drive.
Until society starts providing some sensitive care and social context for those with the deficiencies that might bring this about there should be alternative ways to live, communicate and move about provided. Without that the devastating loss to a major portion of our culture to whom more is owed is morally untenable.
If we are at that point doing this we have become the “Brave New Society” where folks over a certain age are either euthanized or warehoused.
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