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Driving & Dementia / Alzheimer’s: State Laws, Coping & Advice for Caregivers

Last Updated: May 04, 2023

 

 Has this happened in your family? The car ahead was clearly stopped, brake lights beaming bright red. They had several car lengths to react and brake. Instead, we hit the car ahead of us. We were in trouble because we have not told the insurance company about their diagnosis. I have talked to my loved one about giving me their keys because driving no longer seems safe. The conversation did not go well. They are stubborn and I hate talking about subjects that upset them.

 

After a diagnosis of dementia, it is commonly questioned if your loved one can continue to drive. The answer is complex and involves various different aspects. They are:

Knowing if someone with dementia needs to be reported to the Department of Motor Vehicles (DMV)? If so, how soon?

Will your loved one’s doctor report their medical condition to the DMV?

Does the car insurance company need to be notified the insured has dementia?

Will the car insurance company refuse coverage or raise rates due to dementia?

Laws about driving with Alzheimer’s or another form of dementia vary by state and are vague. For example, in California doctors are required to notify the Department of Motor Vehicles if a patient of theirs has been diagnosed with dementia causing the DMV to retest the person. The results of this driving test can result in driving restrictions during certain times of day, or even the full loss of driving privileges. Another example is in Texas where there are no laws about reporting a diagnosis to authorities. A doctor, a neighbor, or a family member can report an unsafe driver to the state DMV. This will result in the driver having to pass a doctor’s evaluation to stay behind the wheel.

 People who are diagnosed with Alzheimer’s or dementia can continue to drive. It varies on how long they can legally do this and their rate of decline from the progression of the disease.

Regardless if driving is still legal, and in order to protect your loved one with dementia and other drivers, it is recommended to take the following steps.

1. Contact your car insurance provider and notify them of the diagnosis. Each insurance company has different rules. It is very unlikely they will raise your premiums. The more likely scenario is they will refuse to cover the driver who has received the diagnosis. While this can sound dramatic, the insurance company can refuse to pay the claim if one does not notify their carrier and an accident occurs.

2. Assess your loved one’s driving abilities. Even if their driving skills have not diminished, starting the conversation about when they will have to give up driving is vital. Preliminary conversations will make the transition easier when the time comes to stop driving.

3. Advise your loved one that the Department of Motors Vehicles will eventually require them to retake a driving test and reevaluate their ability to drive. The timeline for this is based on several factors. They can be based on how soon their driver’s license expires. When renewing a license, all states require that drivers mention any medical conditions that could impact their driving ability. Another factor is whether someone (including one’s doctor or family member) has notified the DMV of their condition. Doctors in California are required to do so by law. Neighbors and family members will often report a person they believe is unsafe behind the wheel.

 

  Did You Know About These Free Resources for Dementia?
Most people with dementia will eventually need Medicaid. Take an online Medicaid Eligibility Test here.
There is free help finding trained Alzheimer’s in-home caregivers. Click here to start.
There are services that help match patients to memory care homes. Not every assisted living residence has the right services and support for people with dementia. Get help finding residences that match your family’s needs & budget.

 

State by State Laws on Driving with Dementia

Below is a chart with the relevant laws by state. The vagueness of many states’ laws should not interfere with you getting help from the DMV. This includes if your loved one refuses to stop driving. Families are the first line of defense to keep a dangerous driver off the road. In almost every state there is a process to have someone reevaluated before they can continue driving. The largest difference nationwide is who can file the report; a family member, a concerned neighbor, or a medical professional. In some states, like Ohio, only a doctor can request a re-examination.

It may be difficult to take this action against someone you love, but the consequences of doing nothing can be devastating. Cars are complicated two-ton machines that should only be operated by someone who can react quickly, understand the cues from other drivers and think logically in a changing environment.

State-by-State Laws on Driving with Dementia / Alzheimer’s – Updated May 2023
State Law
Alabama Alabama lets someone with dementia keep their license unless a request is made to the DMV by a licensed doctor, either for the license to be taken away or for the driver to be re-tested.
Alaska Someone with a diagnosis of advanced dementia is not allowed to drive in Alaska. Simply receiving a diagnosis does not result in a loss of driving privileges. Families can request a retest of their loved one’s driving ability with the Alaska DMV if their loved one resists giving up their car keys.
Arizona Arizona has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. The Department of Transportation will retest a person with dementia if they receive a request to do so from law enforcement or a doctor. Families can notify the DOT of a possibly unsafe driver (but are not required to) through the Medical Review Program, which will investigate.
Arkansas Arkansas has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Arkansas Driver Services will retest a person with dementia upon request by law enforcement, a doctor, or family member.  The agency may request that your loved one’s doctor decide whether driving should be allowed.
California Any diagnosis of dementia must be reported by a doctor to the California DMV. Family members are not required to report. A retest of driving abilities will determine if your loved one can continue behind the wheel.
Colorado Colorado has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors, law enforcement, and immediate family can submit a request for re-examination to the Colorado DMV. Part of the medical reevaluation is a form filled out by the driver’s doctor, asking whether the driver can safely handle a motor vehicle.
Connecticut Connecticut has a law that requires dementia patients in the early stages of the disease to have periodic re-evaluations of their driving ability. The re-evaluation process must include a doctor’s assessment. Family members can also request a re-evaluation here.
Delaware Delaware has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors, law enforcement, friends, and family members can request a special evaluation  of a driver’s ability by the DMV’s Medical Program.
Florida Florida has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Physicians and family members can request a re-evaluation of a driver’s ability with the Florida Department of Highway Safety and Motor Vehicles. An advisory board reviews each case, including an opinion by the driver’s doctor, to determine the next steps.
Georgia Georgia has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can submit a request for driver review  review to the Georgia Department of Driver Services, which will require an evaluation by a doctor within 30 days.
Hawaii Each island has slightly different rules. Generally, drivers are asked that if they have conditions like Alzheimer’s they self-report and provide a DOT medical report form completed by a doctor. To report an unsafe driver, click here
Idaho Idaho only will revoke the driving privileges of someone with dementia if requested to do so by a doctor. Doctors might report an unsafe driver to the Idaho DMV, but no official form exists.
Illinois The Illinois Secretary of State’s office must be notified within 10 days of a diagnosis of Alzheimer’s, and an investigation will begin. Only law enforcement can ask for an investigation into an unsafe driver.
Indiana Indiana has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors and family members can file a Request for Driving Ability Review with the Indiana Bureau of Motor Vehicles.
Iowa Iowa has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone in Iowa can request a driving re-examination from the state’s Office of Driver Services, which will require a test and a note from a doctor.
Kansas Kansas has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. People can write a letter to the Kansas Department of Revenue vehicles division about their concern for a driver in Kansas. This causes an individual to take a test and provide a note from a doctor vouching for their ability to drive.
Kentucky Kentucky has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. If the Kentucky Medical Review Board receives an unsafe driver report, they will investigate and ask for documents from a doctor verifying the person’s ability to drive.
Louisiana Louisiana has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. If a doctor, friend, or family member files a Report of Driver Condition or Behavior, an investigation will be conducted by the Louisiana transportation office and can result in driving restrictions or losing the license altogether.
Maine Maine has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can report an unsafe driver to Maine’s Bureau of Motor Vehicles. This will cause the driver to submit a medical examination and possibly take a driving test.
Maryland Maryland has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone may report an unsafe driver to the Maryland Motor Vehicle Administration, and the case will be examined by a medical review board.
Massachusetts Massachusetts asks drivers to self-report to the Registry of Motor Vehicles if they are diagnosed with dementia. This will trigger a reevaluation of the person’s driving abilities. Doctors, family members, friends, and law enforcement can report an unsafe driver to the DMV.
Michigan Michigan has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Requests for driver reexamination can be submitted to the Michigan Secretary of State’s office. A retest will be ordered, and driving privileges can be restricted based on the results.
Minnesota Minnesota has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. A letter from a physician saying someone in Minnesota is unfit to drive will result in that driver’s license being suspended. Notification from anyone else (to Driver and Vehicle Services) will cause a re-examination.
Mississippi Mississippi has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can submit a Referral for Driver Examination to the Mississippi Driver Records Division. The state will require notes from an eye doctor and general physician verifying the driver’s ability behind the wheel. Additionally, the driver will be retested.
Missouri Missouri has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone in Missouri can submit a Driver Condition Report  for an unsafe driver to the Department of Revenue. That will result in a medical evaluation and the driver being retested.
Montana Montana has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can request a recommendation for re-examination  of an unsafe driver and the Montana MVD will investigate.
Nebraska Nebraska has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone in Nebraska can file a citizen re-examination report with the Driver Licensing Division and the DMV will investigate whether the person should continue to have driving privileges.
Nevada Nevada has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Concerned family members with the support of a doctor can file a request for re-evaluation with the DMV causing an investigation into one’s driving abilities.
New Hampshire New Hampshire has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Family, law enforcement, and doctors can report a driver as unsafe to the New Hampshire DMV and initiate a review requiring a medical evaluation or hearing to determine if the person should continue to have their license.
New Jersey New Jersey has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Family, law enforcement, and doctors can report a driver as unsafe to the New Jersey Motor Vehicle Commission’s Medical Review Unit. After reexamination, the license may be revoked.
New Mexico New Mexico has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. A doctor can contact the New Mexico MVD and a medical review board will determine whether the license should be revoked. There is no formal process for a family member to notify the MVD.
New York New York has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors can file a Physician’s Reporting Form with New York’s DMV; if they do, a person will be retested.
North Carolina North Carolina has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can report an unsafe driver to the North Carolina DMV’s Medical Evaluation Program, which will cause the driver to retake a driving test or provide a medical evaluation in order to keep their driver’s license.
North Dakota North Dakota has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. North Dakota’s Department of Transportation will suspend a license if it receives a Medical Examination Report from a doctor saying a driver is unsafe.
Ohio Ohio has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. A note from a doctor to the Ohio Bureau of Motor Vehicles is required to initiate an investigation into whether someone is able to drive safely.
Oklahoma Oklahoma has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can submit a Request for Driver Review form to the Oklahoma DMV. This causes an investigation to determine if limitations need to be placed on one’s driving privileges.
Oregon Doctors in Oregon are asked to submit a report to the At-Risk Driver Program of the Oregon Department of Transportation if they believe someone is unfit to drive. Families can also submit a Driver Evaluation Request if they feel their loved one is not safe behind the wheel.
Pennsylvania Pennsylvania has mandatory physician reporting to the DMV within 10 days of diagnosis (a link to the form is here). A Medical Advisory Board determines the next steps. This means a doctor will report the person with dementia to the Department of Motor Vehicles. It is not illegal to drive with dementia, but a review process will decide if the person is qualified to drive.
Rhode Island Rhode Island has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. People can report an unsafe driver to the Rhode Island DMV Operator Control Department. An investigation may result in the loss of driving privileges if a person’s medical condition makes them a hazardous driver.
South Carolina South Carolina has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Only doctors and law enforcement can notify the South Carolina DMV about an unsafe driver. If that happens, a driving test or medical evaluation can be required to keep their license.
South Dakota South Dakota has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can submit a Driver Evaluation Request to the South Dakota Department of Public Safety causing an investigation to begin.
Tennessee Tennessee has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can report an unsafe driver to the Tennessee Department of Safety’s Driver Services Division. The report must include a note from a doctor.
Texas Texas has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can report an unsafe driver to the Texas Department of Public Safety’s Drivers License Division. This will begin a review by a medical advisory board to determine someone’s driving privileges.
Utah Utah has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Anyone can submit an Unsafe Driver Review form and the Department of Public Safety will launch an investigation which can cause a loss of your loved ones driving privileges.
Vermont Vermont has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors, neighbors, and family members may contact the Vermont DMV to request a driver re-examination. Vision and other medical tests will determine if there should be limitations on someone’s license.
Virginia Virginia has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors can report unsafe drivers but are not required to do so. If a report is made for medical review to the Virginia DMV, a person’s driver’s license will be suspended until an assessment has been made.
Washington Washington has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors and family members can submit a request for Driver Evaluation to the Washington Department of Licensing. If a complaint is made, an investigation will begin to determine if a driver should continue driving.
Washington D.C. The District of Columbia has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors and family members can submit a Medical Referral Form to the Washington D.C. DMV. This causes an investigation to determine driving privileges.
West Virginia West Virginia has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors, law enforcement, and immediate family can report an unsafe driver to the West Virginia DMV. This will cause the Medical Review Unit to investigate which can result in a loss of driving privileges.
Wisconsin Wisconsin has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Doctors and family members have the option to report a possibly unsafe driver to the DMV causing the Medical Review Unit to investigate.
Wyoming Wyoming has no laws against driving with dementia. The laws are generalized regarding a person with a medical condition that impacts their ability to drive safely. Family members and physicians can report an unsafe driver to the Wyoming Department of Transportation. A report will start an investigation which can result in someone losing their driver’s license.

Why Driving with Alzheimer’s / Dementia is Dangerous?

Someone with Alzheimer’s or dementia can probably continue driving in the early stages of the disease. Over time, driving becomes dangerous and they usually must stop within three years of diagnosis. It is hard for someone to admit they should not be behind the wheel. Losing the ability to drive generally represents a loss of independence and control. It might feel unfair to your loved one. While respecting a person’s dignity and independence is important, the safety of themselves and others must take precedence.

Driving is a complex task that takes lots of multitasking. One must be able to:

Recognize traffic signs and signals.

Pay attention to other cars.

React to other cars.

Maintain correct distances on every side.

Adapt to changing road or weather conditions.

Handle the vehicle, which weighs (on average) about two tons and features countless moving parts.

Dementia impacts memory and also focus. Focus is the most important part of being able to drive safely. Therefore, someone whose mind can not react quickly and whose reaction time is slower, should not be driving.

 

Warning Signs Your Loved One Should Not Be Driving

Getting angry on the road is typical for many drivers, but if your loved one is becoming especially frustrated or confused while driving, the next step needs to be taken. It is a good indicator that it’s time to take the keys away when your loved one:

Misses or disregards traffic signs and signals.

Veers outside their lane.

Decreases their use of appropriate driving etiquette.

Forgets the destination or gets lost on familiar roads.

Increases their dependence on navigation aids in familiar areas.

Has a hard time telling the difference between the brake and gas pedals.

Repeatedly has new dings, dents, or scratches on the car’s paint.

People in the middle to late stages of dementia should not be driving, because they are dangerous to themselves and others. It’s too easy to lose focus and run a red light. Everyone with dementia will have to stop driving at some point, normally within three years of their diagnosis. It is up to the people around them to determine when that point is. Consulting with the doctor or having the local Department of Motor Vehicles administer a driving test are ways to get a concrete answer instead of leaving it up to your feelings.

The decision to stop driving can be toughest with patients in the early stages of the disease. As symptoms become apparent, it may be perfectly fine for your loved one to drive, especially during the day. If your loved one wants to keep driving and has not given you a reason to worry, you might try to let them safely keep their independence by:

Riding with your loved one to observe how well they operate the car and respond to their surroundings.

Limit the time of day they’re allowed to drive. It’s harder to drive at night than during the day.

Limit where they can go. Driving around the neighborhood may be safe, but getting on the freeway is probably bad.

 

Having the Conversation About Not Driving with Dementia

This can be difficult, especially if the person with dementia has been a figure of authority, like your mother or father. Losing the ability to drive can be emotional, so be prepared with hard, non-emotional evidence to make your case. Treat your preparation (though not the talk itself) like you’re getting ready for trial, and accumulate evidence to make a strong fact-based case. Consider:

Who is the best person to deliver the hard news? Is it a spouse, best friend, adult child, or doctor? Or should one recruit a group of loved ones to talk, more like an intervention?

If dementia is diagnosed early, and your loved one can still make informed decisions, talk together about when, and how, to transition away from driving. What milestones, or behaviors, would mean it’s time to quit? This will have to be dealt with eventually, and the sooner the better.

Have a doctor write a note for you ahead of time, backing your case that it’s time to end driving privileges.

Use the DMV. A compromise with your loved one may be to get a new driving test at the DMV, to let the authorities decide whether it’s OK to stay behind the wheel.

Know your state’s laws and your insurance company’s policy.

Present your evidence as sweetly as you can. Demonstrate understanding and empathy, stressing the positives as you offer unconditional love and support. Be ready to have this conversation more than once, and do not lose patience with having to repeat yourself. Someone with memory problems will probably need to be told repeatedly that a major life change has occurred.

Have alternative transportation options already determined for any locations the individual drives regularly. The most common objection to not driving is “But how will I get to ____.” Presenting solutions concurrent with the conversation is key to heading off these objections.

Focus on safety, not just your loved one’s but other people’s safety on the road, including children’s.

Be specific with observations you’ve made, like mistakes the person made while driving.

Remember to stress that it’s the disease, not the individual.

 

More Hard Conversations About Dementia

It is difficult to face the reality that as Alzheimer’s and dementia progress, it is time to make hard decisions. The loss of the ability to drive shows that your loved one is experiencing a cognitive decline. That means, as cells in the brain are breaking down, the brain is affected and functions that make everyday independent living possible become impossible. As you begin a conversation with your loved one about not driving anymore, think about beginning to talk about their housing options too. The sooner these conversations are had, the sooner the searches for an assisted living residence or memory care unit can start. By beginning early, your loved one can have the most amount of input possible as to their future care.

When bringing up a painful subject like the loss of independence, it can be a smart time to evaluate other aspects of your loved one’s life. While they might not be in agreement at the beginning, these conversations and taking these next steps are done to protect them and their well-being. When everyday tasks become complicated, extra support and care services become necessary. Moving into a care facility offers specialized care, support for activities of daily living, activities of socialization, and room and board. Noticing characteristics can be similar in terms of when your loved one should not drive or live alone, it creates situations that are hard to talk about. Addressing them will improve a person’s quality of life. Hopefully, having these conversations and making future plans will put in place a more comprehensive safety and care plan that involves your loved one’s wishes.

 

Transportation Options for Persons with Alzheimer’s / Dementia

Paratransit Services
These are a type of shared-ride public transportation for elderly and disabled people. Depending where you live, paratransit may offer a fixed route with specified stops, like a bus, or door-to-door service. Rides for door-to-door service must be booked in advance. These services usually cost about as much as the bus, and are better for someone in the early to early-mid stages of dementia. To find transit services in your state, visit The American Public Transportation Association.

Private Transportation
This option is also good for someone in the early and middle stages of dementia. Private transportation options include taxis, Uber, Lyft, and Gogograndparent. Uber and Lyft are location-based apps that send a private driver to an individual’s location. They require a smartphone, however, while Gogograndparent is for people without smartphones to still use Uber and Lyft by dialing a traditional phone number or by allowing a loved one to arrange their transportation. Also notable is recent news that Medicaid recipients have coverage for Lyft rides in Arizona, Missouri, Tennessee, Michigan, Georgia, and Virginia. For more on Medicaid coverage for transportation, see below.

Friends & Family
After a diagnosis of dementia, friends and family often want to help but do not know how. Rides may be the answer. Your loved one will need to get to doctor’s appointments, run errands, and get outside for exercise and social activities. Friends and family can help with rides throughout all stages of the disease, providing supervision  and assistance from door to door.

Volunteer Driver Programs
Volunteer driver programs help transport seniors, disabled people, and individuals with middle- to late-stage dementia. In most cases, transportation is modified to meet your loved one’s needs, like carrying healthcare equipment and making multiple stops. Drivers may even be trained on dealing with dementia. These programs can be free, or might ask for a suggested donation between $5 and $10 per ride. Contact your local Area Agency on Aging office to ask about volunteer driving programs, or find one through the National Center for Mobility Management website.

Medicaid Programs
Among the many assistance programs for low-income seniors (including those with dementia) available under Medicaid are transportation services. These programs, however, are not consistent from state to state, or even within states. Generally, transportation assistance is offered via Home and Community-Based Services (HCBS) Medicaid Waivers. Contact the Medicaid office in your state to see if your loved one qualifies.

Adult Day Care / Alzheimer’s Day Treatment
Many adult day care programs provide transportation assistance to and from the centers. Some of these are included in the cost and others add a small fee for transport.

Memory Care / Assisted Living
If driving is impossible and other transportation options are impractical, one might consider removing the need for transportation by relocating to an assisted living or memory care home. Free assistance is available to help families find residences in their area that fits their needs and budget.