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

Last Updated: December 03, 2019

 

  The car ahead was clearly stopped, brake lights beaming bright red. She had several car lengths to react and brake. Instead, we hit the car ahead of us. We hadn’t told the insurance company about her diagnosis. We were in trouble.

 

I’d talked to mom about giving me her keys because driving didn’t seem safe anymore. The conversation didn’t go well. She’s stubborn, and I hate upsetting her.

 

This question immediately comes to the minds of family members, but the questions raised are broader than simply, “does my state have a law against driving with dementia / Alzheimer’s?”. As relevant are the following questions:

-Do I need to report someone with dementia to the department of motor vehicles (DMV)? If so, how soon?
-Will our doctor report the individual to our state DMV?
-Do I need to notify my car insurance that a driver in my house has dementia?
-Will our insurance provider refuse to cover us or raise our rates?

Laws and rules about driving with a diagnosis of Alzheimer’s (or other form of dementia) vary by state and are often unclear. For example, in California doctors are required to notify the Department of Motor Vehicles (DMV) if a person has been diagnosed with dementia, and the DMV then issues a “request for driver reexamination,”. This is a driving test that can result in driving restrictions during certain times of day, or even the full loss of driving privileges. How quickly the reporting and re-examination happen is very vague, as is enforcement. Another example is Texas, where there are no laws about reporting a diagnosis to driving authorities, but anyone can report a potentially unsafe driver to the state DMV. Accordingly, a doctor, a neighbor or even a family member may choose to do so. Then the driver will have to pass a doctor’s evaluation to stay behind the wheel.

 

  To answer the immediate question, persons with a diagnosis of Alzheimer’s or other dementia can continue to drive legally. However, for how long they can do so varies by state and with the progression of their dementia.

 

Regardless of the legality, in order to protect your loved one with dementia, your family and other drivers, it is recommended to take the following steps related to driving when a loved one receives a dementia diagnosis.

1. Contact your car insurance provider and notify them of the diagnosis. Each insurance provider has different rules on how they handle the situation. 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 may be dramatic, if one does not notify their insurance and an accident occurs, the insurance company may refuse to pay for the claim.

2. Assess your loved one driving abilities (more on how to do this below). Even if their driving skills have not diminished, have a preliminary conversation with them mentioning the day will come when they will have to give up driving. Having had this preliminary conversation will make it easier to take away the keys when the time comes.

3. Be prepared yourself and prepare your loved one with the knowledge that the Department of Motors Vehicles will eventually require them to re-take a driving test or re-evaluate their ability to drive in some manner. How quickly this happens varies based on several factors but knowing that day will come will make it easier when it does. Factors that impact how soon this occurs include 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 (perhaps your doctor) or other family member has notified the DMV of their condition. Doctors in California are required to do so by law. Neighbors will often report persons they believe are unsafe behind the wheel and even adult children who disagree about their parent’s ability to drive may notify the DMV.

 

  Did You Know About These Free Resources for Dementia?
Most individuals with dementia will eventually require Medicaid. Online Medicaid Eligibility Test.
Help finding trained Alzheimer’s in-home caregivers. Start here.
Memory care home matching services. Not every assisted living residence is right for everyone with dementia. Get help finding residences that match 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 discourage you from seeking DMVs’ help if your loved one refuses to stop driving. You are the first line of defense to keep a dangerous driver off the road, but in almost every state there’s a process to force a person to be reevaluated before they can continue driving. Who can file the report differs depending on the state. In some states, like Ohio, only a doctor can request a reexamination.

It may be difficult or considered passive-aggressive to take this action against someone you love, but the consequences of doing nothing can be devastating. Again, cars are complicated two-ton machines that should only be operated by someone who can react quickly in a changing environment.

State-by-State Laws on Driving with Dementia / Alzheimer’s – Updated Dec. 2019
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. However, 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 should their loved one resist giving up the keys.
Arizona Arizona has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s 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 specifically but obviously has laws about medical conditions which impact a person’s 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 re-test of the individual’s abilities will determine if they can continue behind the wheel.
Colorado Colorado has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s 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 persons in the early stages of dementia to have periodic re-evaluations of 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 specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely. Doctors, law enforcement and civilians can all request a special evaluation of a driver’s ability by the DMV’s Medical Program.
Florida Florida has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Physicians and family member can request a re-evaluation of the 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 next steps.
Georgia Georgia has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Anyone can submit a request for driver 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 including 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 moves to revoke driving privileges from someone with dementia if asked to do so by a doctor. Doctors might report an unsafe driver to the Idaho DMV, but there is not an official form to do so.
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 a possibly unsafe driver.
Indiana Indiana has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.   Doctors and family members can choose to file a Request for Driving Ability Review with the Indiana Bureau of Motor Vehicles.
Iowa Iowa has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Anyone in Iowa can request a driving reexamination 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 specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Persons can submit a letter of concern to the Kansas Department of Revenue vehicles division about a driver in Kansas, who is then asked to take a test and provide a note from a doctor vouching for ability to drive.
Kentucky Kentucky has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely. If the Kentucky Medical Review Board receives an unsafe driver report, they will investigate and require documents from a doctor vouching for ability to drive.
Louisiana Louisiana has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely. However, if a doctor or concerned neighbor files a Report of Driver Condition or Behavior, an investigation will be conducted by the Louisiana transportation office and may result in driving restrictions or revocation of license.
Maine Maine has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Anyone can report a possibly unsafe driver to Maine’s Bureau of Motor Vehicles, and the driver will need to submit a medical examination, and maybe take a driving test.
Maryland Maryland has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Anyone may report a possibly unsafe driver to the Maryland Motor Vehicle Administration, and the case will be examined by a medical board.
Massachusetts Massachusetts asks drivers to self-report to the Registry of Motor Vehicles if diagnosed with dementia, for a reevaluation. Doctor, family and law enforcement can report a possibly unsafe driver to the RMV to start an investigation.
Michigan Michigan has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely. Requests for driver re-examination can be submitted to the Michigan Secretary of State’s office. A test will be ordered, and driving privileges are amended or restricted based on the results.
Minnesota Minnesota has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s 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 be followed up with a driving examination.
Mississippi Mississippi has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  However, 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 vouching for the driver’s ability behind the wheel, then the driver will be tested.
Missouri Missouri has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Anyone in Missouri can submit a Driver Condition Report on a possibly unsafe driver to the Department of Revenue. Doing so will result in a medical evaluation and new driver’s test being required.
Montana Montana has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.   However, the general public can request a Recommendation for Reexamination of a possibly unsafe driver, and the Montana MVD will investigate.
Nebraska Nebraska has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.   However, anyone in Nebraska can file a Citizen Reexamination Report with the Driver Licensing Division and the DMV with investigate whether the subject should be allowed to continue driving.
Nevada Nevada has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Concerned family members in Nevada can file a Request for Reevaluation with the DMV, with a doctor’s signature included, and an investigation will be launched.
New Hampshire New Hampshire has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Family, law enforcement, and doctors can report a driver as unsafe to the New Hampshire DMV, and initiate a process requiring a medical evaluation or hearing to determine if the license should be taken away.
New Jersey New Jersey has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s 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 a new driving test, a driver’s license may be revoked.
New Mexico New Mexico has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  However, a doctor can contact the New Mexico MVD and a medical review board will determine whether the license should be revoked. There’s no formal process for a family member to notify the MVD.
New York New York has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely. Doctors might file a Physician’s Reporting Form with New York’s DMV, and if so a new driving test will be ordered.
North Carolina North Carolina has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely. However, anyone can report an unsafe driver to the North Carolina DMV’s Medical Evaluation Program, which will order a road test and/or medical evaluation before deciding whether to revoke a driver’s license.
North Dakota North Dakota has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.   That said, the 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 specifically but obviously has laws about medical conditions which impact a person’s 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 specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.   Having said that anyone can submit a Request for Driver Review form to the Oklahoma DMV, which will investigate and determine if limitations need to be placed on 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, and an investigation will start.  Family can also submit a Driver Evaluation Request, should they feel their loved one is not safe.
Pennsylvania Pennsylvania has mandatory physician reporting to the DMV within 10 days of diagnosis (the form is here), then a Medical Advisory Board determines next steps.  What this means is 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 begin and the person may be found unqualified to drive.
Rhode Island Rhode Island has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Persons can report a potential unsafe driver to the Rhode Island DMVs Operator Control Department to start an investigation.  An investigation may result in a loss of driving privileges should a medical condition make the driver hazardous.
South Carolina South Carolina has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Only doctors and law enforcement can notify the South Carolina DMV about an unsafe driver, and if they do so, a driving test and / or medical evaluation is required to keep the license.
South Dakota South Dakota has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  However, anyone can submit a Driver Evaluation Request to the South Dakota Department of Public Safety, and an investigation will begin.
Tennessee Tennessee has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s 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 specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.   However, anyone can report a possibly unsafe driver to the Texas Department of Public Safety’s Drivers License Division, for review by a medical advisory board to determine next steps.
Utah Utah has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Anyone including physicians can submit an Unsafe Driver Review form in Utah, and the Department of Public Safety will investigate which may result in a loss of license.
Vermont Vermont has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Doctors, neighbors and family members may contact the Vermont DMV to request a Driver Reexamination, and vision and other medical tests help determine whether limitations should be placed on someone’s license.
Virginia Virginia has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Doctors might report a potentially unsafe driver but are not required to do so.  If a report is received by the Virginia DMV for medical review, the driver’s license will be suspended until undergoing an assessment.
Washington Washington has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Doctors and family members might submit a request for Driver Evaluation to the Washington Department of Licensing but are not required by law to do so.   Upon request an investigation will begin to determine if the driver is permitted to continue driving.
Washington D.C. The District of Columbia has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Doctors and family members might submit a Medical Referral Form with the Washington D.C. DMV.  Doing so will begin an investigation, the outcome of which may result in the loss of driving privileges.  However, to be clear, neither physicians nor family members are under legal obligation to do so.
West Virginia West Virginia has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely. Doctors, law enforcement, and immediate family can report an unsafe driver, (but are not required by law to do so) to the West Virginia DMV, and the Medical Review Unit will investigate possibly resulting in a loss of driving privileges.
Wisconsin Wisconsin has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  While under no legal obligation to report, doctors and family members have the option to report a possibly unsafe driver to the DMV, and the Medical Review Unit will investigate.
Wyoming Wyoming has no laws against driving with dementia specifically but obviously has laws about medical conditions which impact a person’s ability to drive safely.  Family members and physicians can report a possibly unsafe driver to the Wyoming Department of Transportation but are not legally required to do so.   A report will result in an investigation which in turn may result in the individual losing their driver’s license.

Why Driving with Alzheimer’s / Dementia is Dangerous?

Someone with Alzheimer’s or a related dementia can probably continue driving in the early stages of the disease. Over time, however, driving becomes dangerous for absolutely everyone with the disease, and they usually need to stop within three years of their diagnosis. It is hard for someone to admit they shouldn’t be behind the wheel. Losing the ability to drive represents a loss of independence and control. It might feel unfair. Yet while respecting dignity and independence is important, nothing trumps safety.

Driving is a complex task. Think of the multitasking required to do these all at once:
– 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 most famously impacts memory, but focus is also a casualty, and focus is probably the most important part of driving. Someone whose mind can’t react quickly, 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, this is a good indicator that it’s time to take the keys away. Other signs to look out for:

– Missing or disregarding traffic signs and signals.
– Veering outside the lane.
– Decreased use of appropriate driving etiquette.
– Forgets the destination or gets lost on familiar roads.
– Increasing dependence on navigation aids in their home area.
– Difficulty determining the brake pedal from the gas pedal.
– New dings, dents, or scratches in the paint of the car.

People in the middle to late stages of dementia should not be driving, because the danger to themselves and others is too great. It’s too easy to, for instance, lose focus and run a red light. The sad fact is that everyone with dementia will have to stop driving at some point, probably within three years, and it’s up to the people around them (including you) 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, rather than leaving it up to your own feel.

The tougher decision is in the early stages of the disease. As symptoms first 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 hasn’t given you a reason to worry, then these are the best tips:
– Ride with them, to observe how well they operate the car and respond to 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 OK, but getting on the freeway is probably a bad idea.

 

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: accumulate evidence to make a strong case.

– 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 with regularity. The most common objective 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.
– 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.

 

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, as someone who exhibits late-stage behaviors like aggressiveness and wandering would have trouble with these services. 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 in six states (Arizona, Missouri, Tennessee, Michigan, Georgia, and Virginia) are covered for Lyft rides. (For more on Medicaid coverage for transportation, see below.)

Friends & Family
After a diagnosis of dementia, friends and family often want to help but don’t 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 or social activities. Friends and family can help with rides throughout all stages of the disease, providing supervision you can trust 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 nominal 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 / memory care home. Free assistance is available to help families find residences in their area and within their budgets.