My patient has received a recent diagnosis of dementia and is currently driving. What should I do?

I have concerns about a patient with dementia’s ability to drive. What can I do?

My patient has mild cognitive impairment and no objective impairment of function. What should I advise them about driving?

My patient been told he/she is unfit to drive. How can I help?

What practical advice can I give to patients to help them drive safely?

My patient has received a diagnosis of dementia and is currently driving. What should I do?

• Regarding Group 1 vehicles (cars, motorcycles and work vehicles) discuss the risks and benefits of continuing to drive with the patient and/or family (if patient consents).
• A person with dementia is considered not fit to drive a Group 2 vehicle (buses and trucks) on diagnosis as per RSA guidelines.
• Provide them with a Patient Information Leaflet (PIL) on driving with dementia 
• Advise them they are legally obliged to 
  • Inform their insurance company of the diagnosis.
  • Inform the National Driving License of the diagnosis
    • They may advise the patient to present for an appointment with a completed Driving Medical Report signed by their medical practitioner (if appropriate).
• Advise the patient that it can be difficult to assess driving ability in a person with dementia; a formal driving assessment is generally required. (See next question).

Driving and Dementia: A Factsheet for Patients

I have concerns about a patient with dementia’s ability to drive. What can I do?

In general, if there are major problems with short term memory, disorientation or lack of insight, judgement or executive function then the person is almost certainly not fit to drive. However, if there is uncertainty around driving ability then:

• Consider referral to specialist and associated multi-disciplinary team (e.g. occupational therapy)
•  Have a low threshold for advising an on-road-assessment with a driving assessor.
  • There is a cost associated with this assessment (generally in the region of €150).
  • See our list of available on-road assessment centres in your area (link below)

My patient has a mild cognitive impairment and no objective impairment of function. What should I advise them about driving?

• Where there is no objective impairment of function, the diagnosis of mild cognitive impairment is certain and there are no driving concerns then the person does not need to notify the Driving License Authority.

• Advise patient that the situation may change and as a certain proportion of MCI transition to dementia their driving status will need to be kept under annual review

• The above applies to Group 1 vehicles (cars, motorcycles and work vehicles). If the patient wishes to drive a Group 2 vehicle (buses and trucks)then specialist assessment may be required.

My patient has been told he/she is unfit to drive. How can I help?

• Discuss the impact that this will have on the person's day-to-day functioning.
• Consider alternative transport methods available in your area (link to service directory below)
• The Giving up Driving factsheet by the Alzheimer Society of Ireland is for family members who are supporting a person with dementia to stop driving. 

What practical advice can I give to patients to help them drive safely?

• Keep to familiar routes
• Keep journey short
• Allow plenty of time for the journey
• Travel with somebody where possible
• Avoid busy times of the day, bad weather and night-time driving

  RSA Medical Fitness to Drive Guidelines