dementia driving assessment uk
Jan 12 2021 4:42 AM

There are 850,000 people in the UK with dementia, 1 many of whom are still driving. Back at the centre, the assessors tell the driver what they have found. As long as the person listens to what is said by the instructor, and agrees to give up if they are classed as unsafe. The DVLA will conduct a reassessment every year; however, it is a good idea for people close to the person with dementia to monitor their driving skills throughout the year and speak to the person’s GP if they are concerned. Reaction time and limb strength are tested on a special static ‘rig’. of driving ability than surrogate assessments. Dementia and driving You must tell DVLA if you have dementia. The assessment is done in a supportive way and is understanding of the bad habits that many drivers pick up, such as not indicating or turning the steering wheel while parked before moving off. One in three people over the age of 75 are still driving and older drivers are generally safer than younger drivers. After you've been diagnosed with dementia, the GP should arrange to see you from time to time, to check how you're managing. The NZTA guidelines specify that patients with dementia should not drive “where cognitive impairments may affect an individual’s ability to drive safely”.2This decision is straightforward in cases of moderate or severe dementia, when driving must be stopped, but is more difficult in cases of mild dementia or MCI, as safety cannot be inferred from cognitive test results or dementia stage. Although family and caregivers can watch for signs of unsafe driving, a proactive strategy would be to get a comprehensive driving evaluation by an occupational therapy driving rehabilitation specialist. You may then be asked to take a driving assessment. The loss of a driving licence can present other opportunities for people with dementia and their partner, for example, finding more local groups and going on walks together as opposed to driving. People with a diagnosis of dementia often want to continue driving. 2. In England, Wales and Scotland this is the Driver and Vehicle Licensing Agency (DVLA). This version is the Nottingham Assessment for Drivers with Dementia. In these cases, the person must get in touch with the centre directly and pay for the assessment. NICE guideline [NG97] Published date: 20 June 2018. An immediate revoke of the person’s licence By this stage, a few people will be found to be unsafe to drive and the assessment will end here. Your doctor may ask for feedback from the person with dementia and a caregiver separately to assess risks. A driver (or ‘licence holder’) who is diagnosed with dementia must tell their licensing agency straightaway. Evidence. We hope that you found this resource helpful. It is not only the person with dementia who can be affected by their ceasing to drive. Renewal of the person’s licence Driving is something that many people take for granted; it can represent independence and a sense of freedom. Many clinicians use the adage that if the son or daughter of a person with dementia is happy for their own kids to go in the car alone with the grandparents, then everything is probably fine. The CMA Driver’s Guide defines moderate-severe dementia as new loss of ability to perform 1 ADL (eg, dressing) or 2 IADLs (eg, shopping) owing to cognitive difficulty. If the DVLA decide the person is able to continue driving, they will issue a new licence which is likely to be valid for one year. It can be very worrying for families if the person they care about continues to drive as there can be concerns about the person’s safety. This is a car with the steering wheel and foot pedals linked to a computer. If you are worried about a person with dementia driving, you may find it helpful to do the following: If the person with dementia has been told that they can continue driving, it may be beneficial to suggest the following to them, to help keep them confident and safe: If a person with dementia is no longer able to drive, they and their family might need some support adapting to this change. This is not a driving test but an assessment of ability to continue driving; The person’s licence is cancelled and they … Driving can be part of maintaining independence and an active life. Although decisions regarding possession of a driving licence in the UK are made by the Driver and Vehicle Licensing Agency (DVLA), psychiatrists have a duty to advise patients who are unfit to drive to cease driving and to inform the DVLA of patients who pose a risk to the public by continuing to drive when advised not to. Government advice on dementia and driving You can arrange an independent assessment of your driving performance and safety whilst you still hold a licence to drive. To help a person with decisions about driving: 1. We’ll send you a link to a feedback form. Dad has had his licence rescinded - he's furious! But driving is also an important tool of independence and can contribute to a person’s sense of self and self-esteem. Read more about this and find out what happens if DVLA/DVA decides a person with dementia can keep driving. Based on the doctor’s report, medical advisers at DVLA/DVA will decide if the person can keep driving. A person with dementia may perceive giving up driving as a loss of independence, and deciding not to drive means accepting that one's abilities are changing. In this case, someone else will need to drive the person home if they came to the centre by car. If an on-road assessment is required, then the DVLA will refer the licence holder to a centre close to them. www.dementiauk.org/staying-healthy, Dementia UK tips for better communication Dementia is important in relation to driving. Assessing driving ability in people with dementia is a serious challenge. It is possible to appeal against a licence being revoked. These assessors will make allowances for ‘poor driving habits’ which people have developed over time, as their priority is looking at overall safety, reaction time and limb strength. Driving and dementia: a clinical decision pathway Kirsty Carter1, Sophie Monaghan2, John O’Brien3, Andrew Teodorczuk1, Urs Mosimann4 and John-Paul Taylor1 1Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK 2London and Maudsley NHS Foundation Trust, London, UK 3Department of Psychiatry, University of Cambridge, Cambridge, UK Scores on the Mini-Mental State Examination are not predictive of driving risk or motor vehicle crashes. The effect of dementia on the person’s driving should be considered at these check ups or at other healthcare appointments, where appropriate. DVLA/DVA will ask someone to take a driving assessment if they are not sure if the person can still drive safely. If DVLA/DVA asked for the assessment, the centre will send them a report. It’s an overall assessment of the impact dementia is having on a person’s driving and whether they’re able to drive safely and in comfort. It will take only 2 minutes to fill in. It can also mean a lot of change for their partner, or another person who cares for them. Driving “I did my driving assessment and I passed… I felt 10 feet tall. 7th Floor Registered office at Alzheimer's Society, 43-44 Crutched Friars, London, EC3N 2AE, Alzheimer's Society is a registered Charity No. If DVLA/DVA decides that a person with dementia can keep driving, they will send them a new driving licence. The Dementia Drivers' Screening Assessment (DDSA) is a neuropsychological battery designed to assist in this process. These tests are known as cognitive assessments, and may be done initially by a GP. EC3N 1RE, Tel: 020 8036 5400 This includes notifying the DVLA, your insurance company and GP. Here is some information on the legal requirements, as well as some practical suggestions to support both the person with dementia and their family. UK law on driving and dementia is clear. • Performance on tests compared with the overall decision by the centre on participants fitness to drive. If you are concerned about any other conditions that a person has, it is important to visit your GP, or write to them, if you are caring for someone from a distance. When someone with dementia stops recognising you, How to commission or host an Admiral Nurse service, www.dementiauk.org/emotional-impact-of-the-diagnosis, www.dementiauk.org/changing-roles-and-relationships, www.drivingmobility.org.uk/ find-a-centre/, www.gov.uk/government/organisations/driver-and-vehicle-licensing-agency, Take some time together to share your concerns with the person and explain what you are worried about and why. The DVLA will always write to the licence holder with their decision. Most mobility centres provide an aftercare service for people who have stopped driving (see Sources of support). What kind of information would you like to read?Use the button below to choose between help, advice and real stories. It is better at identifying those who are safe, than unsafe on the road. It can be difficult to know what to do, what decisions need to be made, who to tell, what support is available and what happens next. The Dilemma - You have been the GP to an elderly couple for over 20 years. I know [at some point] I will give up driving.” Three steps you must take following a diagnosis of dementia Step 3: Complete an ‘on-road’ driving assessment Your insurance company and your doctor may ask you to complete an ‘on-road’ driving assessment. This helps them get used to the car and allows the instructor to check that they are safe to go on the public road. www.dementiauk.org/dealing-with-stigma, Dementia UK leaflet on Staying healthy more common dementias i.e. In Northern Ireland it is the Driver & Vehicle Agency (DVA). The person with dementia must also bring their driving licence and any glasses they need for driving. Supportive Conversation × Frank has early stage Alzheimer's and the doctor said it's no longer safe for him to drive. Dementia UK, may also ask you to complete a driving assessment at a DVLA driving assessment centre. www.gov.uk/dementia-and-driving, Dementia UK leaflet on the Emotional impact of the diagnosis The DVLA will then send a questionnaire and a permission request to the person’s GP and/ or consultant, to obtain medical reports. The assessment will be at one of 20 approved driving assessment centres around the UK, or at one of their related ‘satellite’ centres (see Driving Mobility centres under ‘Driving – other resources’). The assessment of driving risk can be difficult for clinicians, not least because there is ... 1.2 As our population continues to increase in age, so too will the prevalence of dementia in the UK, which is estimated to reach over 1 million by 2025 [2]. www.dementiauk.org/helpline, Alzheimer’s Society The person should also have regular check-ups with their doctor to see how their dementia is progressing. It is a good idea for those close to the person with dementia to stay aware of their driving skills. A thorough assessment is likely to require two visits along with collateral history from family members. This is not a driving test. Driving Assessments for people with Dementia. Driving evaluation At the earliest stages, a person with Alzheimer's disease may begin to have difficulty with complex tasks such as driving. The DVLA requires the person to fill out a ‘Declaration of Voluntary surrender’ which can be found on the DVLA website, or can be requested over the phone. It may also be helpful for the person with dementia to discuss these feelings with other professionals or people who have been through the same thing. People can self-refer or be referred by a … People can self-refer or be referred by a … Evaluating driving safety in patients with mild cognitive impairment (MCI) or dementia can be challenging. 296645. A request for further information, either via medical details or by an on-road driving assessment … Assessment Stopping driving in the interim, persuading, breaking confidentiality After informing the DVLA Who to call for advice? There is a charge for this service. Not everyone will need a brain scan, particularly if the tests and assessments show that dementia is a likely diagnosis. A person may do this if they have a valid licence but want some extra advice or teaching. It may also be worth finding local dementia groups such as memory cafes, in which the person is able to talk about this experience with others who are in a similar position. Stopping driving can be seen as a loss of independence and it is important to ensure that the person with dementia feels respected throughout, Try to drive in daylight and during quieter times on the roads, Try to keep driving to familiar routes with short distances, Reduce distractions such as turning off the radio and limiting conversations, Try to have a passenger in the car to help with navigation, Find local services such as peer support groups which are nearby, to help reduce any social isolation caused by stopping driving Invite friends and family over to your house to prevent the need to travel, Set up an account with a local taxi service and order taxis in advance, Find local voluntary agencies which may be able to assist with transport services, Order shopping online to reduce any burden of travelling. A driving assessment will be requested. They assess how much the person’s dementia is affecting their driving and whether they can drive safely and comfortably. The DVLA will talk to your medical team and may, if it feels it is necessary, ask you to attend a driving assessment at a mobility centre. This is the main part of the assessment. © Dementia UK 2021. It might mean the friend or family member being called upon to drive them around more, or accompany them on public transport. A diagnosis of dementia can be a big shock – for the person with the condition, and their family. While giving them the annual flu jab, you realise that his dementia has progressed and he no longer knows your name. Nevertheless, all practitioners involved in the assessment and care of people with dementia should be assessing the risks, and this should be reviewed at the annual care plan . Perhaps everyone should have a driving assessment these days, dementia or not. Regular assessments during office visits may help your doctor identify a decline in abilities that indicate a greater risk. If they decide that you have to stop driving, you will have to return your driving licence. Driving can be part of maintaining independence and an active life. If DVLA/DVA decides that a person with dementia can keep driving, they will send them a new driving licence. Stroke Drivers Screening Assessment, to be purchased. Increasingly as the management of dementia moves entirely into primary care we may find ourselves being presented with this tricky scenario. Practice dilemma - Driving with dementia. There are two components: a cognitive assessment conducted with the patient, and an informant questionnaire (only considered necessary if the results of the cognitive section are equivocal, ie score 5-8 inclusive). Most concur that simply having a diagnosis of dementia should not preclude an individual from driving (Carr & O'Neill, 2015). The person condition’s must be reviewed every time they renew their licence. In such cases, the person’s GP, if informed, may disclose relevant medical information to the DVLA. The assessment is carried out by an Occupational Therapist and an advanced driving instructor and usually lasts between one and two hours. www.bps.org.uk, Counselling Directory The wife is disabled by arthritis and the husband has been slowly developing dementia. Close. If the assessors decide that the person is not safe to drive, the information and advice they receive will be about other options. After that, your competence will be reviewed at least once every 12 months. Following a diagnosis, it is often better if the person with dementia decides to stop driving themselves, as this not only reduces any risks to them and others, but also helps them to maintain their sense of control. You are here: Home / Get support / Diagnosis and next steps / Driving and dementia. 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