Wednesday, April 4, 2012

Drivers with dementia - how do you take the car keys?

You wouldn't let him drive!

We're still talking about this in Canada. Unfortunately, those unable to drive due to dementia, do not recognize their impairment. Society is going to have to intervene, since physicians and adult children seem unable to take responsibility for this issue.

65 going on 16: Medical journal proposes new rules for elderly drivers

An editorial published this week in the Canadian Medical Association Journal says some seniors keep driving as they age despite “substantial physical or mental deterioration.”

The piece points to data from 2009 showing more seniors died in fatal vehicle crashes than any other age group and goes on to suggest a graduated licensing system – like what new drivers work through – to help protect elderly Canadians and others on the road. And a great resource:

Driving Skills and Safety

    Memory impairment can impact your loved one’s ability to recognize traffic signs and signals, drive too fast or too slow, or become confused while driving. As dementia progresses and memory impairment worsens, the senses are also affected. Visual agnosia, caused by changes in the brain, may impair the ability to comprehend visual images, although there is nothing physically wrong with the eyes. Also, their sense of perception and depth may be altered. These changes will cause safety concerns – especially when it comes to driving.

The 5 R's

    As your loved one’s dementia progresses, many behavioral issues may arise. Often, paranoia, false ideas, frustration, irritability and anxiety afflict the person living with dementia. All of these behaviors are bound to have an intense emotional impact on you, the caregiver, as you’re losing someone you’ve known and loved for a lifetime. In the face of this emotional intensity (as your loved one accuses you of stealing, insists that he hates his favorite dish, or is sure that her husband is an impostor), it’s important to resist responding with logic and reason. 

    Instead, try the 5 Rs, a psychological tool-set intended for caregivers. The 5Rs allow caregivers to separate from the emotional impact of behavioral issues that can arise when a loved one has dementia.

    The Rs

    1. Remain calm. Don’t argue or try to reason. Take a deep breath before you act.
    2. Respond to feelings. Validate how your loved one seems to be feeling at the time.
    3. Reassure. Remind your loved one that s/he is safe and cared for.
    4. Remove yourself physically or distance yourself psychologically for a moment to regain your composure.
    5. Return fully to the situation when your loved one begins to calm down.

    Remember, no matter how hard you try, you can never separate the emotional connection to your loved one from the irrational behaviors, but you can try your best to respond in a manner that won’t worsen the situation.

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