Questions answered
There are a number of uncertainties about driving with dementia. Is it still possible at all? Do you have to take a driving test? Can you report someone if you doubt his/her driving skills? We provide the answers to these questions.
It is a well-known phenomenon in many families: a family member has to deal with (the first) symptoms of dementia, but still gets into the car. He or she thinks it is still possible. But it leads to anxiety and questions among the other family members.
Influence of dementia on driving behaviour
Dementia has a major impact on many aspects of daily life, including driving. Reaction time decreases, it becomes more difficult to maintain attention, disorientation, doubt about the traffic rules. These are all symptoms that you can experience when you get into a car with dementia. Given that people with dementia are two to eight times more likely to be involved in an accident, these are not symptoms to be ignored. In addition, insurers may not reimburse the damage, especially if it is known that you knew about the dementia and nevertheless got behind the wheel. So at your own risk!
Can you still drive with dementia?
There is no unequivocal answer to that question. It depends on the form of dementia and the stage to which it has progressed. In general, people with dementia are in principle unfit and unqualified to drive. At an early stage or in the case of a mild form of dementia, you can still obtain a driving license via the CBR, which is usually valid for one year. For this you undergo a driving test, which assesses whether you can still drive safely. You have to request such a test yourself; a doctor may not simply arrange such a test for you on the basis of a suspicion of dementia.
This is what the law says about it
The regulations regarding driving skills are laid down in the Regulation on suitability requirements 2000. This states that dementia can be divided into four categories: very mild, mild, moderate and severe. If you fall under the first two categories, you can get a driving license for a maximum of one year. Only in exceptional cases can this driving license be valid for three years. The other categories by definition make you unfit to drive. The assessment must always be done by an expert in the field of practical suitability of the CBR. In order to be eligible for a driving test, the CBR needs a report from a medical specialist, with which it gains insight into the severity of the dementia.
What kinds of tests are there and what do they look like?
Driving tests come in all shapes and sizes and are tailored to everyone’s unique situation. The CBR distinguishes between tests with an emphasis on thinking, doing or seeing. In the case of dementia, the emphasis is on thinking.
The CBR pays attention to the following points in such a test:
- Attention: Distribution and Concentration
- Automatism of actions
- Decision
- Recognition of danger and traffic situations
- Prediction of behavior of other road users
- Knowledge and application of the traffic rules
The judgment of the CBR is hard: as a result of the test, you may or may not continue to drive. Many people do not dare to take such a test because they are afraid of losing their driver’s license.
New test
Neuropsychologist Dafne Piersma recently obtained his doctorate from the University of Groningen on a design for a new driving test, one that does not give such a harsh judgment. This new test assesses in the hospital whether you are suitable for driving, without running the risk of having your driver’s license revoked. This new test consists of three parts:
- Conversation with the patient and a loved one
- Traffic and neuropsychological test
- Driving test in a simulator
This alternative test does not exclude the inspection by the CBR. But the outcome will match 90 percent of the time. In the event of a negative result, you must therefore assess for yourself whether it is still wise to get in the car.
How do you request a driving test?
To have your driving license tested at the CBR, you must submit a health declaration. You can do this online via My CBR, or on paper via a form that you can request from your municipality. You discuss the health statement with a doctor, who will then determine whether your complaints may affect your driving ability. After you have sent this form to the CBR, they will look at any follow-up steps, such as a visit to a medical specialist and/or a driving test.
Can you request the test for someone?
If you doubt the driving skills of another person due to dementia, you can also indicate this. It would be easiest if you could get him or her to complete a health declaration by talking to the person in question – whether or not in the presence of the GP. Unfortunately, this often does not work, and then you have to indicate to the CBR that you doubt your driving skills. The CBR can then initiate a mandatory investigation. This is only possible if you send an independent statement, for example from a general practitioner or social worker, that supports your doubt. This must clearly show why the person concerned is endangering road safety.
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