Driving and
dementia
Factsheet 439 Driving and dementia
August 2020
Together we are help & hope
for everyone living with dementia
This factsheet is for anyone who wants information
and guidance on what the law says about driving
with dementia.
It is about driving cars and motorcycles, which carry
‘group 1’ driving licences. It does not cover ‘group 2’
licences, which are for large lorries and buses.
A person diagnosed with dementia cannot have
a ‘group 2’ licence.
A person with dementia may also find it useful to
read booklet 1504, Driving.
Contents
1 How dementia affects driving 1
2 What the law says about driving
and dementia 3
3 If the person wants to keep driving 5
4 When DVLA/DVA decides that the person
can keep driving 7
5 When DVLA/DVA decides that the person
must stop driving 8
6 Giving up driving 10
Other useful organisations 12
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Driving and dementia
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1 How dementia
affects driving
A diagnosis of dementia is not in itself a reason to stop driving.
One in three people with dementia still drives. The most
important thing is whether the person can still drive safely.
Driving may feel easy and natural for people who drive often or
have been driving for many years. However, it is a complex task
that involves quick thinking as well as sensory (vision, hearing)
and manual skills. A safe driver must use a range of mental
abilities including:
focus and attention – to switch between different driving
tasks while ‘reading’ the road
visuospatial skills – to keep the right speed, distance
and road position
problem-solving skills – to deal with any challenges on the
road, such as diversions or obstacles
judgement and decision-making – for example to understand
and prepare for the actions of other road users
reaction skills – to act quickly to avoid an accident
memory – for example, to remember a route.
A safe driver also needs to be patient and calm. Being patient
and calm also helps people to drive more safely.
The common symptoms of dementia can affect all the skills
needed for driving – this is why the driver licensing agencies
must know about it. As dementia gets worse, it affects these
skills even more. This means everyone with dementia will
eventually be unable to drive safely.
How quickly this happens varies from person to person. However,
most drivers with Alzheimer’s disease will need to stop driving
in the middle stage of dementia. Some types of dementia have
certain early symptoms that mean an end to driving might
be sooner. For example, visual hallucinations are common in
dementia with Lewy bodies and impulsive behaviour is common
in frontotemporal dementia.
For more information about the stages of dementia see factsheet
458, The progression and stages of dementia.
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Other health conditions
Many people with dementia have other health
conditions that may also affect their driving. Problems
with vision and hearing are common in older people, as
is arthritis. If this affects a person’s neck, it may reduce
their head-turning ability. This can make manoeuvres
like pulling out into moving traffic much harder. Some
older people also have weaker muscles which can make
physical tasks like steering or braking difficult.
Certain medications, such as those taken to help
a person to sleep or some medicines for depression,
may also affect a person’s driving. If the person needs
to inform their driver licensing agency about taking
these medications, the doctor will advise them of this.
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2 What the law says about
driving and dementia
UK law on driving and dementia is clear. A driver (or ‘licence
holder’) who is diagnosed with dementia must tell their licensing
agency straightaway. If they don’t, they can be fined up to
£1,000. In England and Wales, drivers must tell the Driver
and Vehicle Licensing Agency (DVLA). In Northern Ireland, they
must tell the Driver & Vehicle Agency (DVA). (See ‘Other useful
organisations’ on page 12 for full contact details.) The doctor or
other healthcare professional should make these rules clear
to the person and anyone else when they diagnose the
person’s dementia.
Drivers with dementia must also tell their car insurance provider
straightaway. If they do not, their policy may not be valid. It is
illegal to drive without at least third-party cover.
If a person with dementia wants to keep driving, they must tell
DVLA/DVA. The agency will ask about the person’s medical
information and decide if they are safe to drive. Or DVLA/DVA
may ask the person to have a driving assessment. Section 3
‘If the person wants to keep driving’ on page 5 explains this in
more detail.
In some cases, the doctor will tell the person to stop driving
straightaway. This will happen if the person’s symptoms will
clearly make them unsafe on the road. The doctor may be unsure
of someone’s ability and will want them to stop driving until more
tests are done. Medical advice like this must always be followed –
even if it takes many weeks for DVLA/DVA to decide if the person
can keep driving.
Some people diagnosed with dementia decide for themselves
that they want to stop driving and send their licence back to
DVLA/DVA. This is called ‘voluntary surrender’. For more about
this see the section 6 ‘Giving up driving’ on page 10.
Driving and mild cognitive
impairment (MCI)
Mild cognitive impairment (MCI) is a condition that causes minor
problems with memory, perception, reasoning, judgement or
attention. People diagnosed with MCI do not have dementia, but
some will get it over time. For more see factsheet 470, What is
mild cognitive impairment (MCI)?
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MCI can affect a person’s driving, but this happens much less
often than in dementia. This means that drivers diagnosed with
MCI do not always have to tell DVLA/DVA about their condition.
If a person with MCI finds their driving is affected by their MCI
symptoms, they must tell DVLA/DVA about this. A person’s close
family, friends or healthcare professional may be good judges
of their driving and can also tell DVLA/DVA if needed. As with
dementia, DVLA/DVA will ask for a medical report and decide if
the person is safe to drive.
If the person does not tell DVLA/DVA
Some people who are diagnosed with dementia do not tell
the driver licensing authorities and keep driving. This may be
because they do not accept or recognise their diagnosis, or they
aren’t aware of how much their dementia is affecting their driving.
Not telling DVLA/DVA puts the person at risk of a fine and arrest
as well as a possible accident. It also puts them in danger of
driving without insurance as their policy may now be invalid.
If this happens, the doctor should try to persuade the person to
stop driving and encourage them to tell DVLA/DVA (or let their
family do this for them). If this does not work, the doctor may
have to give the person’s relevant medical information to DVLA/
DVA. The doctor does not need to ask the person before they do
this, but they must tell them afterwards in writing.
This can all be very difficult and stressful for the person with
dementia, their family, their doctor and anyone else supporting
them. For tips on how to handle these situations and to find
out what support is available, see ‘If the person refuses to stop
driving’ on page 8.
It may be helpful to try to reason with the person. However, for
some people, their dementia may mean that they are not able to
accept their diagnosis or understand how it affects their driving.
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3 If the person wants
to keep driving
The first step for someone who is diagnosed with dementia
and wants to keep driving is to tell DVLA/DVA about their
diagnosis straightaway.
The person should give their:
full name
address
date of birth
driver number on their driving licence (if known).
They can get in touch with their licensing agency by post,
on the phone or online (see ‘Other useful organisations’ on
page 12).
DVLA/DVA will then send the person a questionnaire and a
request to get medical reports from their doctor. If you live in
England or Wales, this questionnaire can also be downloaded
from the gov.uk website (see ‘Other useful organisations’ on
page 12). Once the person has returned it, DVLA/DVA will speak
to their doctor.
Based on the doctor’s report, medical advisers at DVLA/DVA will
decide if the person can keep driving. There are several possible
results at this stage. DVLA/DVA may:
renew the person’s licence, usually for one year
cancel or ‘revoke’ it straightaway (see section 5 ‘When DVLA/
DVA decides that the person must stop driving’ on page 8)
ask for more information, such as more medical details
ask the person to take an on-road driving assessment before
making a decision (see ‘Driving assessment’ below). This is the
least common of the possibilities.
In all cases, DVLA/DVA will tell the person in writing.
Driving assessment
DVLA/DVA will ask someone to take a driving assessment if they
are not sure if the person can still drive safely. This 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 ‘Other useful organisations’ on page 12). DVLA/DVA
will refer the driver to a centre near their home and will pay for
the assessment.
My husband has
recently been
diagnosed with
Alzheimer’s and
people ask if he
is driving. He is a
good driver so yes,
he is still driving.
Carer for a person
with dementia
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Some people choose to have an assessment without DVLA/DVA
asking them to. A person may do this if they have a valid licence
but want some extra advice or teaching. In these cases, the
person must get in touch with the centre directly and pay for the
assessment. Prices vary but the average cost is between £70–90.
The person being assessed should go to the centre with another
person who can drive or accompany them home using alternative
transport, if necessary. This is in case the assessment finds that
the person is unsafe to drive. The person with dementia must also
bring their driving licence and any glasses they need for driving.
The assessment is not like a learner’s driving test. It is carried
out by a specialist occupational therapist and an advanced
driving instructor. They assess how much the person’s dementia
is affecting their driving and whether they can drive safely and
comfortably. 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. The assessors will work with the person to help
them keep driving if this can be done safely.
The driving assessment takes about two hours and generally
includes the following steps.
1
The person with dementia answers questions about their
medical and driving history, and any driving problems they may
have. After this, they do a short written test of mental abilities.
2 Reaction time and limb strength (for steering and braking) are
tested on a special static ‘rig’. This is a car with the steering
wheel and foot pedals linked to a computer. The person’s
eyesight is also checked. By this stage, a few people will be
found to be unsafe to drive and the assessment will end here.
3
The main part of the assessment is a drive on public roads,
along a set route. This is the best test of a person’s driving
ability. This part happens in a dual-control car, which has a
brake on the passenger’s side as well as the driver’s side. Some
centres have a private road that the person drives around first.
This helps them get used to the car and allows the instructor
to check that they are safe to go on the public road. The
person drives with the advanced driving instructor in the
passenger seat and the occupational therapist in the back.
4 Back at the centre, the assessors tell the driver what they
have found. If the decision is that the person can drive safely,
they’ll be advised how to do this confidently. If the assessors
decide that the person is not safe to drive, the information and
advice they receive will be about other options. In this case,
someone else will need to drive the person home if they came
to the centre by car. If DVLA/DVA asked for the assessment,
the centre will send them a report. The licence holder can ask
the agency for a copy of this.
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4 When DVLA/DVA decides
that the person can
keep driving
If DVLA/DVA decides that a person with dementia can keep
driving, they will send them a new driving licence. It will usually
be valid for one year. For people with early dementia, this may be
up to three years.
The person’s condition must be reviewed every time they renew
their licence. They won’t have to pay a fee for this and DVLA will
send a reminder letter.
It is a good idea for those close to the person with dementia to
stay aware of their driving skills. The person should also have
regular check ups with their doctor to see how their dementia
is progressing. The effect of dementia on the person’s driving
should be considered at these check ups or at other healthcare
appointments, where appropriate.
Reducing the risks
While a person with dementia may be able to drive safely, driving
may feel a bit more difficult than before. It may be easier to stay
safe on the road if they:
don’t go for long periods without driving – to keep their skills
and stay confident
keep to short and familiar routes at quiet times of the day – so
they are less likely to get lost or stuck in heavy traffic
drive in daylight – with good road and weather conditions
drive without distractions, like the radio – for better focus
only drive when they feel fully awake and well.
Even if DVLA/DVA decides the person can keep driving, it may
be helpful for them to plan ahead for when they must stop
completely. Talking to others about this and making some
changes to their usual arrangements can make it much easier
to stop driving when the time comes. See ‘Tips: Supporting
someone who has given up driving’ on page 10 for more on this.
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5 When DVLA/DVA decides
that the person must
stop driving
If DVLA/DVA decides that the person is not safe to drive, the
person must return their licence to DVLA/DVA and stop driving.
Drivers who wish to appeal must send a formal petition to the
Magistrates’ Court in England and Wales within six months of
the refusal letter being sent. Or, to a Clerk of Petty Sessions
in Northern Ireland, within three months. During this time, the
person is not allowed to drive, even if they think they will win
their appeal.
Being told to stop driving affects people in different ways.
For some it is a relief, but many others feel it is a huge loss.
A few are very angry with the decision as they may not
understand how much dementia impacts their driving skills.
You can help them to accept the decision by listening to them,
acknowledging their feelings and addressing their concerns.
If the person refuses to stop driving
Some people keep driving even though DVLA/DVA has assessed
them as unsafe to do so. This can be a very distressing situation
for both the person and their family.
However, it is important to remember that the person is not being
difficult on purpose. Their dementia may mean they cannot see
how their symptoms affect their driving. They may not accept
their diagnosis, or keep forgetting that their licence has been
cancelled. This means they may find it very difficult to accept
DVLA/DVA’s decision or listen to reasoning from their doctor,
family members, carers or professionals.
When this happens, the person’s doctor or family should write in
confidence to DVLA/DVA. The agency will follow things up with
the local police.
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Supporting someone who is unsafe to drive but refuses to stop
can be very challenging. Where possible, many carers may:
hide the car keys
sell or give the car away
disable the car or lock the steering wheel
park the car out of sight.
They can also get help by calling Alzheimer’s Society’s Dementia
Support Line on 0333 150 3456 or by talking to people with
similar experiences on our online community, the Dementia
Support Forum at forum.alzheimers.org.uk
At first we were
disappointed about
not driving… but
it doesn’t really
affect us too much,
in fact we go out
more now than we
used to before.
A person with
dementia
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6 Giving up driving
Many people with dementia choose to stop driving because
they begin to find it stressful or they lose confidence in their
abilities. A person should consider stopping if they:
get annoyed easily and frequently when driving
get lost even on routes they know well
misjudge speeds or distances
drift between lanes or hit kerbs
get very confused by roadworks
have minor accidents or near-misses
find that passengers worry about their driving.
Giving up driving can be a very difficult decision to make.
A person who feels they must do this will need support and
understanding from those close to them. They may feel
unhappy about stopping driving if:
they are used to being independent
they have always driven their partner or family around
they are used to visiting friends or family or going on
day trips by car
it means everyday tasks will get more difficult, such as
shopping, going to places of worship or seeing the doctor.
However, it may be easier for a person with dementia to accept
not driving if it has been their choice, rather than DVLA/DVA
telling them to stop. It can also help if they have planned for
the change by slowly adapting their use of the car over time.
If a person decides to give up driving, they must send a
‘Declaration of voluntary surrender’ form to DVLA (or a covering
letter to DVA) along with their licence. They can download
the form from gov.uk or get one by calling DVLA (see ‘Other
useful organisations’ on page 12).
Tips: Supporting someone who has
given up driving
Giving up driving is not always an easy decision for
a person with dementia. However, with plenty of support
and understanding they can adapt to this change.
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The following suggestions may be useful:
Recognise how the person is feeling. Driving may have been
an important part of their independence. Without it, they may
lose confidence and feel unhappy. Using public transport may
also seem stressful or difficult, particularly if the person has
physical problems. Cuts in public transport may also mean the
services in their area are expensive or not very regular.
Encourage the person to use new transport options, so that
they can feel more in control. They could find out details and
timetables of local transport services, for example. Make sure
the person is getting all the travel discounts they are entitled
to. Many mobility centres also offer an ‘aftercare’ service of
practical local advice for people who have stopped driving.
There are many day-to-day tasks that a person can still do
without driving. Other than using public transport, a person can:
book a taxi to go to and from the supermarket once a month
or when they have larger amounts of shopping. They could
set up an account with a taxi firm they trust and like, and
order taxis in advance
get a shoppers’ bus to the supermarket and back
find out about local organisations that offer community
transport services to help people who are older or have
difficulty accessing public transport to get out and about
(such as Dial-a-ride)
ask if the hospital can help with transport for appointments
pay bills by direct debit so they don’t need to visit the bank or
post office so often – if they’ve made someone an attorney,
under a property and financial affairs LPA, this person may be
able to do these things for them, or with them
order shopping online (if possible) for home delivery, or be
helped to do so.
Pointing out the benefits of not driving may also help, such as:
no longer having to find parking spaces or remember routes
not spending money on petrol, servicing, road tax and car
insurance every month
no more stress of having to drive in busy traffic
meeting and chatting to people on public transport
getting more exercise if they decide to walk instead.
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Other useful organisations
Driver & Vehicle Agency (DVA)
Driver Licensing Enquiries
County Hall
Castlerock Road
Waterside
Coleraine BT51 3TB
0300 200 7861 (9am–5pm Monday–Friday)
dv[email protected]v.uk
www.nidirect.gov.uk/index/information-and-services/
motoring.htm
The DVA manages the licensing and testing of vehicles and
drivers in Northern Ireland.
Driver and Vehicle Licensing Agency (DVLA)
Drivers’ Medical Enquiries
DVLA
Swansea SA99 1TU
0300 790 6806 (8am–7pm Monday–Friday,
8am–2pm Saturday)
www.gov.uk/contact-the-dvla
The DVLA looks after the database of drivers in Great Britain,
and a database of vehicles in the UK. Search ‘Form CG1’ on their
website to find the medical questionnaire.
Driving Mobility centres
Driving Mobility is a network of driving assessment centres
across the UK.
Enter your postcode to find a centre near you at
www.drivingmobility.org.uk/find-a-centre
You can also call 0800 559 3636. If you call from a mobile, this
goes to the Driving Mobility Head Office. They will give you
contact details for your nearest Driving Mobility centre. Calls
from a landline will divert to your nearest centre automatically.
Factsheet 439
Last reviewed: August 2020
Next review due: August 2023
Reviewed by Dr Paul Donaghy, Consultant in Old Age Psychiatry,
Gateshead Healthcare NHS Foundation Trust and Intermediate
Clinical Fellow, Newcastle University
This factsheet has also been reviewed by people affected
by dementia.
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please email publications@alzheimers.org.uk
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