By Lolita Tramel, DNP | Family and Psychiatric Nurse Practitioner
If you’ve ever had to sit across from a parent or loved one and gently suggest it might be time to stop driving, you know how heartbreaking and complicated it can be.
Recent reports of a wrong-way crash on Interstate 10 where an elderly driver became confused reminded me of the harsh reality I faced with my mom after she was diagnosed with Alzheimer’s disease. She just wasn’t the same person. She became forgetful, easily distracted and lost. For her own safety and for the safety of others we had to do the hard thing: take away the keys.
It’s not just my story. Across Arizona, more and more families are facing this same dilemma. This year, nearly 200,000 Arizonans over the age of 65 will be living with Alzheimer’s or another form of dementia. That’s a 33% jump in just five years. And while some will naturally stop driving as their condition progresses, many won’t. Studies show about one in three people with dementia continue to drive, with the risk of collisions increasing significantly.
That’s where the real concern lies. Dementia can impact judgment, reaction time and spatial awareness, all crucial for safe driving. And yet, there’s no clear-cut rule about when someone with dementia should stop. It’s often left up to families, doctors or sometimes, tragically, the wake-up call comes after a dangerous incident.
This isn’t about blaming older drivers. It’s about recognizing the unique challenge dementia presents. It’s about protecting people we love, and everyone else on the road. Starting the conversation early, knowing the signs and having support can make all the difference.
A dementia diagnosis doesn’t mean someone has to stop driving immediately, but the warning signs should never be ignored. As both a daughter who’s walked this path and a nurse practitioner who works with families navigating these decisions, I’ve seen how critical our role is once cognitive decline begins.
As the disease progresses, people with dementia can’t always recognize when they should stop driving. That responsibility will inevitably fall to those who love them. I recommend looking for patterns such as getting lost on familiar roads, unexplained dents or scrapes on the car, confusing the gas and brake pedals, or reacting too slowly to situations on the road. They also might start to miss traffic signs, or even grow anxious while driving. All of these things can be indicators that it’s time to consider giving up the keys.
It’s important to listen not just to what they say, but to what their behavior is telling you. These conversations are rarely easy. But starting them early and coming from a place of love makes a difference. Instead of saying, “You shouldn’t be driving,” try saying, “I’m worried about your safety.” And rather than arguing opinions, focus on real examples.
If you’ve noticed several near-misses or recent confusion behind the wheel, bring those moments into the discussion. That helps avoid feelings of blame or shame. Let them know you are worried and concerned for their safety. Ask how they’d like to get around if they were to stop driving. It helps shift the focus to solutions and independence, not just loss.
This can be a journey that requires multiple discussions and emotional support. It may even require including the opinion of a health care professional.
In some cases, the decision isn’t mutual. If a loved one refuses to give up driving, be ready to remove the keys or disable their vehicle temporarily.
When needed, I encourage families to discuss options with their physician, such as submitting a confidential report to ADOT’s Medical Review Program. That can prompt a reevaluation without placing the full burden on the family.
The decision to stop driving is never simple or clear-cut. With compassion, planning and support, families can help loved ones stay safe, respected and connected — even when they’re no longer behind the wheel.
Editor’s note: Lolita Tramel, DNP is a dual-board certified family and psychiatric mental health nurse practitioner, and founder and CEO of Scottsdale-based Hearts For Dementia. Please send your comments to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.
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