Direct Line magazine

Driving and Dementia: The essential guide for seniors

Updated on: 19 January 2022

Older person's hands on steering wheel.

Starting to drive is a memorable moment in many people’s lives. But when’s the right time to stop?

It’s something we don’t really talk about, but as we get older our ability to drive can worsen. 

It could be due to medical conditions, a decline in our health, or being physically unable to manage car journeys. At some stage, many of us will have to accept that our driving days are behind us.

In this guide we look at the legal requirements for driving, how health can affect your ability behind the wheel, and tips on deciding when it’s time to stop.

An introduction to driving for older drivers

Can you continue to drive as you get older?

There’s no age at which the law says you must stop driving. So long as you remain in good general health and have no medical conditions that affect your ability to drive, it’s essentially up to you when you stop. 

However, when you turn 70 your driving licence expires and will need to be renewed if you wish to continue driving. The DVLA should get in touch 90 days before your 70th birthday. From then on, you’ll need to renew your driving licence every three years. At this age, your health is more likely to rapidly change than when you were younger. Renewing your licence as an elderly driver helps ensure your safety and the safety of other road users.

Legal requirements for driving in the UK

Regardless of age, to drive in the UK, you need a valid driving licence, insurance, an MOT certificate (where applicable) and road tax.

Did you know?

The NHS offers free eye tests to people over the age of 60. Those aged between 60 and 70 are entitled to a free test every two years. For those over 70, your optometrist may recommend you have an eye test more often. 

In addition to renewing your licence when you’re over 70, there are some considerations applicable to elderly drivers. Firstly, you must be able to read a number plate from 20 metres – if you need glasses or contact lenses to see this far you’ll be legally required to wear them when you drive. 

You also need to inform the Driver & Vehicle Licensing Agency (DVLA) about any medical conditions that could affect your ability to drive. Professionals, such as GPs and opticians, may offer guidance as to when you need to contact the organisation. 

Generally speaking, if anything changes in your health and wellbeing that could affect driving ability, you should seek advice from the DVLA.

Medical conditions that can affect driving ability

It’s a driver’s legal responsibility to make the DVLA aware if they have certain medical conditions, and are worried about the impact it could have on their driving. You can find a full list of conditions on the website, but we’ve highlighted some common age-related conditions:

  • Arthritis. Making your joints swollen, stiff and painful can limit movement. Common affected areas that present challenges to driving include hands, feet, back, hips and knees.
  • Alzheimer’s and dementia. Changing the way the brain works, Alzheimer’s and dementia often result in forgetfulness and disorientation. Many sufferers will not be aware of their condition, adding to the risk they pose to themselves and others by driving.
  • Diabetes. Left unmanaged, diabetes can cause spells of sleepiness, dizziness and confusion, which would be dangerous when in control of a car.
  • Parkinson’s. Although it affects people in different ways, Parkinson’s disease does have symptoms that affect movement, including tremors and stiffness, making it difficult to react quickly when driving.
  • Stroke. The effects of a stroke vary. Common problems include issues with vision and memory, but can be as severe as partial paralysis. As such, driving ability could be seriously impaired.

Safety checklist for older drivers

Whatever their age, few drivers could say they’ve never experienced a tricky moment on the roads. It’s easy to have your confidence knocked, fall into bad habits, or simply forget the things you were taught while learning. There are also health conditions that could affect you while driving, such as visual impairments, arthritis, and muscle weakness. Medication can impact your concentration and ability to drive, too. Discuss this with your doctor, who will be able to advise you. 

For older drivers, it’s worth asking a few questions to see if further support is needed:

  • Do you feel confident on the roads?
  • When was the last time you had a near miss?
  • Have you asked if other people feel safe in your car? How do they respond?
  • Are you happy to drive and park during busy times of the day? Or do you avoid driving at certain times?
  • Are you comfortable with all manoeuvres, including reversing under pressure?
  • Have you recently had any comments from other road users?
  • Do you know speed limits and common road signs?

If your answers to these questions have made you question your driving ability, don’t panic. Some uncertainty means you might benefit from a refresher course, spending a few hours with a driving instructor to brush up on your skills. You can’t fail or pass; refresher courses are simply meant to provide additional support.

Check out the following:

  • The AA’s refresher lessons
  • The Institute of Advanced Motorists’ Mature Driver Review, along with many other useful training programmes
  • Private tuition with a Driving Standards Agency (DSA) registered instructor

How dementia affects driving ability

Red car parked on drive

Driving gives us freedom and independence, which is why it can be difficult to cope when changes in our health affect our ability to do it.

An introduction to dementia in the UK (statistics)

Driving is a great way to get out and about, keep up with hobbies and stay in touch with friends and family. That’s why many dementia sufferers will continue to drive even though their health is declining. They might adapt their routine slightly by changing when or where they drive, rather than giving it up completely.

But not everyone can instantly recognise when they have an issue with their health.

Dementia refers to a group of symptoms that affect and deteriorate brain functions – including recognition, memory, language, and planning. Symptoms of dementia gradually get worse over time, so it can be difficult to recognise the point at which it starts to affect day-to-day life.

The Alzheimer’s Society believes one in three people with dementia still drive, and that being diagnosed doesn’t necessarily mean you have to give up driving straight away. However, as dementia progresses, there’ll come a point when you should no longer be behind the wheel.

When looking at the signs of dementia, it’s easy to see how driving can be affected:

  • Memory loss impacting day-to-day life
  • Difficulties with planning and organising
  • Losing track of time or place
  • Problems with vision, speaking and writing
  • Misplacing objects
  • Increasingly poor judgement
  • Withdrawal from work or social activities
  • Changes in behaviour and personality

According to the Alzheimer’s Society, there are around 850,000 people with dementia in the UK.

And that’s not all. The Alzheimer’s Society says:

  • In the UK, the number of people with dementia is set to rise to over 1.6 million by 2040.
  • 209,600 will develop dementia this year – that’s one every three minutes.
  • One in six people over the age of 80 have dementia.
  • 70% of people in care homes have dementia or severe memory problems.
  • There are over 42,000 people under 65 with dementia in the UK.

Although it’s not considered a natural part of ageing and there are many factors involved, statistics indicate the chance of developing dementia increases with age.

What support is available?

Dementia is one of the main causes of disability in later life – ahead of cancer, cardiovascular disease and stroke – yet the UK government spending on dementia is less than these other conditions.

According to the Alzheimer’s Society, two thirds of costs linked to dementia are actually paid for by people with the condition, their families, or a combination of the two. Unpaid carers save the economy £13.9 billion a year. 

 In addition to family and friends, key places of support include:

  • Local dementia groups, such as memory cafés
  • Talking therapy with a trained professional
  • Online discussion boards, where people going through the same thing can share their experiences
  • Charities. The leading dementia charity is the Alzheimer’s Society, which is committed to spending at least £150 million over the next decade on dementia research to improve care and find a cure. It offers excellent support and advice for people with dementia and their families

Other dementia charities include:

  • Dementia UK
  • Alzheimer’s Research UK
  • Admiral Nurses. Registered nurses and experts in dementia care give practical, clinical and emotional support to families affected by the condition. Admiral Nurses work in the community for the NHS, care homes, hospitals and hospices. They can help improve quality of life, and provide coping mechanisms. You can contact the Admiral Nurses dementia helpline on 0800 888 6678.

Covering the costs of getting around

Having additional financial support can make a real difference to people with dementia. But what could you be eligible for that might help you get around?

Personal Independence Payment (PIP) is designed to help with some of the extra costs caused by long term ill-health or disability. The Motability scheme allows some people getting PIP or War Pensioners’ Mobility Supplement to get a car, powered wheelchair or scooter. Using some or all of your mobility benefit payments, you can cover the cost of contract hire or hire purchase of an appropriate vehicle. You can also apply for discounted or free road tax to help with the costs of running a car. The NHS website has further details.

Instructing the DVLA of your medical condition

It’s a requirement to tell the DVLA about a dementia diagnosis. You can do this by contacting them by phone, email or post. Contact details can be found on the website. You can also download and fill in form CG1, sending it to the address found on the form. Those who’ve been diagnosed with Lewy body dementia must fill in form B1.

After speaking with your consultant or GP, medical advisers at the DVLA will decide between three options:

  • Renew your licence, typically for one year before reassessment
  • Cancel your licence immediately
  • Request more medical information, or ask you to take an on-road driving assessment 

A DVLA driving assessment can be completed at one of 20 accredited driving assessment centres around the UK. You’ll need to go to the centre with an adult able to help you get home if necessary.

A driving assessment isn’t the same as a driving test. Instead, it takes an overall look at how dementia is affecting your driving and whether you’re safe and comfortable enough to drive. It’s a supportive process, not a judgemental one, carried out by a specialist occupational therapist and an advanced driving instructor.

Here’s what you can expect from a driving assessment:

  1. An interview. First, you’ll be asked about your medical and driving history, and if you think you’re having any problems with driving. As part of the interview, you’ll also have to do a short pen-and-paper test of your mental abilities.
  2. Reaction time and limb strength test. To test you’re physically capable of steering and braking, test centres have special static 'rigs'. It’s the set-up of a car with a steering wheel and foot pedals linked to a computer, so all data can be assessed by experts. Eyesight is also checked. By this stage, some people will be found not to be safe to drive. If this happens, you won’t carry on with the rest of the driving assessment.
  3. On-road session. Spending time on the road is the best measure of driving ability. In a dual-braking car, you’ll drive with an advanced driving instructor who acts as a front passenger. An occupational therapist will also attend this part of the assessment as an in-car observer.
  4. Finding out the news. Having returned to the centre, staff will tell you their assessment. If they think you’re able to carry on driving, they’ll suggest strategies and adaptations to help improve your safety and confidence on the roads. Where DVLA/DVA have asked for the assessment, the centre will send the report directly to them. As the licence holder, you can ask the agency for a copy too.

Your handbook for keeping safe on Britain’s roads

When someone is diagnosed with dementia, there’s always a concern as to whether that person should still be driving. This is understandable, but many people in the early stages of dementia still have the necessary skills to remain safe on the road.

The key is detecting a problem before accidents occur. There are things you can do to self-regulate and improve your road safety. Here are some of the basics to keeping safe when you’re at the steering wheel: 

  • Plan ahead. Know your route beforehand and plan for any stops you’ll need to make. Also remember to give yourself time to adjust your seat and mirrors before you set off. Another good habit is to check the weather before you travel so you can prepare and avoid disrupted roads.
  • Allow more time for journeys. This means you can take your time and not feel rushed or pressured to get somewhere.
  • Don’t get distracted. Multi-tasking when you’re driving simply isn’t worth the risk. Anything that takes your mind or eyes off the road can cause a serious accident. This includes loud music, noisy passengers, and distractions from electronic devices.
  • Drive defensively. Being a defensive driver means being aware of what other drivers around you are doing, as well as anticipating their next moves. You shouldn’t assume other drivers will follow the rules of the road, so it’s best to err on the side of caution. Always be prepared for some unpredictable driving from others.
    Look after your car. Keep an emergency kit in your car, and make sure you regularly check your key fluids, as well as the wear and tear on your tyres.

Think about other road users. Driving safely means taking care around other road users, such as cyclists, pedestrians, and horse riders.

  • Avoiding certain driving situations, times and types of road. Assessing your ability might mean you stay away from driving:
    • At night
    • During rush hours
    • Through large, busy junctions or roundabouts
    • On certain types of road
    • For long periods of time, or on unknown routes
  • Gradually reduce the amount of driving you do. Try out buses, taxis or trains to see if you prefer travelling this way.
  • Take regular driving assessments and refresher training.
  • Learn from your mistakes. If you have a near miss, make sure you think about what you found difficult and how you could approach the situation differently next time to ensure it doesn’t happen again.
  • Change or adapt your car. Some adaptations might make it easier for you to drive, including:
    • Steering aids
    • Hand controls
    • Special cushions
    • Swivel seats 

If someone you know has been diagnosed with dementia, yet has been assessed and is still allowed to drive, there’s no harm in discreetly monitoring their driving habits if you’re concerned. 

Here are some of the warning signs to look out for:

  • Driving too slowly
  • Stopping in traffic for no reason or ignoring traffic signs
  • Becoming lost on a familiar route
  • Lacking good judgement
  • Difficulty with turns, lane changes, or highway exits
  • Drifting into other lanes of traffic or on the wrong side of the street
  • Signals incorrectly (or not at all)
  • Has difficulty seeing pedestrians, objects, or other vehicles
  • Falls asleep while driving or gets drowsy
  • Parks inappropriately
  • Gets ticketed for traffic violations
  • Is increasingly nervous or irritated when driving
  • Has frequent accidents or near misses

When is it the right time to give up driving?

Elderly couple in the car smiling while driving

According to the Alzheimer’s Society, most people continue to drive for around three years after being diagnosed with dementia.

If you’ve been diagnosed with dementia, be aware there will likely come a time when you’ll have to stop driving. It’s your responsibility to acknowledge the warning signs and prioritise safety over convenience.

What does the law say about driving with dementia?

You might not realise how dementia is affecting your ability to drive, or you might think it has had no effect at all. But driving requires a complex mix of thought processes and manual skills, all of which can be affected by dementia. 

Dementia symptoms gradually get worse over time, meaning they might not initially cause issues with driving. No matter, you’re still legally required to tell the DVLA. In Scotland or Ireland, you must notify the Driver & Vehicle Agency (DVA). You shouldn’t wait until your licence is due for renewal.

Your doctor will probably have made this clear to you and in cases where dementia is advanced your doctor will tell you to stop driving straight away. Alternatively, your doctor might advise you to stop as a precaution until further assessments are carried out. When you notify the DVLA or DVA, ensure you give details of your specific medical condition. That way, you’ll be sent the necessary medical questionnaire to fill out.

Even if it takes the DVLA several weeks to assess your medical notes and make a final decision, you should listen to the initial advice from your doctor. GPs now have the power to contact authorities on your behalf if they feel you shouldn’t be driving. A doctor will still encourage you to contact the DVLA yourself, but can inform them if they’ve exhausted all efforts to persuade you to do so.

Failure to tell your car insurer provider of your condition may invalidate the policy, and it’s a criminal offence to drive without third-party cover at a minimum. You could face a fine of up to £1,000 for failing to notify the correct authorities that you have dementia and may be prosecuted if you have an accident as a result of your condition.

When should someone with dementia stop driving?

You should always listen to the DVLA or your doctor if they’ve instructed you to stop driving. But it’s important to also pay attention to other signs. These include:

  • Your gut instinct. Due to the convenience of driving, it can be tempting to carry on even though you know it may no longer be safe to do so. Be wary of the warning signs that suggest your driving ability is getting worse and don’t be afraid of listening to your instincts. Safety should always be the top priority.
  • Advice from family, friends or carers. We don’t always want to listen to the advice of those closest to us, but it’s important to understand they’ve got our best interests at heart. Seek their advice and support.

Top safety risks and concerns

These are some of the skills which could be affected by dementia and why driving with dementia can be dangerous:

  • Spatial awareness. The ability to accurately judge distances between areas and cars is crucial if you are to avoid causing an accident.
  • Understanding road signs. As well as remembering the rules of the road, you’ve also got to be able to read the road and know how to react accordingly.
  • Reaction times. You’ve got to be able to react quickly enough to stop and start, and respond to the actions of other drivers.
  • Attention and concentration. Driving requires you to focus on, and switch between, different tasks. Not having the necessary concentration levels could pose a safety risk.
  • Problem-solving skills. You have to be able to respond to unplanned incidents, diversions or obstacles. If you’re not able to process and respond quickly, you could hold up traffic and create a stressful scenario for yourself.
  • Judgement and decision-making. When driving, you need to interpret and anticipate what other road users are doing. Misjudging their intentions or movements is potentially dangerous.

Tips for family members and carers

Understandably, you might be worried about talking to a loved one about their driving ability, afraid to hurt their feelings or cause offence. But nothing is more important than their safety. If you think their driving ability is getting progressively worse, you should bring it up. To ensure it’s a positive conversation, bear the following tips in mind:

  • Ask questions, don’t make judgements. When you feel uncomfortable or scared in someone’s car, it can be easy to make quick statements that cause more harm than good. Think about the way you word things. Rather than telling them they shouldn’t be driving at night, perhaps ask them how they feel about driving home in the dark.
  • Highlight the positives of giving up. A great way of convincing someone to give up their car is to explain how much money they’ll save. Other forms of transport could be cheaper if they’re not covering many miles.
  • Use examples. Ask them to recall whether they’ve recently felt scared driving, and perhaps give your own example of when you thought they might be struggling. Finding out someone else has noticed their difficulties driving may be the wake-up call they need. But remember it can be a difficult realisation, so always be sympathetic.

The best alternatives to driving

Giving up driving doesn’t mean giving up your freedom. There are practical travel alternatives and they often end up being cheaper than running and maintaining a car.

These include:

  • Buses. This is a cheap way of getting around, especially once you reach state pension age. You’ll also be able to apply for a bus pass, travelling locally for free during off-peak times.
  • Trains. For substantial discounts on fares, you can apply for a senior railcard from the age of 60.
  • Walking. Forget about the worries of parking and walk to local places. This is good exercise for you too.
  • Lifts from family and friends. People around you are probably more than happy to help. For example, if a neighbour goes to do a weekly shop, why not ask to catch a lift from time to time?
  • Community transport. Local charities often run free transport services for things like hospital appointments. For instance, The Royal Voluntary Service provides around 87,000 journeys to hospital and GP appointments, to the shops or into town.
  • Taxis. When you consider how much you save on the costs of running a car, the occasional taxi doesn’t seem that expensive.
  • Get online. You don’t always need to visit the shops in person. You can do a lot of daily chores online, including food shopping and paying bills.

Once you consider the options available to you, hopefully you’ll become more comfortable with the transition from relying on a car to using other forms of transport.

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