How to Talk About the Need to Stop Driving When Dementia Is Involved

Strategies to Help with Making Life-Altering Changes

By Valerie Feurich, Positive Approach to Care Team Member

As dementia progresses, some routine activities or life circumstances can become unsafe. You may notice your person living with Alzheimers or another type of dementia starting to have blunders in the car, or that they no longer notice cars beside them when behind the wheel.

So, what can you do to increase the chances of your loved one being willing to give up their keys? Below are some tips and strategies you can try:

1. Plan Ahead, If Possible

As with many things in life, planning ahead can positively affect your care situation. You may want to start thinking about the person’s preferences and possible transportation alternatives that still allow the person to keep some independence. You may also try listing some potential challenges you’ll face when it comes time to have the conversation:

• What is going to keep the person from agreeing?
• Which alternative methods of transportation are there?
• What are some things we can start building into their life now to lessen the desire for their car? While carpooling with a friend to the grocery store may not be safe during the COVID-19 pandemic, is there another way they could safely get to where they need to go?

While planning ahead is still no guarantee of a successful outcome, having a plan for most contingencies will likely allow you to remain calmer and at ease should the conversation go awry.

2. Slowly Ease-In the Topic with Some Sidebar Conversations

While you don’t want to avoid talking about the car, you also don’t want to confront the person with the topic head on. Doing so will likely cause a defensive reaction, derailing your talk instantly. Instead, try to weave the topic of the car into your conversations on the side.

You may start casually chatting about the vehicle, and even try to see if there may be another person in their life they care about enough to voluntarily pass it to. Maybe a grandchild that is about to leave for college, or a daughter that has always loved that specific vehicle?

Your conversation could go something like this:

• Teepa: Hey Greg! I’m curious: If you ever got to a place where driving was a problem, let’s say due to your eyes getting worse, how would you get around from where you live right now?
• Greg: Well, I’m fortunate to be living very close to a transit hub, so I don’t think it would be too much of a problem. But, I do love my car though, so that is one thing I would probably be reluctant to give up.
• Teepa: Yeah, so that would be hard not because of the driving, but that car represents something to you. Maybe it represents your freedom. And it’s also status, because if I remember correctly, that car is pretty nice looking.
• Greg: Well, it’s clean.
• Teepa: It’s clean. What color is it?
• Greg: It’s bright white.
• Teepa: Uhhh, white. Nice! And how many years have you had it?
• Greg: Oh, let’s see, five I think.
• Teepa: Ah, five years. And that was an investment when you got it, ey?
• Greg: Well, it’s an investment when you take care of it.
• Teepa: Ahhh, okay. So, Greg, I have a question for you: Now, if you were not driving so much, let’s say you were using the transport hub near your place and that was going pretty well. I’m wondering: Is there anyone that you could imagine making use of this beautiful car, who would value and care for it like you? Someone where if you offered it to them, it would make a difference in their life? Could you imagine that, or something else?
• Greg: Well, I could. I know my daughter has been sort of eyeing that car up for quite some time. I think she appreciates its beauty.
• Teepa: The beauty of the car. It is an eyecatcher. So, thinking about gifting her the car at some point, but there’s this whole title thing you have to do. So, I’m wondering about that, how would that feel, turning the title over? Is that okay, or something else?

Let’s pause here. What do you notice about this conversation? Are there any conversational techniques you’ve heard Teepa Snow use previously?

Below are some of them. (Tip: To get the most out of this article and help you remember these on another day, read each of these techniques below and then go back through the text to see if you can identify them.)

• Reflect: By repeating back the last few words of what the other person has just told you, you reaffirm that you heard what the other person said and give them a sense of control over the conversation. For people living with dementia, reflecting back a few of their last words can be particularly helpful as it helps them gather their thoughts to continue on the conversation.
• Be curious, not directive: Be honest — do you like to be told what to do? Most people don’t. So instead of making statements that could come across as confrontational, try rephrasing your thought into a question. Not only will it make the other party feel like you value their opinion, but you’ll also reduce the chance of confrontation. Plus, it may offer you some less-obvious insights into the person’s motivation for wanting to keep their car.
• This, or something else: When you finish a statement with a question, try offering one concrete option and using something else as the later choice. By doing this, you’re assisting their thought process without limiting it.

3. See If You Can Find and Gently Nudge the Person’s Motivation

Maybe the reason your loved one is still driving is that they simply have no other way to get around. Maybe the idea of letting go of their beloved car, and thereby the independence and freedom they’ve enjoyed for many years, is too difficult to process. What does the car mean to them? What is it that will keep your person from saying yes to letting go of it?

Whatever it may be, you’re much more likely to have a successful conversation if you can address the person’s motivations. Using facts and details that are accurate but not understood by the person living with dementia aren’t going to help transition them away from driving. Instead, see if you can figure out what truly makes them hold on to their car, and see if you can find a way to lessen that grip.

How do you uncover motivations? Similar to the conversation shown above — be curious, ask questions. Instead of approaching the topic head on, you may want to try asking a series of little questions that can help you get closer to the source.

Once you know a little more, you can think strategically of how you could ease their transition to let go. As an example, if there is a grandchild that they deeply care about, could he or she occasionally bring up the car in conversation? Maybe an occasional phrase like Wow, I hope to have a car like yours someday, grandpa can help with letting go.

Not only can a strategy like this soften the motivation to hold on to the car, but it also gives the person living with dementia a way to let go that isn’t about them. So instead of having to admit to themselves that their driving capabilities are changing, an approach like this allows them to feel like they’re making the change for someone that they care about.

4. What’s In It For Them?

In an effort to keep this transition as positive as possible, you may try to think of things that your person living with dementia may gain from giving up their car.

What is the positive side of this for them?

If we’re going to take away something they value (their car, aka their independence), what is that going to do for them?

Try to put yourself in their shoes and see if you can think of positives that may help them see this matter in a different light.

5. Rehearse and Be Ready For Surprises

Do you have someone that you can practice with? Thinking through these strategies can help, but roleplaying the conversation with someone that knows your loved one well can make all the difference. Try talking through different scenarios that may arise, and see if you can discover potential pitfalls to avoid.

Don’t have someone you can practice with? Thinking through several different directions this chat may take prior to your conversation can help you feel calmer.

Will everything go perfectly? Maybe, maybe not. As with many things in life, there are no guarantees which direction this talk will go. But if you do find things go sideways, you may want to consider backing off. Once a person is on the defensive, it’s very hard to find a common ground.

Instead, step back, cool down, and try again another time. And if you find that you genuinely upset the other person, you may want to let them know you’re sorry you made them feel that way. As the saying goes:

Apologizing does not always mean you’re wrong and the other person is right. It just means you value your relationship more than your ego.- Unknown

6. Be Ready for More Talks and Follow-Through

You’ve had the talk and your loved one agreed to give up driving? Wonderful! Now, will this be the last time you’ve had this conversation? Maybe, maybe not. Forming new memories is truly difficult when dementia is involved, so be prepared that this topic may come up again.

To reduce your chance of that, you may want to make sure all potential triggers are removed. As James Clear, author of Atomic Habit, explains: Environment is the invisible hand that shapes human behavior. Think of this as you look around.

Are the keys removed from sight to not trigger old behaviors? Has the car been moved from its old spot? Paying attention and following through with details such as this will help you improve outcomes, and increase your chances of keeping everybody safe.

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Positive Approach to Care

Positive Approach to Care (PAC), founded by dementia care educator Teepa Snow, offers caregiver education through effective hands-on care skills and techniques.

Interested in learning more? Visit www.teepasnow.com/blog.