"Still Driving with Alzheimer’s? When It’s Time to Let Go — And How to Do It With Dignity"

[Janna opens playing a flute intro] 

*Be sure to check out the links at the end of this transcript for actual studies and publications on the topic 

Janna: Hi, I'm Janna, and I'm an Alzheimer's Thriver. 

Larry: And this is her husband Larry, and I'm also thriving. Hey, can I start this one? Can I start it? 

Janna: No. 

Larry: No? All I want to say is, and now you'll be hearing from... 

Janna: The Horse. 

Larry: ...The Horse? You're not a horse. “Now you'll be hearing from...” 

Janna: “The horse’s mouth.” 

[brief flute interlude] 

Janna: We have a “driving” episode coming up, but we won't talk to you about. But before that, I want you to realize that... I still cry, and I still say to myself, and sometimes out loud, self-deprecating statements, which are... Damning. 

Larry: Just your emotions boiling over. 

Janna: Yeah, yeah, it's just, it's not good. And it puts me down and takes away any confidence I might have. And it's... frankly... it's sin, you know? You're not supposed to think of God's creature being stupid. Whoever they are. 

Larry: Including yourself, you mean? 

Janna: (Jokingly) Well, for you, of course, you're so frequently... (Laughs) ...no. 

Larry: Well, you haven't. You haven't heard the times where I go into the closet and shut the door and scream myself. 

Janna: That's why you're up in the workshop so often. 

Larry: Yeah, so that's probably a good disclaimer and a good caveat to this whole thing we're doing in the podcast, is that we still have our challenges. Even though things are getting better in a lot of ways, I mean you're more fluid speaking. You know, a lot of things have gotten better. 

Janna: I'd like to get past that part of telling myself that I'm stupid and yelling and crying. 

Larry: That doesn't happen as often as it used to. I can say that. 

Janna: That's good. We'll work on that. But I wanted to come out and be straight with it because some of you who are in this and have been working about it, maybe have much more self-control than I do, and you've never let a tear come out. I don't know if that's healthy either. But yeah, we're getting in need to get past that part of feeling like, oh, I'm dumb. People say with their eyes sometimes, “she’s not very smart.” I mean, I can feel it. But I can't tell that to myself.  I have to give myself some encouraging messages. 

Larry: Right. So, this episode is about what now? Driving, right? 

Janna: Driving, yeah. Oh, you want to drive? You want to take a long ride with me and see how long that lasts? 

Larry: Well, it's like a Disney ride. 

Janna: It’s more excited than that. 

Larry:  Yeah, without the rails. So, okay, when did you first notice that there was something going on with the driving? 

Janna: Yeah, I couldn't say just exactly as far as timeline when it was. I could say that I had to concentrate. Well, I've always been a concentrating driver, but I concentrated more and more. And maybe that should have given me the hint that it's because I was losing my ability to stay with it. But since I didn't catch onto that quite fast enough, I managed to get myself into a conundrum with another person on the road. And he put me in my place and let me know, “Hey, you shouldn't be driving! 

Larry: So, before we get to that, there was one time that I can remember where you ran over a curb. And we had to change the wheel of the car because it got bent and, of course, the tire. And I was kind of thinking that was because of your traumatic brain injury that you were just having trouble coming back from that. That was a little before we got the diagnosis of the Alzheimer's. So, I just was just in denial about it, weren't you, too? 

Janna: I'd say so, if you were to talk about where I ended up after that little drive. 

Larry: And so, okay, so continue with this thing where you got in trouble. You missed an exit, I think, was the thing. 

Janna: Yeah, I missed an exit. And there were two lanes. And I thought, and now what's the logic of this? I don't know. I mean, I don't have it memorized from the past because you can't remember things very long time when you have Alzheimer's anyway. But I didn't have it. (On second thought) no, I had it at that point. I'm driving along and there's two lanes and I go, oh, shoot. I don't want to go there. I want to go over there. Okay, Well, it's just getting in this other lane and turning left. But there wasn't another lane. And as I turned, this man jumped out, started screaming and yelling at me. And I realized, oh, shoot, there's not another lane 

Larry. Well, it was a lane, but it was coming the wrong way. It was his lane and he was coming at you head on. Right? 

Janna: Yeah. And so, I got out, I got out of that situation. And he was up on the hill by his house looking down at me, screaming and yelling. And kind of cussing and all that. No doubt. I mean, he couldn't believe that it happened. 

Larry: Then what did you tell him? 

Janna: I said, “Hi, I have a little difficulty with driving, I can tell that. I want to tell you right now; I'm going to call my husband. He's going to come get my car. I will never drive again.” 

Angry man: “Well, you better not!” 

Janna: “I will never drive again. I promise you that.” 

Larry: He was yelling at you. So, he started to calm down a little bit, As I remember, you called me, and I came back, and he was there. He had driven away – and he was back. You said he was calling down from a house, but you guys were in a parking lot, right? You pulled in and he pulled in after you, up on a hill. 

Anyway, you said he drove away and then came back and was starting to be nice to you, because he realized he screamed and yelled at you, and you had a problem, but that you humbled yourself 

Janna: He realized I was sincere. Okay. This is it. I can't drive. That's it. 

Larry: And that was hard because you wanted, even after that, you wanted to drive around the neighborhood close by. Maybe you could stay closed. Just go to the store. But I think the thing that we've discovered about Alzheimer's is that when it comes to thinking fast, things can happen pretty quick when you're driving. If you're going 35, you think that's not very fast but something can happen and then you can make a wrong decision. So what kind of got me was that we could have lost everything. Had you caused an accident or killed somebody? 

Janna: Well, somebody else could have lost everything. 

Larry: We would have lost everything... Yeah, they would have lost their life. 

Janna: And I couldn’t live with that. 

Larry: We would have lost everything because they could have sued us for everything we have. And the reason being ...that I knew you had a problem, and I didn't do anything about it before that. 

Janna: You didn't know I had Alzheimer's though. 

Larry: Well, okay. So back when you ran over the curb, we thought it was TBI. But when you decided to stop driving, we actually had had a diagnosis of Alzheimer's. And so the neurologist might even have been on call for being a mandated reporter. She would have been in trouble. I would have been in trouble. But the worst of it would have been we would have hurt somebody. 

Janna: Thank God nobody was injured. 

Larry: Yeah, it took that. I think talk about why people insist on driving after they get the diagnosis. Because we know Alzheimer's people that are still driving out there. 

Janna: Well, there's the big P. 

Larry: What's that? 

Janna: I can’t remember. (Laughs at herself) Pride! Pride! And let's see if I could say it's the next one. The big D ...denial. Pride and denial. And I don't want to sound like a female... 

Larry: You are a female. You better sound like one. 

Janna: When you say male. 

Larry: Oh, a female chauvinist or something? 

Janna: A female chauvinist. But I don't know where I was going. Laughing 

Larry: Okay. So, yeah, denial and pride. And I think people are, yeah, they're very proud of the fact they can still drive. And we've talked to some Alzheimer's friends. And it's like, why are you still driving? And it's like, oh, I don't have any problem with driving. I can get around anywhere. I can drive on the freeway. I can do this I can do that. So, what that does to me is it makes me think when I'm out driving, there's people out there who think they can do it. You know? 

Janna: No doubt. And we should all be aware of that. You know, a person back in the day was always such good driver and got all the way up all over the country and all that so many time. without a problem. Everybody should be aware that there's lots of people out there who think they're in the zone. The zone of, yeah, I can do everything. Everything's great because, you know, I haven't hit anybody. I haven't killed anybody yet. You know, everything's great. No, I don't need any help. But it happens. Yeah. And so watch out for yourself, watch out for the people around you, watch out for your people in your family - people who might be losing some skills and are in denial. Denial is huge, of course. 

Larry: Yeah. And you know, this just brings up the whole concept of: Things that you've never had to think about before. And you just did. Like, walking downstairs without holding the handrail, you know? 

Janna: Yeah, we did that pretty well. I did that pretty well. Yeah. Until I believe I fell, right? Didn't I fall? 

Larry: Yeah. You broke your collarbone. 

Janna: And broke my collarbone. And now in our family, anybody in our home who's walking on steps has to have one hand on the railing. I don't care how good you are. You have to have one hand on the railing. 

Larry: Well, and it keeps reminding us too, that as we get older ...you know, I kind of slipped the other day - had to really grab the rail coming down the stairs. 

 Janna: You slipped and kind of dropped down a little bit - had to catch yourself? 

Larry: Yeah. And I'm like.... I'm just a young chicken.   

Larry: Just a year younger than you 

Janna:  It's a wake-up though, for sure. 

Larry: But yeah. You might wonder, well, how old are these guys? Well, we should tell them how old we are. Don't you think? Because we probably sound like we've got it all together -We don't. 

Janna: Okay. You say it first since you're the young one. 

Larry: I'm 72. It'll be 73 this year. 

Janna: I'm 73. 

Larry: Yeah. 73. So, there it's a mission an admission of guilt. 

Janna: No, just reality, not guilt. 

Larry: Safety items. It's important to start thinking about that. The care partner really needs to think about that as well. What kind of things can I do to help with that? I can chop the vegetables now and let her enjoy the good meal that I'm cooking. 

Janna: And why don't I chop the things? I was a good chopper. I was a great cooker. 

Larry: Well, probably because you've got to use a knife and it's sharp. 

Janna: You think that's dangerous huh? 

Larry: Yeah, it can be. It can be. 

Janna: I'm sure it is. 

Larry: It just takes one little... “That's not a carrot ...that's my finger.” I shouldn't have said that. 

Anyway, back to driving. So, how do you get around now? What's that about? 

Janna: Oh, gosh. With humility. 

Larry: With humility. How do you travel around in the car? 

Janna: I don't drive around to drive. I don't drive. 

Larry: Okay, so you've got to go somewhere. How do you get there? 

Janna: Uber. Uber. But really foremost, we have a walking community, and a lot of times I'll walk somewhere that's like half-a-mile, a mile. And it forces me to exercise. So that's not bad. Of course, I've sometimes kind of turned the wrong way when I turn around to go in the house and it was not my house. That's a different story. 

Larry: Well, the worst part is when you put your arm around a stranger and say, come on, honey, let's go, and I’m standing there going, “wait, who is this guy?” 

Janna: And you know what? To a word, nobody has complained. They just look at me and smile. (Larry and Janna laugh) Yeah, but I'm sure his lady probably doesn't appreciate it. 

Larry: So, okay, I guess I'm chopped liver because what I was trying to get at is I drive you everywhere now. 

Janna: Yeah. And then when I say I want to back out the car for one of our adult sons or something - like no big deal and I go, “where's the car? I can back it up.” He won't even let me. I don't even know where the key is. And it's demeaning to me. But it's probably brilliantly smart. 

Larry: Probably? What? It's not just probably. It's a good thing. 

Janna: Yeah, I know. I know. Accept it. 

Larry: That's got to be the toughest thing to accept because, you know, there are 95-year-olds that are out there driving around, passing their driving test, and written, and still driving. And so, you think, dang, I'm not that old. No, I'm not going to give up driving. So, it's got to be a huge, huge problem for people out there. And I went to the internet, and I found out the percentage of people with Alzheimer's who drive, and a high percentage of them get into accidents. So, that's already been studied. 

Janna: Yeah, yeah. So, you know now why I stopped driving. For those of you listening who have Alzheimer's, you can still thrive and not drive. It'll be up to you when that point comes, but it will   come, and I hope you notice it. This is Janna, an Alzheimer's thriver.(With a pretend deep voice) “And this is her husband Larry.” 

Larry: No, it's not. That was Janna, pretending to be me. This is Larry. And I'm a thriver, too. 

Janna: Signing off, until next time. You’ve been hearing from the horse’s mouth. 

Links and studies  

Here are scholarly studies and real‑world insights on why and when people with Alzheimer’s stop driving—and the legal implications if they continue to drive despite cognitive decline: 

1. Mild cognitive impairment & early Alzheimer’s: predictors of driving cessation 

🔎 “Mild cognitive impairment, Alzheimer’s disease dementia, and predictors of driving cessation” (7‑year prospective study) 

• Design: 109 participants (NC, MCI, mild AD) followed for ~7 years. 

• Findings: 

• Dangerous driving events reported in ~45% of MCI, ~59% of AD. 

• 38% of MCI stopped driving after ~35 months; 83% of AD after ~15 months. 

• Predictors: age, verbal fluency, multitask walking test; simulator accidents correlated univariately. 

• Conclusion: Cognitive/functional tests help gauge when individuals should stop driving. 

• Link: PubMed    

2. Subtle cognitive decline often precedes self‑withdrawal from driving 

🔎 Study at Washington University St. Louis, published in Neurology & summarized by WashU and Harvard 

• Design: 283 cognitively normal older adults tracked ~6 years; assessed annually. 

• Findings: 

• Even subtle impairments (Preclinical Alzheimer’s Composite score) predicted stopping driving—more so than age or biomarkers. 

• Women 4× more likely to stop driving   . 

Link ScienceDaily and Harvard Studies 

Reddit commenter: 

“People who met the criteria for cognitive impairment by scoring 0.5 or greater on the CDR were 3.5 times more likely to stop driving… women four times more likely to stop driving…”   

3. Driving in early‑stage AD: literature review 

🔎 “Driving in Early‑Stage Alzheimer’s Disease: An Integrative Review” (2016) 

• Summary: 

• Driving ability declines from early AD onset. 

• Self‑support groups and structured interventions can ease the transition off driving. 

• Link: Research in Gerontological Nursing  

4. Objective driving tests & on‑road assessment 

🔎 “A Longitudinal Study of Drivers with Alzheimer Disease” (PMC article above) 

• Design: On‑road testing over time, comparing mild dementia patients with controls. 

• Findings: 

• Drivers with mild AD can still pass tests but decline faster. 

• Crash rates similar per mile; many with dementia self‑restrict or cease driving. 

• Recommendation: periodic assessments every ~6 months for dementia patients. 

⚖️ Legal ramifications of driving with Alzheimer’s 

While research focuses on safety and cessation, legal liability primarily depends on state laws and licensing regulations: 

• Many U.S. states allow or require family members or physicians to report dementia diagnosis to the DMV, which can prompt license review or revocation   . 

• Continuing to drive after diagnosis, especially if involved in an accident-causing injury or death, can result in: 

• Civil liability (malpractice or wrongful death lawsuits), particularly if known diagnosis and ignored risks. 

• Criminal charges, if gross negligence is proven. 

• Licensing authorities vary: some revoke immediately upon diagnosis, others require failed assessments or observed incidents. 

From Reddit: 

“Could get sued for all you’re worth if they run a stoplight and kill someone, and the family knew they had been diagnosed.”   

In short: 

• Research underscores cognitive decline—not just age or biomarkers—as the key trigger for stopping driving. 

• Drivers with AD may still pass some tests but decline faster than peers. 

• Careful, regular assessments are vital to keep roads safe while preserving independence. 

• Legally, continuing to drive with known Alzheimer’s can lead to license revocation, lawsuits, or criminal charges, especially if an accident causes harm.