MS3219 Asked July 1, 2024
When can mom drive after having a stroke?
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She’s 3 mos out and physically, she is fine. But was diagnosed with vascular dementia. Mainly just short term memory issues. She has been begging to drive again but I am so worried about what would happen if she gets in or causes an accident! The drs have said she can drive with restrictions but they think she should have the driver assessment given by an OT. They don’t have an opening to test her for 6 mos! Meanwhile, we are having to pay a caregiver for 5 days/week in case mom needs to go anywhere. Should i insist she go to the driver test or just let her go ahead and drive close to her home & hope nothing happens? As her POA, could I be held liable? We live in NC.
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Your mum could be having a good day when she takes the test, then experience a marked cognitive decline the next day, yet seem fine again the day after.
Then, there's the changes that occur throughout the day. I know that my mum will be different depending on how tired she is or whether she has experienced something that has affected the oxygen levels in her brain (TIAs, worsened COPD, epileptic event, etc.), let alone sundowning.
I think it's time for your mum to stop driving.
She doesn’t have to be driven around 5 days a week. I do my weekly errands over 2 days.
It would be helpful to everyone if you could gain some control over this.
Would you be ok telling me I can drive drunk as long as we both hope nothing happens? What if I kill innocent people and not myself? You honestly cannot be serious with that question.
If it were my mother or a friend, I would say "ABSOLUTELY no driving.
It isn't just a preventative measure for their own safety, it is necessary so she doesn't possibly kill herself, an/other/s and/or people walking. She could kill children crossing the street ... a family in a car. One person is too many.
She could lose control of the car and crash into someone's garage or house ... The scenarios of what COULD HAPPEN are voluminous and frightening.
Muster up the psychological and emotional energy and mind-set to have this difficult talk with your mom. Expect resistance, perhaps crying or arguing (she may be 100% convinced ["I am okay ... I can do it ...].
Keep you eye 'on the ball' - that no one is injured or killed with her on the road, driving. ALTHOUGH ... read on...
Research differs with my assessment or feelings about it. I stand corrected (from a medical perspective). From a medical standpoint, it 'likely' depends on the severity of the stroke and what parts of the brain have been affected.
See below where they speak about car modifications.
See website:
https://www.stroke.org/en/life-after-stroke/recovery/daily-living/driving-after-stroke.
In part, it says:
Here are a few things to consider before you pick up your car keys:
Discuss with your healthcare professional whether it’s safe for you to drive and, if so, whether you need to modify your car.
Check with your state’s department of motor vehicles to see whether your physician must report your health status before you can drive again.
Your state might have other requirements as well.
What if I need to make modifications to my car?
The right modifications can help you regain confidence and independence on the road.
Contact a rehabilitation specialist in your area to help assess your ability to operate a motor vehicle. The specialist can also evaluate whether modifications will be necessary or helpful. Look for certified driver rehabilitation specialists in your area by visiting aded.net.
Contact the National Mobility Equipment Dealers Association for assistance with car modification. Visit NMEDA.com.
Enroll in an adaptive driving course to help you understand new equipment. These programs are often available for a fee through rehabilitation centers. You can also contact your state’s department of motor vehicles. Ask for the office of driver safety to find out the vehicle or training requirements for people who’ve had a stroke.
It is clearly a slippery slope no matter how you decide.
It is a difficult situation for a person who is losing independence and driving is huge. I APPRECIATE YOU bringing up this subject matter as it affects so many people / families on this site.
I did take a webinar years ago with Teepa Snow, one of the country's leading experts on dementia, on elders / people with dementia driving.
You might want to call her office or google what she says about it.
Gena / Touch Matters
She can beg all she wants, but you cannot risk innocent lives.
You only need to pay someone ONE DAY A WEEK to drive her for errands.
Sure you can let her drive, and get sued and loose everything when she causes an accident. Take the keys, sell the car....or risk loosing your home and more.
Tell Mom the (idiot) Doctor said NO. The DMV said NO. Your auto insurance company said NO.
First he hit a car that had stopped to allow pedestrians through a crosswalk, then he accelerated around a road closure sign, crashed through sawhorses and plowed through the marketplace crowd. He had accidentally placed his foot on the gas pedal instead of the brake. He tried to stop but obviously couldn’t.
The end result. Ten people died and about 70 people injured.
This whole unfortunate collision happened in about 10-20 seconds.
Please don’t let this happen again!!!
You say that your M is “very shy and refuses to call friends to get together”, plus various other difficult traits. You don’t say how old M is, but clearly she is an older adult with fixed habits that you are not likely to change – at least not radically. You are being realistic about the danger of her turning YOU into ‘her “plus one” for everything in life’, because not only is she shy but she “hates the idea of hanging around with “old ppl”. Giving her a chauffeur who can drive her whenever she wants, is not going to solve her mindset, nor is it going to mean that she socialises when she is driven somewhere.
We have many posters who find themselves drifting into the danger that you can see ahead. Independent Living may be worth thinking about, because there are usually activities that don’t require a car, and in fact may be hard to avoid. You may want to be firm about what you are prepared to do – ‘if you do X then I am willing to do Y’. It might help to tell her bluntly what you are concerned about and why you are pushing her to change. Don’t rely on M changing the habits of a lifetime, you will need to push! Think about the longer term, not just the present challenge, if you want to avoid the problems you can clearly see looming ahead.
Worth a thought?
No more driving.
Yes, you may be held personally liable.
I made an appointment with her primary under the pretense that my Mom never got her annual Medicare wellness physical (my Mom, the retired RN, wanted lab work yada yada). I sent a note to her doc in the portal saying I needed her to be assessed because I needed a daignosis on the clinic letterhead signed by the doctor. I gave her the verbatim words from the PoA and the financial institutions requiring this to recognize my PoA.
At that medical appointment I sat in the room with her, and let her speak for herself. The doc gave her a basic assessment, but then my Mom mentioned she still drives (95 yrs old). This raised the doc's eyebrows, she talked to my Mom about safety, reaction time, etc. and my Mom was adamant that she is a good driver. So the doc ordered a virtual driving assessment through their OT.
At first my Mom balked, and I was worried she wouldn't go but I told her if she's a good driver then she can prove it so that others will stop hassling her about it. They gave her a MOCA test and other tests, then a reaction time test. She failed by a lot. The OT (experienced in talking to seniors) explained that she was obligated to put "high risk" driver in her records.
The doc gets this information and fills out a form that she signed and sent into our Dept of Public Safety. They sent out a letter cancelling her license. She could go and take the driving test again (with a special instructor who works with elders) but she never asked to do it.
I then didn't talk about it with my Mom for several days, instead just reminding her that she now cannot legally drive. Then I mentioned that she should consider selling her car so she wouldn't have to pay the insurance, but she gave more resistance.
This past weekend she had pulled her car out of her garage to spray paint something, and lost the keys. Of course she blamed me and made me swear on "God's life" that I didn't take the keys. Luckily I have the backup non-fob key because she's yet to find them. My suspicion is she hid the keys so I wouldn't take them, and then couldn't remember where she put them.
I recommend your get your Mom in for an assessment and let doctors and government be the bad guys. Feel free to use therapeutic fibs to manuever her to the appointments.
This is an Australian website but may have some good info for you.
Besides then obvious issue of safety, having a diagnosis of vascular dementia (& without clearance to drive) may void all car insurance.
I met a woman (newly dx with Vas Dem) who forgot which was the brake pedal. Planted her foot hard on the accelerator & drove at speed into her garage door. Broke her neck (although able to function would be in a neck brace the rest of her life). Damage to house NOT covered as her car insurance was voided. Imagine if that was a shop front or an intersection.
I would call around & find another OT to assess before even contemplating driving. She may be fine - but I would want to be SURE.
Your Mother should now learn order a taxi (either by phone or via an app). That is IF solo taxi rides are safe for her. That will improve her independance. You (or her carer) may need to go with her to gain confidence a few times.
This diagnosis is a game changer.
Exactly , vascular dementia only gets worse .
Assume that as POA you could be liable for any damage she causes. That will focus your attention. Even if not found liable, you could be sued to prove it, which is almost as nasty. Do you really want to find yourself saying 'I let her drive (and kill a child) because I thought I wouldn't be liable'?
Cut the caregiver down to two days a week , for errands , shopping , lunch out and appointments. Schedule everything on those 2 days. It sounds like Mom can’t order food online to be delivered either , you could do that for her . Or order other things from Amazon etc . Don’t let Mom make you take her or tell you to run to the store for one thing at a time 5 days a week either.
Mom better get used to having to accept changes in her life because her driving days are either over for good or soon anyway . By accepting changes , I don’t mean that she gets to monopolize your time around her routine either . The person that needs help is the one that has to compromise . She had the stroke , you did not. You don’t have to upend your life .
My Mom gave up driving even before her stroke , when Dad was on hospice dying , she wagged her finger in my face and said “ I have a routine “. She expected me to drive her everyday out to lunch like my Dad was doing .
If I was POA I would say no driving or I give up POA . Both my mother and father in law had vascular dementia . Memory isn’t always the earliest symptom like it is in Alzheimer’s . For vascular dementia reasoning and judgement go first. They seemed more capable and with it than they really were which is often the case in the beginning . They can showtime and carry on good conversations . Doctor’s go by a 15 minute conversation . I had trouble getting the doctors to believe that my father in law ( especially ) was not “ right “.
That's bit ridiculous to have a caregiver all week just in case mom needs to go anywhere. It would be cheaper for her to take an Uber or taxi in that regard. If mom has memory issues chances are she should not be driving again. Period.
If you really think mom can drive, then have her drive you around for a week or so and see how she does. Don't offer prompts as she drives, just observe her.
His left side was affected by the stroke, and he didn't attend well to his left (which the examiner knew). He might or might not look in the left mirror. It was as if it wasn't there sometimes. This resulted in several near misses when I was in the car. Another time he pulled out of a parking lot onto the road and apparently only then recalled that he wasn't wearing his prescription sunglasses, which were in the compartment above the rearview mirror. He let go of the steering wheel with his left hand and reached for the compartment with his right hand. No hands on the steering wheel! I quickly grabbed the wheel and kept us from running off the road. This was a formerly good driver. I refused to ride with him after that. He had another driving evaluation and was okayed again, which boggled my mind.
I'd say no more driving for mom. She has dementia. Those "just short-term memory issues" are major when driving. MAJOR, and then add in all the things you don't yet know, such as deficiencies in attending to one side or the other, or what she'd do in an emergency situation that requires fast action and fast thinking. I wouldn't be too hopeful that she's capable enough to manage those issues now.
If the only reason the caregiver is there is that mom might want to be driven somewhere, the caregiver can come twice a week and mom needs to scrunch all her wanna-go-outs into that time frame.
A stroke is a major life-changing event, and you can talk about recovery and how well they're doing blah blah blah, but the fact is that they can go downhill fast and must accept their limitations. As must their loved ones.
You should worry about being held liable. You know she had a stroke, you know she hasn't been evaluated for driving (little good that does, IMO). If she kills or injures someone, yeah, that would be on you because you knew she shouldn't be out there. Plus the person she kills or injures could be herself, and you don't want that.
Take the car keys or disable the car. I'm sorry I can't give you more encouragement, and I wish this weren't happening to your mom.
Your moms brain is now broken and it will never get better only worse. And I'm sure you know, vascular dementia is the most aggressive of all the dementias with a life expectancy of just 5 years.
Someone driving with any of the dementias is no different than someone driving drunk or high on drugs. And if she were to kill or injure someone while driving, and it was discovered that she has dementia, she could be sued and literally lose everything she has.
It's just not worth it. Of course your mom won't like it but she's just going to have to suck it up as it's really not fair to all the innocent drivers on the roadways when she is.
I would get her doctor to tell her that she can no longer drive. That way you won't have to be the bad guy. But in reality you may have to be the bad guy, if her doctor won't step up and do their job.
I have to say...shame on her doctor for even suggesting that she can still drive even with restrictions. That is so maddening to me.
My late husband had vascular dementia after having a massive stroke many years earlier, and I would NEVER have let him drive with his broken brain once he was diagnosed. He was diagnosed in 2108(even though he was showing signs a good year before)and he died in 2020.
Again because vascular dementia is so aggressive, your moms decline will be much quicker than the other dementias, so instead of wondering if she should be driving again, I would concentrate more on getting all of her legal and medical ducks in a row, so you will be better prepared for the near future.
And I will end with this.....would you be able to live with yourself if your mom were to kill or seriously injure some innocent person/child, because of her poor judgement and broken brain?
If not, please do whatever you have to to keep her from behind the wheel.
Would you let mom drive you to a store? If it's yes let her bring you to the store and back, see how does.
If it's a no. Then I think you know the answer.
Sorry about your mom. 😔
Because other peoples children are out running around