When a parent with dementia is still driving, the most important thing you can do is act early, involve their doctor, and treat it as an ongoing conversation rather than a single confrontation. The goal is not to win an argument but to protect your parent, other drivers, and pedestrians — while preserving as much of your parent’s dignity as possible. Start the conversation before there is a crisis, frame it around safety and love rather than control, and have concrete transportation alternatives ready before you sit down to talk. Consider a common scenario: your mother has had dementia for about a year, and you have noticed she missed a stop sign last Tuesday and got lost driving home from the grocery store she has visited for thirty years.
She insists she is fine. What you are facing is not stubbornness — it is a neurological condition called anosognosia, in which the brain loses the ability to accurately perceive its own impairment. Understanding that distinction changes how you approach the conversation. This article covers the statistical risk data that can anchor the discussion, specific warning signs to document, how to structure the conversation itself, when to bring in a doctor or professional evaluator, and what to do if all reasonable approaches fail.
Table of Contents
- Why Is Driving with Dementia So Dangerous, and What Do the Numbers Say?
- What Are the Warning Signs That Driving Has Become Unsafe?
- How Does Anosognosia Change the Way You Should Have This Conversation?
- How Should You Structure the Conversation Itself?
- What Should You Do When Your Parent Refuses to Stop Driving?
- What Role Does Transportation Alternatives Planning Play in the Long-Term?
- What Does the Future of This Conversation Look Like as Dementia Progresses?
- Conclusion
- Frequently Asked Questions
Why Is Driving with Dementia So Dangerous, and What Do the Numbers Say?
The risk is not theoretical, and having real numbers in hand can help ground a conversation that might otherwise devolve into competing opinions. According to data cited by the Fisher Center for Alzheimer’s Research Foundation, approximately 14 percent of people with very mild Alzheimer’s fail a standardized driving road test. That number rises to about 33 percent among those with mild Alzheimer’s — compared to only 1.6 percent of older drivers without dementia. When you look at all stages combined, only around 46 percent of people with Alzheimer’s passed a professional driving evaluation at all. Beyond test results, real-world driving behavior tells the same story. Research has found that drivers with dementia encounter twice as many critical driving events as unaffected older drivers, and three times as many “unaware” critical events — moments where the driver does not even register that something went wrong.
Perhaps the most striking finding comes from a 2025 review published in the journal Alzheimer’s and Dementia, which documented a nearly fivefold increase in motor vehicle crashes in the three years before a dementia diagnosis is even made. That pre-diagnosis window is particularly dangerous because neither the family nor the person themselves may yet understand what is happening. Most people with Alzheimer’s do stop driving within three years of diagnosis, but that is three years during which serious harm can occur. These numbers are not meant to shame or frighten your parent. They are the foundation of an honest, caring conversation. Framing the issue as “the statistics suggest this is genuinely risky, not just my worry” is more productive than presenting it as a personal judgment.
What Are the Warning Signs That Driving Has Become Unsafe?
Before having the conversation, it helps to document specific behaviors rather than speaking in generalities. The Alzheimer’s Association identifies a consistent set of warning signs: forgetting how to get to familiar places, failing to observe traffic signs, making slow or poor decisions in traffic, driving at inappropriate speeds, and becoming angry or confused while behind the wheel. If you have observed any of these, write them down with dates and details. “You seemed confused at the intersection on Oak Street last Thursday” is far harder to dismiss than “I just think you should stop driving.” However, the absence of obvious incidents does not mean driving is safe. One limitation of relying on observable warning signs is that many critical failures happen in the car alone, without a family witness. Your parent may be getting lost and finding their way home without telling you.
A professional driving evaluation by an occupational therapy driving rehabilitation specialist is the only way to get an objective assessment of behind-the-wheel performance. These specialists are trained specifically to evaluate people with cognitive impairment and can administer standardized tests that go far beyond what you can observe from the passenger seat. The American Academy of Neurology recommends that people with very mild dementia who continue to drive be formally reassessed every six months. If your parent has already been diagnosed, the clinical guidance is relatively clear: people with early or mild dementia may still be able to drive but should be evaluated immediately upon diagnosis. People with moderate or severe dementia should not drive at all, according to the National Institute on Aging. The stage of the disease matters, and a neurologist or geriatrician can help you understand where your parent currently falls.
How Does Anosognosia Change the Way You Should Have This Conversation?
Anosognosia — the neurological inability to perceive one’s own deficits — affects a significant portion of people with dementia and is one of the most misunderstood aspects of the caregiving experience. When your father insists that his driving is perfectly fine despite having backed into the garage door twice this month, he is not lying to you or simply being defensive. His brain has lost the circuitry that would allow him to accurately perceive his own limitations. Understanding this shifts the emotional framing of the conversation from confrontation to care. This means that logic and evidence alone are unlikely to be sufficient. You can show your parent the statistics, replay a dashcam video of a near-miss, or describe what you witnessed, and they may still genuinely not believe there is a problem.
That is not a failure of your communication — it is the nature of the condition. What this tells you is that the conversation cannot rely entirely on your parent reaching the same conclusion you have. The goal instead is to get them to agree to a process: agreeing to see a doctor, agreeing to take a professional driving evaluation, or agreeing to involve a neutral third party. Framing the conversation around the safety of others rather than their own ability can sometimes be more effective. Statements like “I need to feel confident that other people on the road are safe” or “this is about protecting someone else’s child, not about whether you can drive” appeal to a sense of responsibility that may be more accessible than self-assessment. Organizations like Bella Groves and the Family Caregiver Alliance both emphasize empathy and patience as core strategies — not because they always work, but because they preserve the relationship and reduce the likelihood of your parent becoming so defensive that they shut down entirely.
How Should You Structure the Conversation Itself?
The structure of the conversation matters almost as much as the content. Family Caregiver Alliance guidance recommends starting the conversation early — ideally while your parent is still driving safely — and pairing it with other future-planning discussions, such as healthcare directives or financial planning. If driving comes up for the first time in a moment of crisis, it is much harder to handle calmly. Involve the doctor early and deliberately. Physicians carry authority that family members often do not, and a formal written recommendation from a doctor that a patient should not drive carries legal and practical weight that a family argument does not. The Alzheimer’s Association specifically recommends physician-led conversations as more effective than family-only discussions. Before your parent’s next appointment, call ahead and ask the doctor to address driving directly.
Some physicians are reluctant to initiate this topic on their own, but most will engage it if asked. In some states, physicians are legally required to report certain medical conditions, including moderate or advanced dementia, to the DMV. One practical tradeoff to consider: involving the physician can sometimes shift the dynamic in a way that feels less personal, which is helpful — but it can also feel to your parent like a betrayal or a conspiracy. Be prepared for that reaction. The tradeoff is usually worth it, because objective medical authority is more difficult to dismiss than family concern, and it removes you from the position of being the sole adversary in the conversation. Expect multiple conversations. The Hartford, which has published extensively on this topic, is clear that this is rarely resolved in a single discussion. Each conversation plants a seed, and returning to the topic consistently and calmly is part of the process.
What Should You Do When Your Parent Refuses to Stop Driving?
Resistance is the norm, not the exception. The most common objection is practical: “How will I get to my doctor’s appointments? How will I get groceries? I can’t depend on you for everything.” These are legitimate concerns, and you will make far more progress if you address them proactively rather than treating them as obstacles. Before the conversation, research specific alternatives: local ride services, volunteer driver programs through area agencies on aging, family scheduling rotations, or paratransit options. Having a concrete plan ready — “I’ve already looked into a ride service that serves your area, and I can drive you on Tuesdays” — demonstrates that the goal is independence, not control. If your parent continues to drive despite your concerns and despite medical guidance, you have several more formal options. Most states have a process through the DMV for requesting a driving re-evaluation or license review based on medical or family referral.
Some states allow physicians or family members to file a confidential report. A forced re-examination by a DMV evaluator shifts the decision to a neutral authority and removes the interpersonal weight from the family. If these approaches fail and the situation becomes a genuine safety emergency, more drastic steps may be necessary. Disabling the vehicle — disconnecting the battery, removing or hiding keys, or installing a hidden kill switch — is a last resort but is sometimes the only option that works. Local adult protective services can be contacted if a person with dementia is posing an imminent danger to themselves or others. These are not steps to take lightly, and they will likely cause significant distress and conflict. They are documented here not as first responses, but because families sometimes need to know that they exist and that using them does not make them bad caregivers.
What Role Does Transportation Alternatives Planning Play in the Long-Term?
Giving up driving is not just a safety issue — it is a profound loss of independence, identity, and spontaneity for many older adults. A person who has driven themselves everywhere for sixty years experiences the removal of their car keys as a loss of autonomy, not merely a logistical inconvenience. Acknowledging this explicitly in conversation — “I understand this is a huge loss, and I want to help you find ways to stay as independent as possible” — is not a negotiating tactic. It is an honest recognition of what your parent is experiencing.
Practical alternatives vary significantly by geography. In urban and suburban areas, ride-hailing services, senior-specific transportation programs, and volunteer driver networks through local nonprofits can be quite good. In rural areas, options may be extremely limited, and the family may need to build a more intensive schedule of support. AgingCare.com recommends having the transportation alternative plan fully developed before the driving conversation, so that when your parent asks “how will I get anywhere?” you are not scrambling for an answer.
What Does the Future of This Conversation Look Like as Dementia Progresses?
Dementia is a progressive condition, which means that the driving conversation is not a single event but a recurrent theme across the arc of caregiving. A parent who is at a very mild stage today may be driving safely enough to continue with professional monitoring, but the same parent will need to stop within a relatively short window. Building a trusting relationship around these ongoing assessments — rather than treating each evaluation as a confrontation — pays dividends as the disease progresses.
The AAN’s recommendation of reassessment every six months for people with very mild dementia is a useful framework for normalizing the process. If each six-month evaluation is framed as a routine check-in rather than a test to pass or fail, it becomes less fraught over time. And as the broader culture of dementia care continues to mature, more families are finding that having these conversations openly and early — as part of a larger conversation about wishes, values, and future planning — produces better outcomes than waiting for a crisis to force the issue.
Conclusion
Talking to a parent about giving up driving is one of the hardest conversations in dementia caregiving because it sits at the intersection of safety, identity, autonomy, and love. The most effective approach combines early action, physician involvement, documented observation of specific warning signs, and a concrete plan for transportation alternatives. Anosognosia means your parent may genuinely not understand the risk they pose, so the conversation must be structured around care and process rather than winning an argument.
The statistics are clear that the risk is real and that it rises steeply with the progression of the disease. But the goal is not to alarm — it is to protect. Starting the conversation before a crisis, returning to it patiently over multiple discussions, and enlisting professional evaluators and medical authorities where possible gives you the best chance of reaching a safe outcome while preserving as much trust and dignity as the situation allows.
Frequently Asked Questions
At what stage of dementia should someone stop driving?
According to the National Institute on Aging, people with moderate or severe dementia should not drive. People with early or mild dementia may still be able to drive but should be evaluated immediately upon diagnosis and reassessed every six months per American Academy of Neurology guidelines.
What is anosognosia, and why does it matter for this conversation?
Anosognosia is a neurological condition in which a person cannot accurately perceive their own impairment. It affects many people with dementia and explains why a parent may sincerely believe their driving is fine despite clear evidence to the contrary. It is not denial — it is a symptom of brain damage, and it means that logic and evidence alone are rarely sufficient to resolve the conversation.
Can a family member report a person with dementia to the DMV?
In most states, yes. Many DMVs have a process for family members or physicians to request a driving re-evaluation or license review based on medical concerns. The process varies by state, and in some states physicians are legally required to report certain conditions. Contacting your state’s DMV directly is the best way to understand the specific options available to you.
What if my parent agrees to a driving evaluation but passes?
A professional driving evaluation by an occupational therapy driving rehabilitation specialist is the most objective tool available, and if your parent passes, that result should be respected for the time being. However, given the progressive nature of dementia, the AAN recommends reassessment every six months. Passing once does not mean the issue is permanently resolved.
What are my options if my parent refuses to stop driving despite the risks?
Options escalate from involving the physician, to requesting a DMV re-evaluation, to disabling the vehicle (disconnecting the battery, removing keys, installing a kill switch), to contacting adult protective services if there is an imminent danger. These are last resorts but they are legitimate and documented options for families in crisis situations.
How do I find transportation alternatives for a parent who no longer drives?
Start with your local Area Agency on Aging, which can connect you with volunteer driver programs, senior transportation services, and paratransit options. Ride-hailing services work well in urban areas. In rural areas, options are more limited and may require a coordinated family schedule. The key is to have alternatives identified before the driving conversation, so you can address the “how will I get around?” objection with a concrete plan.
