Do Memory-Impaired Drivers and Their Family Members Agree on Driving Ability and Behaviors?

It is estimated that approximately one-third of people with dementia continue to drive. Compared with the general driving population, drivers with dementia are at an increased risk of unsafe motor vehicle operation. Self-screening is often the basis for self-regulation of driving. It is not known how well self-screening as a predominant strategy works for drivers with memory impairment. This descriptive study explored the perceptions of 22 dyads of drivers with memory impairment and their family members through 44 structured telephone interviews within 4 months after specialized driving assessment to gain insights into their level of agreement on the driver's health, functioning, and critical driving behaviors. Drivers and family members were in fair agreement about current driving patterns and driver self-regulation (such as avoiding driving at night, in bad weather, or in unfamiliar areas). However, when reports of functional ability (such as vision, strength, and flexibility) were compared, drivers rated their fitness more highly than those abilities were rated by their family members on most measures. Moreover, there was poor agreement between drivers and family members on reported occurrence of driving behaviors suggestive of impairment in critical driving skills. These results have implications for health care and other professionals engaged in determining driver fitness. The findings suggest limited value in self-screening or in family reports when assessing fitness to drive in persons with memory impairment. Professionals should exercise caution in relying on reports from family members or drivers, especially with respect to reported driving fitness and driving behaviors.