Dementia gradually diminishes the ability to communicate. This makes it difficult for caregivers to discuss necessary medical diagnoses with patients who suffer from Alzheimer’s disease or another type of dementia.

Alzheimer’s is a progressive disease marked by many symptons, often including:

• Memory loss and confusion.
• Problems recognizing family and friends.
• Inability to learn new things.
• Difficulty carrying out multi-step tasks (such as getting dressed).
• Being unable to cope with new situations.
• Hallucinations, delusions, and paranoia.
• Impulsive behavior.

In the early stages, memory loss and confusion may be mild and vary day to day. In late stage Alzheimer’s, patients may be unable to hold a conversation or recognize or respond to their environment, according to the Alzheimer’s Association.

Gradually, patients with Alzheimer’s and other types of dementia will see a loss of freedom and autonomy. Patients who were once productive, thriving, healthy adults will need help with basic activities for daily living like cooking, getting dressed, or driving.

Patients in the late stages of dementia will need around-the-clock care.

When it comes to one of the key components of independence for adults – driving – the progressive nature of dementia means that all patients will eventually have to give up this key component of personal autonomy.

This degeneration of cognitive and executive functions has a drastic impact on quality of life. It is hard for most patients when family, friends, and caregivers tell them it’s time to stop driving.

As communication barriers gradually increase for patients, conversations about when driving becomes unsafe – for the patient and the public – inherently become more difficult.

In general, patients with dementia need patience and understanding while communicating. According to the Alzheimer’s Association, as the disease progresses patients will:

• Experience difficulty finding the right words.
• Use familiar words repeatedly.
• Describe familiar objects rather than name them.
• Easily lose a train of thought.
• Have difficulty organizing words logically.
• Revert to a native language.
• Speak less often.
• Rely on gestures more than spoken words.

Even patients in the early stages of the disease will see negative changes in their ability to communicate effectively. Dealing with the issue of driving early on can help patients ease into the transition more easily as the disease progresses.

By planning ahead, patients are able to keep control of their future driving ability and develop an agreement that all are comfortable with. This includes practical safety steps, such as:

• A GPS monitoring system for the vehicle.
• Alternative travel options.
• Regular driving assessments by an objective party.

Difficult conversations with Alzheimer’s patients or those with other dementias should include a firm stance coupled with sincerity and acknowledgement of the pain or uncertainty associated with change. Allowing the patient to feel heard, understood, and supported throughout the conversation will go a long way toward achieving a desirable outcome.

The patient should also feel dignified in their communication. It’s important to always address Alzheimer’s patients directly. Give them time to respond. Also, find the communication method they feel most comfortable with, whether it’s face to face, by phone call or otherwise.

Family and friends should avoid overwhelming the patient with too many questions, or lengthy requests. Family, friends, and caregivers can use, and also attempt to interpret visual cues, such as pointing to certain objects, or displaying specific emotions in communicating.

Third-party evaluations can be helpful when patients are resistant to change. An objective look at driving ability may provide a smoother transition and open the door to initial conversations between caregivers and patients.

Initial recommendations may include strategies to reduce driving risk during the early part of the disease. The goal is always for the patient to maintain the highest levels of independence. One increasingly popular method of evaluating a dementia patient’s driving fitness is through driving simulation. In the case of DriveSafety’s SimClinic™ tools, patients can be evaluated not only on driving skills performance, but also on underlying abilities in visual, cognitive and motor control functions. These tools can help clinicians address such functions as working memory, decision making, reaction times, -motor integration and a whole host of other cognitive and physical abilities required for safe driving.

Communicating with dementia patients should always be clear, firm, and done with love and support.

DriveSafety certified trainers help clinicians start the assessment process with virtual driving simulators. Schedule a call to find out which clinical simulator can best support patients with neurological conditions.