Driving, Dementia, and Dignity: An Urgent Plea for Change

Navigating an uncertain road, this image highlights the critical intersection of driving, dementia, and dignity, urging a re-evaluation for safer journeys ahead.

Hello, as my regular readers will know, I live here in the UK with early-stage dementia. I'm writing this because every time that brown envelope from the DVLA lands on my mat, my heart sinks. It's not just the fear of losing my independence, though that is huge; it's the indignity of the assessment process itself.

The law says that once you are diagnosed with dementia, you must inform the DVLA. If they allow you to continue driving, they'll issue a new licence, often for just one year (or sometimes longer for early stages), which is constantly under review. The moment they are unsure about your fitness to drive, they refer you for a driving assessment. And while the driving centre staff, often made up of occupational therapists and advanced instructors, are supportive, the system they work within is not designed for people with cognitive impairment.

I'm being asked to prove I'm a safe driver, but the assessment process acts like a test of pure cognitive function, offering no meaningful adaptations. It feels like an inflexible pass/fail hurdle that ignores the entire concept of reasonable adjustments.

The Myth of 'Reasonable Adjustments'

The reality is that for a person with a progressive cognitive condition, the current assessment simply doesn't acknowledge how my brain works differently now. We have laws, like the Equality Act 2010, that are supposed to protect us and ensure that services, including assessments, make changes (reasonable adjustments) so we aren't put at a substantial disadvantage. Yet, when it comes to the practical driving assessment for dementia, those adjustments seem completely forgotten.

They focus on what I can't do, rather than exploring how I can still drive safely with small, simple modifications to the test environment, especially when supported by modern technology.

The Adjustments That Could Exist

The biggest irony is that while I am assessed on my own ability to remember directions, in my everyday life, I use tools explicitly designed to help with navigation and warning signals. The assessment needs to reflect modern driving and how it can be supported by in-car technology.

Here are just a few simple, practical changes that would make the assessment process fairer and more accurate for people like me:

1. Allowing Navigation Aids (Sat Navs): My dementia means my spatial awareness and ability to remember a sequence of directions is diminished. But in my own car, I rely on a Sat Nav. It completely removes the cognitive load of navigation, allowing me to focus 100% on the road, hazards, and vehicle control. The assessment should allow me to use a Sat Nav for the on-road drive, not penalise me for not remembering three verbal instructions in a row. A restriction could be placed on my licence saying I must use one, if necessary, but denying their use in the test is denying a vital, real-world aid.
   

2. Credit for In-Car Warning Systems: Newer cars are built with safety systems, such as parking sensors, lane-departure warnings, and automatic braking. For an older driver, or one with slight cognitive slowing, these systems are a powerful safety net. The assessment should recognise and credit a driver for utilising a vehicle equipped with these systems, rather than treating the driving task as if I'm still in a 1980s car with no aids. If my car can keep me safer, the assessment should test me in that car.
   

3. More Time for Verbal Instruction and Directions: Cognitive processing can slow down with dementia. An assessment where the examiner is patient, gives instructions one at a time, and offers a concise diagram before moving off, is much fairer than rushing through multiple turn-by-turn directions.
   

4. Alternative Cognitive Testing: Part of the assessment involves an interview and sometimes paper-based cognitive tasks. A reasonable adjustment would be to use driving-specific screening tools (e.g., tests that focus on visual attention and reaction to road signs) that have been proven to link to on-road safety, instead of just general memory recall or abstract problem-solving.

The Time to Update is Now!

The current process is outdated and disproportionately penalises people with cognitive impairments who may still be perfectly safe to drive for the short-term, especially with the use of modern technology.

I want the public to be safe, of course I do, but I also deserve to be assessed in a way that is respectful of my condition and allows me to maintain my independence for as long as I safely can.

Call to Action:

The DVLA and the driving assessment centres must urgently review their processes to implement genuine, measurable, reasonable adjustments for drivers with cognitive impairments, specifically by integrating and crediting the use of modern in-car safety and navigation technology.

We need an assessment that focuses on safety-related skills in a supportive environment, not a memory test designed to trip us up. Our independence and dignity depend on it.