Many American family members say they are capable of knowing when a loved one with Alzheimer's disease should give up driving, according to a national survey sponsored by the Hartford Financial Services Group.

However, 51 percent of those with a family member with Alzheimer's disease say they are unsure or don't know enough to make an informed decision.

A diagnosis of Alzheimer's disease is not always a signal to stop driving, said Beverly Hynes-Grace, Hartford's vice president of corporate gerontology. "As people are diagnosed earlier in the development of the disease and with today's better medication, we are finding many people can still drive safely for a period of time."

There is no single reliable test to determine whether or not a person with Alzheimer's disease should be driving.

"Our survey found that 62 percent of families feel that they are in the best position to decide when a spouse or parent should stop driving," said Hynes-Grace. "But most families lack the know-how to recognize exactly when their loved ones can no longer drive safely."

As Alzheimer's disease progresses, it affects cognitive functions critical to driving. "So it's important to observe driving behavior directly over time," advised Hynes-Grace. "Family members should watch for an accumulation of warning signs that present a pattern of unsafe driving."

Early warning signs can include driving at inappropriate speeds, trouble navigating turns, hitting curbs and confusion at exits.

The Hartford recommends families involve the Alzheimer's patient early on in discussions about limiting and eventually stopping driving. "Open and early communication about driving and its alternatives as soon as a diagnosis is made can help the person with Alzheimer's disease and the family agree on a course of action before a crisis occurs," said Hynes-Grace.

According to the survey, only 30 percent reported talking with the patient directly about his or her driving. About 44 percent said they talked with someone else instead, usually another family member. Twenty-six percent didn't speak with anyone about the issue.

More than half of the survey respondents said that confronting a person with dementia about driving was extremely difficult.

"It's not surprising that the vast majority of families find the issue emotionally trying. Driving means independence, competence and control," said Hynes-Grace. "But we've found that families who involve the person with dementia in the discussions can truly help them more easily make the transition from driver to passenger."

The Hartford suggests the following steps:

• Frequently observe the loved one's driving behavior;
• Begin discussions early and involve the loved one;
• Line up transportation alternatives, such as regular rides from friends or relatives, car service and senior vans. Be sure to include methods of transportation for social visits and other outings; and
• Enlist the support of doctors and other healthcare providers.

The nationally representative survey of 1,068 adults was conducted in July 2002.

Other sources: The Hartford