Editorial: When do you take the keys away?
Published 12:00 am Monday, August 7, 2006
Alzheimer’s disease befuddles us all. It creeps on its victims slowly and even slower on the rest of us discerning its signs. And it creates ethical questions that become difficult for society to answer. One question is: When can a patient with Alzheimer’s can no longer operate an automobile?
Here’s what Dr. William B. Orr, a neuroscientist and geriatric and forensic psychiatrist at the University of Minnesota School of Medicine, told the Associated Press:
&8220;The well-learned behaviors, like turning on the ignition of your car and steering down the road &045; things learned so well that they are almost automatic &045; these are the last things to go. The first things that are lost are those related to what we call ‘executive functioning’ &045; the ability to plan, organize and initiate.&8221;
He continued: &8220;The Alzheimer’s patient who has lost executive skills can’t put together a reliable search plan and can’t figure out how to get out of the problem. To compound it, many people with Alzheimer’s have no insights into their loss, which interferes with measures they might have taken to get help.&8221;
Weigh those factors against what Elin Schold Davis of Edina, who heads the Older Driver Initiative for the American Occupational Therapy Association, said: &8220;The problem we have as a society right now is that giving up driving strands people at home, it maroons them.&8221;
We cannot claim to know an answer to this riddle. But we do know this: Minnesota needs to find a clearer means to determine when people suffering from a form of dementia can no longer drive. There are children and other loved ones in those oncoming cars.
Consider these words from Dr. Orr:
&8220;It’s common in the early stages that patients will use their ongoing unaffected cognitive and &045; particularly &045; their social skills to superficially look superb. It’s only when they get into challenging or multi-tasking situations that they get into trouble.&8221;