Few conversations are harder than telling someone with dementia that it’s time to stop driving. In moments of clarity, many genuinely believe they’re still perfectly capable behind the wheel, and for both the person and their family, raising the topic can feel like an impossible balancing act between safety and dignity. New research from Flinders University has mapped out a genuinely better way to approach it.

Why this conversation is so difficult to navigate

In Australia, people with dementia aren’t able to hold an unconditional driver’s licence, but may qualify for a conditional one, subject to at least an annual review. Health professionals are responsible for assessing fitness to drive, and under mandatory reporting laws, must notify the relevant licensing authority if they believe a driver poses a danger to the public.

But as cognitive impairment progresses, the responsibility often shifts heavily onto family members, many of whom say they feel genuinely unprepared, lacking the expertise, and fearful of being blamed, particularly when their loved one has little insight into their own cognitive decline and strongly identifies with being a driver. Families also report receiving conflicting advice from different health professionals, and often find that driving cessation only becomes a serious topic once a family member raises concerns themselves, rather than being proactively addressed earlier.

What the research found

Flinders University PhD student Claire Spargo led the study, interviewing 12 people aged 65 and over living with dementia or mild cognitive impairment, to better understand their own needs and experiences around how health professionals manage driving cessation.

Ms Spargo said the aim was to genuinely understand what older people themselves need and experience when it comes to how their health professionals handle this process. The findings point to a clear need for more structured, compassionate communication delivered in phases, well before driving actually becomes unsafe, rather than a single, difficult conversation delivered all at once.

The four phases researchers say should guide this process

1. Prepare the person before driving becomes unsafe. Health professionals should begin early, ongoing conversations about driving cessation well in advance. The researchers recommend a collaborative approach involving an Advance Driving Directive, a document outlining the person’s own preferences for how future decisions about their driving should be made, and by whom, typically a GP or specialist, with input from family. A memory or cognitive clinic can provide formal diagnosis where needed, and if the underlying condition is likely to progress, the person should be told clearly that driving cessation will eventually be necessary, giving them time to plan ahead, build new routines and explore alternative transport options early.

2. Navigate fitness-to-drive decisions together. People should be given clear information and genuine choices, such as pursuing a practical driving assessment or voluntarily relinquishing their licence. Family should be involved in these discussions where the person wishes it, with a shared decision-making approach that keeps the person genuinely involved, while health professionals retain ultimate responsibility for the actual fitness-to-drive recommendation.

3. Deliver the recommendation with real compassion. When the moment comes to actually recommend someone stop driving, the research emphasises simple, straightforward language delivered with genuine compassion. Safety should be framed as the central reason, for the person themselves as well as the wider community, while still acknowledging their personal connection to driving and recognising both the real challenges and the potential benefits that can come with no longer driving.

4. Support adjustment to life without driving. Losing the ability to drive often brings a genuine sense of lost independence and loneliness. The researchers recommend connecting people with practical support services, such as CarFreeMe, which offers counselling and help with transport planning and social support, alongside offering genuine guidance to family members who often end up managing the practical, social and emotional fallout themselves.

A genuinely important detail for families and clinicians

Ms Spargo noted something worth remembering for anyone involved in this process: support offered by the same clinician who delivered the driving cessation recommendation isn’t always welcomed by the person affected, and engaging a different health professional or service to support that next phase may actually work better.

Why this matters

The researchers hope these findings will help shape better tools and resources for health professionals managing these genuinely difficult conversations, ultimately making the process more compassionate and less fraught, for both people living with dementia and the families supporting them through it.

This article reports on research published in the Australasian Journal on Ageing and is general in nature. If you or a family member are navigating a driving cessation decision related to dementia or cognitive impairment, speak with your GP, or contact CarFreeMe for dedicated support.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.