Dementia and driving??

[Thanksforthedonuts, MSN, APRN]

I don't know what to do.

I have a resident in our LTC setting who was admitted A&Ox4. Here short term for rehab from broken tail bone. The resident was documented as alert and oriented upon admission. And family all believes resident is completely with it. However, I've picked up on quite a bit of forgetfulness, not to the point of dementia but it's significant enough that I'm concerned. There have been multiple significant events that should have been remembered but are forgotten, repeated conversations, forgetting meds that were administered and forgetful with the date. Calls certain family members 5+ times a day. The resident has a smartphone and is constantly harassing others by calling them (mostly family) nonstop and not remembering.

My concern is when the resident leaves. The resident still drives and lives independently (part of the year) in one of those favored senior retirement states (Hawaii, Arizona, Florida, etc.). With their increasing confusion I'm worried about the safety of others while this resident is behind the wheel. I can totally see this resident get lost for hours on end not know how to get home or even, God forbid, hit someone because they though the car was in drive but it was in reverse.

I have had a frank conversation with the resident. The resident believes I'm manipulating them and lying. I've pointed out 3 significant situations that they were forgetful about. Resident won't accept it.

Family doesn't believe their loved one is forgetful.

Im the only nurse in this community based LTC.

The MD is not the most helpful person.

What can I do? I LOVE my seniors. It's why I do what I do. But what I don't love is when safety is

compromised because family members have a hard time seeing the decline of their mom/dad and don't accept a change in condition.

[Thanksforthedonuts, MSN, APRN]

Sorry for the typos. Submitted from my not-so-smart phone.

[VivaLasViejas, ASN, RN]

I have had to report a resident to the DMV, over his and the family's objections. It didn't make me very popular, but it was necessary to protect him and the other people on the road. Sometimes you just have to take action when you know the resident is unsafe; lives may depend on it.

[Oldmahubbard]

The resident's symptoms are consistent with dementia, not mere forgetfulness.

A tragedy is looking for a place to happen. And I have seen it more than once.

My opinion only.

[djh123]

Oh boy. Tough situation. I wouldn't have thought of what VivaLasViejas did. I guess that's legal... Did you do that anonymously, VLV?

[amoLucia]

To OP - What state are you in? I'm guessing that you're in Assisted Living or do Home Health?

I thought this was very interesting so I googled 'reporting unsafe driving New Jersey'. I was very surprised by the readings.

In NJ, reporting a driver for impairment is NOT anonymous. And there are some professionals for whom their reporting an individual to NJ DMV is actually mandated.

I'd be curious if your connection to the pt could be expanded for mandated reporting so as to protect you from HIPAA violation.

This inquiring mind wants to know and may try to make a few phone calls.

[NurseSpeedy, ADN, LPN, RN]

I worked in an ALF with a memory care unit. I had a number of admissions that occurred after the resident had to be picked up in another state because they got in the car, started driving, and some how ended up a few states away from their intended destination. This was the families wake up call. The resident was always still in denial. Notifying the DMV could save this resident.

[Dobbysanurse, BSN, RN]

I wonder if there is a way you could speak to PT that would give him and order to be reevaluated for his license? I know PT department works with our post-surgical pt (who are with it - just surgical) before they can discharge.

[Thanksforthedonuts, MSN, APRN]

So sorry for the late response! Life happened.

resident moved to another "active" senior living community. I spoke with the family after the resident had moved and agreed that she will no longer drive and is now taking the bus everywhere. However, the way she said it makes me think that its a lie.

I've learned since then that we can report it to state patrol or straight to the DMV. I spoke with a off duty officer and they recommended that I call the DMV as they found them very helpful in situations like this.

Another posted mentioned about extending our "mandated" reporting a bit further to include this without risk of a HIPAA violation. I think it would work. I don't see why reporting a risk to appropriate authorities would be a violation. If I encounter that situation again I would TOTALLY report it.

My biggest pet peeve in life are seniors driving who SHOULDN'T be driving. There are soooo many programs in place to help seniors now.

Thanks for the help everyone!

Again sorry for the late reply!