Driving & Thinking Skills
Driving & Thinking Skills
For many people, driving represents much more than getting from A to B. It can mean independence, freedom, seeing friends and family, getting to appointments and continuing to take part in everyday life.
That is why changes in driving can be a difficult subject to raise. The aim is not to take away someone's independence unnecessarily. It is to help them keep driving safely for as long as they are able to do so, while recognising when additional advice, assessment or support may be needed.
Driving Uses a Lot of Thinking Skills
Driving is a complex activity.
At any one time, a driver may need to:
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concentrate on the road
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notice pedestrians, cyclists and other vehicles
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judge speed and distance
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follow signs and road markings
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remember where they are going
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make quick decisions
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manage several pieces of information at once
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react when something unexpected happens
Someone may manage well in a quiet, familiar environment but find busy traffic, unfamiliar roads or complicated junctions much more difficult.
Changes in thinking do not automatically mean that someone is unsafe to drive. Age alone does not tell us whether someone can drive safely either. What matters is how the person's abilities are affecting the real task of driving.
What Might You Notice?
Someone whose thinking skills are beginning to affect their driving may:
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become lost or confused on familiar routes
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miss turns or have difficulty following directions
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find busy junctions or roundabouts harder than before
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become overwhelmed when several things are happening at once
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miss road signs or traffic signals
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have difficulty staying in the correct lane
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misjudge gaps when pulling into traffic
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react more slowly to unexpected situations
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become noticeably anxious, frustrated or confused while driving
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have new scrapes or dents on the car
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experience near misses
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receive comments about their driving from passengers or other road users
One mistake does not necessarily mean someone is no longer safe to drive. What is more important is whether there is a pattern of change.
Think About the Whole Person
Thinking is only one part of driving.
Driving may also be affected by changes in:
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vision
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hearing
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strength
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movement
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sensation
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pain
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reaction time
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sleep
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fatigue
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medication
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physical health
If someone's driving has changed, it is worth considering whether one or several of these things may be contributing.
Some difficulties may be treatable or manageable.
“They Only Drive to the Shops”
People sometimes adapt their own driving as they get older or notice changes in their abilities.
They may choose to:
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avoid driving at night
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avoid motorways
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avoid rush-hour traffic
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stay on familiar roads
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make shorter journeys
Reducing the demands of driving can sometimes be helpful. However, a familiar journey is not automatically a safe journey. Even a short drive to the shops can involve a pedestrian stepping onto the road, temporary roadworks, a difficult junction or another driver doing something unexpected.
A useful question is:
Can the person manage the journey safely when something does not go according to plan?
If You Are Becoming Concerned
Try to talk about what you have actually noticed, rather than immediately telling the person that they should stop driving.
For example:
“I've noticed that junction seems much harder to manage than it used to be. That's happened a few times now. Could we get some advice about it?”
This keeps the conversation focused on the difficulty rather than on age or diagnosis.
It can also help to make a note of:
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what happened
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where it happened
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whether it has happened before
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whether anyone else noticed it
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whether the person recognised the difficulty themselves
This information may be useful if professional advice is needed.
A Memory Test Does Not Decide Whether Someone Can Drive
Driving uses many different abilities. A memory or cognitive screening test can provide useful information, but a score should not be used on its own to decide whether someone is safe to drive. Assessment may need to consider the person's health, vision, physical abilities, thinking skills, driving history, everyday function and, where appropriate, their actual performance on the road.
If there is uncertainty, a more specialised driving assessment may be recommended.
What Is a Specialist Driving Assessment?
This varies between countries, but a specialist driving assessment is designed to look more closely at whether changes in health or ability are affecting real-world driving.
Depending on where you live, it may be completed by a specially trained occupational therapist, specialist driving assessor, driving instructor, licensing authority or a combination of professionals.
An assessment may have two parts.
Before Going on the Road
The assessor may first look at areas such as:
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driving and medical history
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vision
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movement and physical ability
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attention
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memory and thinking
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judgement
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reaction to information
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knowledge and understanding of road rules
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whether vehicle adaptations might help
This helps the assessor understand what needs to be explored during the practical part of the assessment.
The On-Road Assessment
If an on-road assessment is appropriate, the person drives while their ability to manage everyday traffic situations is observed.
Depending on the service and country, this may take place in a dual-control vehicle with a specialist driving assessor, driver-trained occupational therapist and/or driving instructor.
The person may be asked to drive through different situations so the assessor can look at things such as:
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observation of the road
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positioning
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judgement
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responding to traffic
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following directions
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managing junctions
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reacting to unexpected situations
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following road rules
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managing more than one demand at a time
The purpose is to understand how the person actually manages the task of driving, rather than relying only on what happens during a clinic-based assessment.
It Is Not Always “Drive or Stop Driving”
People are often frightened that asking for a driving assessment will automatically mean losing their licence.
That is not necessarily the case.
Depending on the person's abilities and the rules where they live, possible outcomes may include:
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continuing to drive as before
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continuing to drive with regular medical review
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driving only under certain conditions
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using a particular type of vehicle
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using vehicle adaptations
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having driving lessons or rehabilitation
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repeating an assessment after further practice or recovery
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gradually reducing driving
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stopping driving if it is no longer possible to do so safely
Where conditional licences are available, examples may include driving only during daylight, within a particular area or under other specified conditions. These options vary considerably between countries and licensing authorities.
Importantly, any restriction must also be realistic for the person. Someone needs to be able to understand, remember and consistently follow the conditions placed on their driving.
The specialist assessor may make recommendations, but the relevant driver licensing authority ultimately decides what licence can be issued or retained under the rules where the person lives.
Driving Skills Can Sometimes Be Supported
Assessment is not only about identifying problems. Sometimes it can identify ways to make driving safer.
Depending on the difficulty, recommendations might include:
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treatment of a contributing health problem
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updated glasses or vision assessment
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reviewing medication with an appropriate healthcare professional
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driving lessons or rehabilitation
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changing to an automatic vehicle
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vehicle adaptations for a physical difficulty
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changing when or where the person drives
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further assessment after recovery from illness or injury
Not every difficulty can be compensated for safely, particularly where thinking skills are changing progressively.
But it is worth finding out what is possible rather than assuming that every concern means driving must immediately stop.
What If They Will Not Seek Help?
This can be particularly difficult for families. Someone may not recognise changes in their own driving or may feel that their independence is being threatened.
If you have significant concerns and the person will not seek advice, you may be able to:
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speak with their doctor or another appropriate healthcare professional
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contact the local driver licensing authority for guidance
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ask what process exists for raising a concern about another driver's safety
The rules are different around the world. In some countries or regions, relatives, healthcare professionals or members of the public can report concerns directly to the licensing authority. Some authorities allow this information to be provided confidentially or anonymously. Other countries have different reporting requirements. Check the procedure with the driver licensing authority where the person lives rather than assuming the process is the same everywhere.
Raising a concern does not necessarily mean that someone's licence will automatically be removed.
It may instead trigger a request for medical information, further assessment or an on-road driving assessment.
When There Is an Immediate Safety Concern
There are situations where driving should not continue while advice is being sought. For example, someone who is suddenly confused, unusually drowsy, acutely unwell or significantly affected by medication may not be able to drive safely. A sudden change in thinking also needs prompt medical assessment.
If someone is about to drive and you believe there is an immediate and serious risk to them or other road users, follow the appropriate emergency or road-safety procedures in the country where you live.
If Driving Eventually Has to Stop
Stopping driving can be a major life change.
It may affect:
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independence
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confidence
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social life
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shopping
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appointments
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hobbies
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family roles
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sense of identity
Planning ahead can make this easier.
Rather than simply asking:
“How do we stop them driving?”
also ask:
“How will they continue doing the things that driving allows them to do?”
This might mean exploring:
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family or community transport
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public transport
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taxis or ride services
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accessible transport
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grocery or medication delivery
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lifts with friends
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reorganising appointments
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choosing activities closer to home
The goal is not simply to remove the car. It is to protect safety while helping the person remain as independent, connected and involved in everyday life as possible.
Remember
Changes in thinking do not automatically mean someone must stop driving. Look for changes in real-world driving, consider the whole person and seek appropriate advice if concerns are developing. If there is uncertainty, specialist driving assessment can provide much more useful information about actual driving performance.
And remember:
Driving assessment is not always an all-or-nothing process.
Where it is safe and permitted locally, rehabilitation, adaptations, monitoring or conditions may sometimes allow someone to continue driving. Driving laws, medical reporting requirements, assessment pathways and licensing decisions vary between countries. Always check the requirements of the relevant driver licensing authority where the person lives.