There are a number of reasons why automobiles pose particular risks for persons afflicted with Alzheimer’s disease and other forms of dementia. Most obviously, a motor vehicle is a 2,000-lb missile in the hands of an impaired driver. And, if it is anything, Alzheimer’s is a mental impairment.
But not all perils presuppose that the Alzheimer’s sufferer is in the driver’s seat. Dangers abound for passengers as well.
But there are several things that you can do with a car to minimize the risk to the patient and to others.
(Readers will observe that there are numerous points of contact between “Alzheimer’s proofing” and childproofing. For a few thoughts on that topic, see my overview, HERE.)
Let’s begin by distinguishing various categories of danger. On the one hand, there are dangers to persons inside of a car and, on the other hand, there are dangers to persons outside of a car.
Minimizing Dangers Inside of a Car
To add a further layer of complexity, this arguably has two versions to it. On one version, the Alzheimer’s sufferer is the driver (see the subsection “Supervise, Supervise, Supervise!” below) and on another (probably the more usual case for readers), he or she is a passenger.
1. Utilize Your Child Safety Locks
As discussed in a previous article (HERE), many childproofing suggestions pull double duty for Alzheimer’s proofing. In this case, we note that many (even most) sedans come with special safety latches built into the rear doors. On the majority of passenger cars built in the United States since the 1980s, turning on this safety feature is as easy as flipping as switch.
The function of the child lock is easily summarized. Most doors can be opened (and many can be unlocked) from within the cabin by simply pulling on the interior door handle. However, once the child-lock system has been engaged, the door cannot be opened from the inside. Even if the door is unlocked, the occupant has to be released from the cabin by someone operating the exterior door handle.
The only “loophole” is that the exterior door handle can be operated by reaching outside the vehicle – for example, through an open window. So, in addition to using the child-safety locks…
2. Utilize Your Window-Switch Locks
On most modern vehicles that are equipped with power-window switches, there is a master panel located on the driver’s door panel. On that door panel, usually, there is a “lock” or “window lock” button situated near the window switch assembly. The button gives the driver the ability to override auxiliary door switches so that the window positions on passenger doors cannot be changed without the driver’s authorization. Of course, it was designed primarily with children in mind. The idea was to prevent youngsters from playing around with the windows – perhaps raising and lowering them haphazardly, or at inappropriate times – and possibly getting one of their little digits crushed in the process.
But, as in other cases, what works to prevent children from getting hurt sometimes also translates into a workable solution for keeping Alzheimer’s patients out of trouble.
3. Clean up the Cabin Interior
This one may seem commonsensical, but it’s worth mentioning, nonetheless. Don’t leave a lot of trash lying around – anywhere. But inside the vehicle, it is impractical to expect that you can thwart your loved one’s every peculiar gesture while you’re driving the car. In other words, you may notice that mom or grandpa is straining to pick something up, but there will be little that you can do about it when you’re operating the vehicle. Before you put an Alzheimer’s sufferer in your car, double check that there is nothing dangerous (or just disgusting) within his or her visual field. If you encounter trash, discard it! If it’s something that you need to keep with you – like pepper spray or a first-aid kit, then at least put it inside of the glovebox. Most gloveboxes can be locked with your key.
4. Consider Using a Seatbelt-Button “Guard”
I have seen a few of these. Don’t be put off if the gizmo is stocked in the childproofing section – or even in pet supplies. The last thing you want is for grandma to release her seatbelt before it is safe to do so. Placing a “guard” over the seatbelt button can make it more difficult for grandma to inadvertently (or advertently!) trigger the retraction of her safety belt. Doubtless there are various models available, but the general idea is that releasing the guard takes a bit more dexterity than just depressing the seatbelt button. Alzheimer’s certainly diminishes fine motor skills, making it less likely that grandma (or whoever) will be able to defeat the extra layer of security. Remember: we’re trying to stack the odds in our favor.
Minimizing Dangers Outside of the Car
1. Restricting the Keys
One important consideration is going to be access to the vehicle’s keys. This is very basic. If a person has some form of dementia, such as Alzheimer’s, it may be necessary to restrict access to those keys for a number of reasons.
Why Might You Have to Restrict Key Access?
Depending upon the degree of impairment, it might be that the person in question can no longer safely or reliably operate a motor vehicle at all. So, one primary reason to restrict key access is simply to prevent your loved one from being able to drive the car on the road in the usual sense. Even starting a car and leaving it to idle in place can pose a danger (for example, with respect to things like carbon-monoxide buildup – click HERE for recommended CO detectors), especially if the vehicle is enclosed inside of a garage. (Of course, it’s a good practice to place carbon monoxide detectors inside of the garage and inside of the living space. I personally recommend getting a low-level detector, even though it costs a bit more, because of the fact that most detectors do you not report low-level conditions that can be dangerous over time.)
How Can You Restrict Access to the Keys?
A. Never leave the keys lying around; hide them. (As a special case, especially do not leave your keys inside of the ignition!)
Alzheimer’s is peculiar. People with the condition have periods of lucidity. Do not count on your aged mom, dad, grandma or grandpa being unable to recall that these keys go with that car. The best strategy is a comprehensive one, with layers of redundancy.
The first thing to do is to place the keys inside of a lock box or inside of a locked drawer or safe.
B. Alternatively, secure the keys some other way – for example, keep them on your person.
If it is inconvenient or otherwise infeasible to lock the car keys away someplace, another option is just to hang onto them yourself. Add your aging relative’s car key onto your own keychain, for instance. Or just keep their entire key ring in a pocket.
As I have mentioned in other places, I am a big believer in redundancy. So even after you have restricted access to the keys (e.g., by locking them safely out-of-reach or keeping hold of them), I would still recommend restricting access to the vehicle in other ways.
2. Controlling Entry to the Garage
If the car is inside of a garage, then you can do several things. Firstly, you can secure the door from the house to the garage – if such a door exists. Of course, the obvious first pass attempt would be to keep the door locked in the typical sense. If this is the route that you wish to go, a double-keyed deadbolt would be advisable.
In my dad’s case, I found a little gadget called a door “Guardian” and installed it on the relevant door. When engaged, the ingenious device holds the door closed, even if the usual locking mechanisms have been unlocked. The Guardian can be mounted up high, which is advantageous because I found that my dad seemed not to even notice that it was there. It’s also ideal for the present application because the disengagement of the Guardian, while easily accomplished by an adult possessed of all his or her mental faculties, is complex enough to frustrate a person with diminished cognition.
It may also be necessary to stow the garage-door openers, to prevent the Alzheimer’s-afflicted individual from gaining access to the vehicle from the driveway. However, I would also recommend securing the main entryway, to lessen or eliminate the possibility that mom or grandpa will be able to get outside unsupervised.
3. Defeating the Starting System
Another thing that you can do is install (or have installed) an inline switch between the vehicle’s battery and the starting circuit. The function of such a switch is basically to disable the car’s starter, even if dad or grandma get past your other measures. An alternative would be to have a full alarm system put on the car (which might not be such a bad idea, for other reasons). Many vehicle security systems include a “starter-interrupt relay” that prevents the car from being started – even with the key in the ignition.
(For specific product recommendations, see HERE.)
4. Sell, Donate, or Otherwise Get Rid of the Car
A final suggestion – and a harder pill to swallow for some families – is to simply get rid of grandpa’s car. Of course, this doesn’t safeguard against the Alzheimer’s patient absconding with someone else’s car. But, truthfully, such a situation is probably out of the realm of the normal. Alzheimer’s decreases cognitive function. A sufferer is unlikely to be able to devise a plot to steal your car. What is more typical is that dad or grandma simply wants to do what he or she has always done: drive. So, they go to the usual place to find the key and try the usual things to get to the familiar car. The name of the game is Making It Difficult. But there is no substitute for supervision.
Supervise, Supervise, Supervise!
Even after you have secured the keys; even after you have interrupted the battery; even after you have secured the garage doors or emptied the garage altogether; there is no replacement for supervision. In many ways, a person with Alzheimer’s is like a child. Surrounded with environmental perils, such an individual lacks the discrimination to avoid (or get out of) danger. The bottom line? Your loved one needs your constant and watchful supervision.
When Should You Begin Alzheimer’s Proofing?
See here: