A diagnosis alone isn't the trigger
A dementia diagnosis alone does not automatically mean someone must stop driving that day. In the earliest stage, some people can still drive safely for a period of time. What matters is actual functional ability behind the wheel, not the diagnosis label by itself — but that ability only moves in one direction over time, and safety has to take priority over independence once real warning signs appear.
Warning signs that mean driving needs to stop now
- Getting lost on familiar, routine routes
- New dents, scrapes, or damage on the car with no clear explanation
- Near misses or actual accidents
- Confusion at intersections or traffic signals
- Slowed reaction time
- Difficulty doing more than one thing at once — checking mirrors while managing pedals and steering
- Family members or neighbors reporting concerning incidents
- Increased confusion or agitation specifically while driving
Getting an objective answer instead of a family argument
There's no single test that perfectly predicts when someone must stop. A specialized driving evaluation — performed by an occupational therapist who is a certified driving rehabilitation specialist — gives an objective, road-tested answer instead of leaving the family to guess or argue about it. Ask the neurologist or primary care physician for a referral to a driving rehabilitation program.
The conversation tends to go better when it isn't the adult child's personal opinion being enforced. Redirecting to an outside authority — "the doctor wants us to get a driving evaluation" or "the DMV requires this after a diagnosis like this" — is often easier for the person to accept than a family member unilaterally taking the keys.
If persuasion doesn't work
If the person is not safe to drive and won't stop voluntarily, practical last-resort steps include:
- Having a doctor state directly and in writing that driving is not safe
- Disabling the vehicle or removing the distributor cap/battery
- Keeping the car out of sight
- Controlling access to keys
- Arranging alternate transportation — rides from family, senior transportation services, or rideshare — so the loss doesn't feel like total loss of mobility
Every state has some mechanism for a concerned family member, physician, or law enforcement officer to request that the state's DMV formally reevaluate a driver's fitness — the exact process varies by state.
Virginia specifics
Any concerned person — a family member, physician, or law enforcement — can submit a written Medical Review Request (Virginia DMV form MED 3) asking the DMV's Medical Review Services team to evaluate whether a driver is safe to keep their license. The report should include the driver's identifying information and specifics about the safety concern.
Submit by mail to DMV Medical Review Services, PO Box 27412, Richmond, VA 23269-0001, or fax to 804-367-1604. For questions, contact Medical Review Services directly at 804-367-6203. DMV can require a vision test, knowledge test, road test, or a physician's evaluation, and can restrict or suspend the license based on the outcome. Reporting is not mandatory for family members or physicians in Virginia, but it's available whenever it's needed.