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Why does the DMV suspend a Driver License for Dementia?

The California Department of Motor Vehicles (DMV) is a prominent government agency empowered by the State Legislature to issue driver licenses to qualified drivers. What most people are not aware of is just how much power the DMV also possesses to suspend or revoke a person’s privilege to drive for a variety of reasons.  The DMV’s mandate is to protect public safety by ensuring that all drivers possess the Skill, the Knowledge and the Physical/Mental Fitness to drive.

Under the category of Physical/Mental Fitness to drive, the DMV will continuously monitor the health of all drivers to ensure there are no Physical or Mental Disorders that could affect one’s ability to drive.  If such a disorder were to come to the DMV’s attention, the Department can act to remove that person from the road until it can be established they are fit to drive.

Some of the more common disorders that would cause the DMV to suspend or revoke a person’s driving privilege are: Disorders of the Head, Neck or Spine, Seizures, convulsions or epilepsy, Dizziness, fainting or frequent headaches, Vision disorders, Disorders of the heart or circulatory system, Heart attack, stroke or paralysis, Disorders of the lungs, Diabetes or high blood sugar, Kidney disease, Muscular disease, Sleep Apnea, Narcolepsy, Dementia, Alzheimer’s or Cognitive Decline and or Drug or alcohol abuse.

In this chapter we discuss the DMV’s concern over a person’s ability to safely operate a motor vehicle if they suffer with Dementia, Alzheimer’s disease or any form of Cognitive Decline.

Cognitive Decline:

As we age, it is common for us to experience mild issues with memory.  We can all struggle to recall dates or the names of people we once knew.  It’s even common to forget where we placed our car keys or what we had for dinner the night before.   The problem with Cognitive Decline is that many of the symptoms of this natural phenomenon are that they mimic many of those symptoms occurring with Dementia or Alzheimer’s patients.  Even more problematic is the instance where a driver is evaluated by a Primary Care Physician with a specialty in Internal Medicine who doesn’t understand the difference between Cognitive Decline and Dementia.  All too often, overzealous physicians with little or no specialized training in issues of cognition make incorrect assessments of patients that bring them into the DMV focus.

As a general rule, the DMV will not take an action to suspend or revoke a driver license based upon issues of Cognitive Decline, provided it is mild and stable.

Dementia/Alzheimer’s disease:

Dementia/Alzheimer’s disease is an organic brain disorder that is characterized by impaired cognition which normally has a negative effect on memory and judgment.  As the disease progresses, patients will commonly experience problems with paranoia, and disturbances of higher cortical function.  Unfortunately, many people affected with this disorder will also experience changes in their personality and will be prone to inappropriate behavior.

Dementia/Alzheimer’s disease is as progressive disorder that will develop through stages of severity.  In assessing a driver’s ability to operate motor vehicles, the DMV will use a graduated series of stages to estimate the impact the disorder has on a person’s ability to drive:

Mild Cognitive Impact

At this stage, the driver is basically able to care for their own needs.  This person is generally able to shop for themselves, live independently and care for their own personal hygiene. Memory issues begin to arise.

Moderate Cognitive Impact

At this stage, the driver is experiencing greater difficulty with independent living and may require supervision.  Spacial awareness may be affected and reasoning may be impacted to a point that they are unable to cope with their environment.  Perception/reaction time may be delayed and memory deteriorates.

Severe Cognitive Impact

At this most advanced stage, the person is no longer able to care for their own safety or hygiene.  Continual supervision is necessary and the person may be incoherent or mute.

How does Dementia/Alzheimer’s disease affect safe driving?

Just because a person has been diagnosed with Dementia or Alzheimer’s does not mean they automatically must stop driving.  30% of people who are diagnosed with this disorder are fully capable of safe driving.

Over a lifetime of driving, many people consider driving to be an automatic function.  The truth is, however, safe driving is actually a multi-faceted skill that requires quick reasoning and thought processing, combined with need for good vision, hearing and manual dexterity.  While safe driving may seem like a natural function to an experienced driver, it is actually a quite complex task.

A person diagnosed with Dementia or Alzheimer’s disease may have difficulty with:

  • Attention and Concentration: This is critical as the driver must be able to evaluate roadway conditions and be able to move between several different driving tasks.
  • Visual Spatial Skills: This is critical as the driver must be able to discern depth and distance so they can appropriately judge the distance between vehicles as well as properly maintaining speed and lane position.
  • Problem Solving Skills: This is critical as the driver must be able to analyze obstructions, diversions and obstacles present or appearing in the roadway.
  • Judgement and Decision Making: This is critical as the driver must be able to interpret and anticipate the actions of other drivers or pedestrians.
  • Perception/Reaction Time and Processing Skills: This is critical as the driver must be able to react quickly to an ever changing environment.
  • Anger Management: This is critical as it is common for drivers to encounter other rude or aggressive drivers and losing one’s temper is a sure fire path to problems.
  • Memory Issues: This is critical as the driver must recall routes to be travelled, how to change gears and activate turn signals; and the meaning of road signs.

Probably the hardest truth to reconcile is that Dementia/Alzheimer’s is a progressive disorder that will cause a deterioration of the driver’s ability over time.  The progression of the disease is different for all people, but eventually it will cause the effected person to lose their driving privilege.

How does the DMV define Dementia/Alzheimer’s disease?

In fulfilling its obligation to protect Public Safety, the California Department of Motor Vehicles (DMV) will focus upon any person it suspects suffers with any Physical or Mental condition that can affect safe driving.  One of the most aggressively investigated issues is the driver who has been diagnosed with Dementia or Alzheimer’s disease.  This is because these disorders can profoundly affect a person’s ability to safely operate a motor vehicle; and because the driver may have no clue as to the level at which they are impaired.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life and therefore, clearly affects one’s ability to drive.  Alzheimer’s disease is the most common and identified form of Dementia.

Dementia is not a specific disease. It is an overall term that describes a wide range of symptoms associated with a decline in memory or other cognitive skills severe enough that a person’s ability to deal with day to day life is impacted.  Alzheimer’s disease accounts for 60 to 80 percent of diagnosed Dementia.  Vascular Dementia normally occurs following a stroke and is the second most common form of Dementia.  There are several other forms of Dementia, some of which are reversible, such as vitamin deficiencies and problems with the thyroid gland.

Many forms of dementia are progressive, meaning that symptoms begin slowly and gradually worsen over time.  Different types of Dementia are associated with particular types of damage to brain cells.  For example, in Alzheimer’s disease, high levels of certain proteins inside and outside the brain cells make it difficult for the cells to remain healthy and to communicate with one another.  The region of the brain known as the Hippocampus is the center for learning and memory and is often the first region attacked by Alzheimer’s disease.  As a result, memory loss is one of it’s earliest symptoms.

The DMV’s working definition of Dementia/Alzheimer’s Disease is:

“Any chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning.”

  How does the DMV learn that a driver has Dementia/Alzheimer’s disease?

Of all the California Government Agencies, the California Department of Motor Vehicles (DMV) is among the most interactive with the general public.  Every day, there are literally thousands of interactions between the public and the department for issues ranging from vehicle registrations to driver license applications.

Because there is so much information flowing back and forth between the DMV and the public, the department is very much “hardwired” into the very fabric of our society.  Additionally, various laws in the State of California mandate that certain information be forwarded to the DMV, even if individual drivers would prefer it not happen.

Even though a diagnosis with Dementia or Alzheimer’s disease a profoundly private matter, it absolutely can affect the safety of the motoring public and therefore is a point of concern for the DMV.  There are a variety of means by which the DMV learns of such a diagnosis:

  • Physicians or other medical professionals: 12% of states require physicians to report individuals who are cognitively, or medically impaired to the DMV (California, Delaware, Nevada, New Jersey, Oregon, and Pennsylvania). In California, reporting by physicians accounts for the vast majority of cases handled by the DMV.
  • Law Enforcement Officers: In most cases, a driver with Dementia/Alzheimer’s Disease isn’t aware to the extent his driving is affected.  Because police officers are a “first line” contact with the motoring public, it is common for officers to detect symptoms of cognitive decline during contacts with drivers which are then reported to the DMV.
  • Family, Friends or Caregivers: This group of people has the most direct contact with the affected driver and are very often the source of information to the DMV.  This can create difficulty within the family as they struggle with their desire to protect the independence of loved ones vs. their desire to protect everyone from a disastrous accident.
  • Social Media: We all live in a media driven world and the DMV is very much embedded in it.  It is not uncommon for DMV employees to see something unfavorable on Social Media and then begin an investigation.
  • Anonymous Tipsters: The DMV will accept information regarding a potentially dangerous driver from any source, including those people who wish to remain anonymous.  It is common for Family, Friends or Caregivers to anonymously report a Dementia patient to the DMV in an effort to protect the public while keeping peace within the family.
  • The Individual Driver:            Many times the individual driver ends up being the source of information to the DMV.  This occurs commonly when a driver enters a DMV Field Office to renew their driver license and displays symptoms that come to the attention of DMV employees.

 What should I do if I receive an Order of Suspension for Dementia/Alzheimer’s?

It is estimated that as many as 500,000 Americans currently are diagnosed with Dementia or Alzheimer’s disease; and as our population ages, the numbers seem to be increasing exponentially.  The fact is, as human beings, we are frail creatures that are subject to any number of medical maladies, especially as we age.

Remember that a diagnosis with Dementia or Alzheimer’s disease is not in itself a reason to stop driving.  One in three drivers with some form of Dementia are still able to drive– some for many, many years.

If you have received an Order of Suspension/Revocation from the California Department of Motor Vehicles (DMV) that was triggered because of Dementia or Alzheimer’s Disease, the first thing to do is to take an honest assessment of your situation.  If you believe you are still stable enough to drive, contact the DMV Defense Experts at California Drivers Advocates.  We have been defending the rights of California Drivers for many years; including those who have been diagnosed with troubling medical disorders.   DMV defense is the only thing we do and we have represented hundreds of drivers who were on the verge of losing their driving privileges.

Yes, it’s true that a person diagnosed with Dementia or Alzheimer’s disease will eventually be forced to terminate driving.  Our goal at California Drivers Advocates is to keep drivers on the road enjoying their independence and freedom as long as it is reasonably possible. Call CDA today.  We care, and we have the training and knowledge to assist you.


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COVID-19 Update: The California DMV is OPEN!!!The California Department of Motor Vehicles - Driver Safety Office is Open & SUSPENDING Licenses

If you received a notice from the California Department of Motor Vehicles, Driver Safety Office you must act now.

The Driver Safety Offices are still doing business as usual, which means suspending your license. 

Hearings are still being processed and you can still defend yourself. 

California Drivers Advocates is a team of expert DMV Defense advocates. We represent drivers throughout California when their driver license comes into question with the California Department of Motor Vehicles.

We are already defending drivers in their new virtual hearings at the DMV. Learn more here >

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