I think Tumbleweed was thinking your wife was the woman with the MMSE
score of 21, but I believe thats another poster.

Anyway, back to the driving issue.

If she is impaired enough for it to have been diagnosed, and for the
short term memory issues to be quite obvious, she is impaired in other
areas - whether or not those impairments are obvious in social
situations or not. I've often related the story of my MIL's tests -
they sent her to a psychometrist for a day's worth of testing - very
similar to what they would put a child through looking for learning
disabilities. It covered reaction time, reasoning, judgement, depth
perception, memory etc. etc. My husband sat with her during the
testing. At the time, had you met her, you would not have thought there
was much wrong with her. However, the test results were quite shocking
to us, as the impairment was so much more extensive than we would ever,
ever had guessed.

Even if your wife has had this extensive cognitive testing to determine
her precise degree and areas of impairment, its a moving target. She
might be fine in January but missing a key ability by February.

In most jurisdictions, doctors have a legal responsibility to report
any patient who is driving with a medical condition that might impact
their ability to do so safely. The usual drill is to report them to the
licensing authority, who will then send out a letter saying they have
to have an assessment or a drivers test by a specific date, or their
license will be suspended. You don't say where you live - do a google
on the subject and see.

In some places, there are people who make their living doing in car
driving assessments for the elderly. Here in Ontario, just an
assessment is not enough - the person has to actually redo both the
written and driving portions of their drivers test. Faced with the
learners manual full of speed limits, signage etc. my MIL threw in the
towel. She knew she wouldn't be able to do the written portion - and
I'm sure the driving portion would have been failed as well.

I personally think its irresponsible for her neurologist to say its
okay for her to drive - never mind that he's putting himself in a
position of liability should she have an accident. She has a
progressive, incurable brain disease - he's not a trained driving
expert sitting in the car watching her to see what she's doing on a
daily basis.

Most accidents happen very close to home - here are some figures from
an insurance company. Being close to home may keep her from getting
lost (at this stage,  anyway), but won't stop her from panicking or
making an error in a situation that requires fast reactions and good
judgement. Its not just her you have to protect - its other people on
the road and the sidewalks.

1 mile or less     23 percent
2 to 5 miles     29 percent
6 to 10 miles     17 percent
11 to 15 miles     8 percent
16 to 20 miles     6 percent
More than 20 miles     17 percent

My suggestion would be to find out what the rules are where you are,
and as a bare minimum, have her driving assessed by a professional -
and start planning for the end of driving - perhaps get a standing
account with a local cab company to come drive her to whereever she
wants to go.

Mary G.

I'd say by making the simple decision "no one with Az should be driving,
full stop".
If she is just doing local errands, then its very likely anyway that getting
rid of the car will easily release enough money to pay for taxis and still
have some to spare.

At some point, you are going to decide she isnt safe to drive. That point
is, most likely, to be after an 'incident'. That might be innocent, maybe
she just gets lost, or goes a strange way, but it might be a near miss,  or
it might be after she injures or kills someone. You are gambling it wont be
the latter. WIth her life, and more importantly, other peoples lives.

If you are in the car with her , you''ll be giving her subtle hints without
even noticing it. 'turn here', 'look out for the kid on the bike', etc.
Whats her driving like when there is no one else there? You are likely only
going to find out when its gotten really bad because something bad happened.

I thought she was the lady with a score of 21, got my posts mixed up.

<snip>

Two of the large rehab facilities in our area - upstate New York - offer
driving evaluations.  My husband's was ordered by his primary care doctor
and paid for by his insurance.  The results were conclusive - do not drive.
Having a neutral party decide this issue kept me from being  "the bad guy".
Ruth

you call your DMV and tell them she has been diagnosed, and in
most states, they will require that she take and pass a driving
test.  or in states where a diagnosis means an automatic
cancellation of her license, they will cancel her license and
send her a notice.  in some states doctors *are required* to
report an alzheimer's diagnosis to the DMV.

i personally would not get in the passenger seat with someone
driving who was diagnosed, and i would want the driver tested as
soon as possible after diagnosis and every few months thereafter.

as evelyn said, part of the problem is the unpredictablility ---
abilities can disappear suddenly, often when the AD person is
under stress.  that's when they hit the accelerator instead of
the brake pedal or turn the wrong way down a one way street, or
enter the wrong lane on the freeway.

for the safety of everyone on the road, please check with your
DMV on state law, and then have her tested if the law won't
immediately stop her driving.

----snip----
Our neurologist (and if I gave you the guys name and you did a

Alan, it may seem like a familiar area would be safe, but I was with my MIL
when she blew past an elementary school at 50+ on a neighborhood street.
When the school zone was pointed out, her comment was "There didn't used to
be a school there."  However familiar, neighborhoods aren't static, they
change.

OTOH, I've actually seen a few articles saying it's not an automatic
decision.  I can only think that's due to better drugs and earlier
diagnosis.  Her doc is probably the best one to make that call.  But I'd
want to know how frequently the doc re-evaluated.  It's not something you'd
want to drop off their radar screen.

Karen
------------
http://www.cnn.com/HEALTH/library/HO/00046.html
The transition: Gradual or abrupt

Some people believe that anyone who has been diagnosed with Alzheimer's
should not drive. Others say that people in the early stages of the disease
should have their driving skills evaluated individually. People who can
still pay attention to the road and judge speed and distance with reasonable
accuracy may be able to give up driving in stages. Such people may continue
to drive on short daytime trips in familiar surroundings.

------------

http://alzheimers.about.com/cs/diagnosisissues/a/Driving.htm
People with early stage, very mild Alzheimer's disease, can and do drive
safely, however when the disease progresses to the moderate or severe
stages, then driving must stop.

------------
http://www.alzgreatplains.org/alzheimers/day_to_day.html?day_to_day_item=1087&db
_item=listitem
A diagnosis of Alzheimer's disease does not mean the person has lost all
ability to drive. Caregivers should evaluate the person regularly to
determine if it is safe for him or her to drive.