These words sum up the feelings of France Alzheimer and related diseases and the Médéric Alzheimer Foundation the decree of March 28, 2022 prohibiting driving for anyone with mild cognitive impairment.
Surprised by the calendar, a few days before the presidential election, why such a rush? People living with Alzheimer’s disease or a related disease are more than one million in France. What contempt for these people and their caregivers, many of whom can still express their civic rights.
Surprised by the lack of clarity of this order. Who will make this ban decision? The general practitioner, the neurologist, the geriatrician? What is the level of responsibility of each? With what support tools and what links with driving professionals? What is the place of the family? How will she be supported in this process? Have we taken into account the risks for the sick person of arbitrary decisions at inopportune times, such as anxious or depressive decompensation?
Incomprehension: the Médéric Alzheimer Foundation, France Alzheimer and related diseases and the Association Prévention Routière have been carrying out a research project “Alzheimer and Mobility” for more than a year, financed mainly by the State, the main objective of which is to design tools to support caregivers, people living with cognitive disorders, the medical profession and driving license professionals to stop driving. The results were to be announced in a few months and should allow the co-construction of concrete solutions, adapted to the realities on the ground and to the experience of the people directly concerned.
Solutions exist
Outrage at the stigmatization of our elders. Admittedly, age is the most important risk factor for the occurrence of cognitive disorders but not for the occurrence of serious accidents. Indeed, the figures speak for themselves: only 11% of those presumed responsible for accidents, fatal or bodily, on the road in 2019 were aged over 65, compared to 24% for 15-24 year olds, on a total of 53,835 accidents. (1). International examples show that control measures (systematic health examinations, etc.) have never proven effective (2). But the most shocking thing is that no support measures have been proposed, nor even alternative solutions.
Anger, faced with a right to mobility questioned. Anger at the failure to take into account the teachings of the health crisis which has particularly impacted people living with cognitive disorders: isolation, breakdown of social ties, breakdown of care, etc. Prohibiting them from driving without offering alternative solutions is a double penalty which will lead to a breakdown of care, the fear of being diagnose… even though all the players, public authorities, patient associations, health professionals encourage early diagnosis. These two years of health crisis have shown that it might be possible to reconcile the right to freedom to come and go and the requirement of security. Was the Ministry of Solidarity and Health involved in the process?
Because make no mistake, the issue is not that of banning driving but that of support for stopping driving for all people who have an incapacity to drive.
Solutions exist such as the education and community support program, CarFreeMe, in Australia, developed by university experts, which aims to help elderly people who have stopped driving.
How did we get there ?
More than ever, our “Alzheimer’s and Mobility” research project takes on its full meaning and should provide solutions in the face of the ax that fell last Sunday.
(1) National Interministerial Road Safety Observatory. “Road safety in France – 2019 accident rate report”June 2020.
(2) OECD. “Aging and Transport: Reconciling Mobility and Safety”January 16, 2002.