Dementia and Driving

Newsletter | Feb 9, 2018 | Letha Sgritta McDowell

Currently, more than 5 million Americans are living with dementia, and that number is expected to increase to over 16 million by the year 2050.  While many aspects of dementia are still a mystery, the disease itself and many of its affects are familiar.  Due to the eventual impairment to memory and executive decision-making skills, a person living with dementia will eventually need to stop driving.  Unfortunately, many individuals living with dementia are shocked and dismayed to hear family members or a physician suggest they stop driving.  The inability to drive represents a loss of freedom and the (very real) potential for isolation and confinement.  In order to lessen the blow, it is important to prepare in advance for this eventuality.

First, it is important to recognize signs which may indicate that it is time for an individual with dementia to stop driving.  In order to plan ahead, it is helpful if both the person with dementia as well as family and friends are familiar with this.  Indications that it may be time to stop driving can include:

  • Failure to obey traffic signs
  • Getting lost in familiar places
  • Confusing the gas pedal with the brake
  • Difficulty staying in lane
  • Making poor choices about passing, stopping, and speed
  • Mysterious dents or scratches on the vehicle
  • Longer than typical drive times
  • Confusion or anger while driving

This list is not exhaustive but contains good examples of signs to watch for.  If the person with dementia is educated in advance about these concerns and the possibility that driving may no longer be feasible, it tends to ease the transition when confronted with the situation.

When considering the need to stop driving and preparing for the eventuality, it is also helpful to have a plan in place so the individual with dementia can maintain some independence.  Locating resources in advance is critical to this.  Many counties have public transportation that can be easily arranged; some even have special transportation systems for older adults and adults with disabilities that can be arranged in advance.  This alleviates the stress and concern which can surround locating a bus stop or train station.  In addition, many senior centers will provide transportation to and from activities as will church groups.  It may also be helpful for a family to consider in advance what transportation they may provide.  Some families will agree in advance to schedule regular outings to grocery stores, department stores, restaurants, theaters, concerts, or other social events.  If in place in advance, these outlines can alleviate much of the anxiety associated with the feeling of loss of freedom due to the loss of driving skills.

Some adults living with dementia will choose the time they are unable to drive as a time to move into either an older adult community or assisted living community.  While not the right choice for everyone, these communities provide regular meals (alleviating the need for trips to the grocery store), prearranged shopping outings, and a large number of social activities which combats the feelings of isolation and depression that can exist when someone is no longer able to travel independently.

Some may be tempted to simply limit driving to familiar areas close to the home.  However, professionals caution against this as the large majority of all accidents happen within close proximity to home.  In addition, slowed reaction times and misjudgments which may occur with dementia are especially dangers in neighborhoods where children may be playing outside or pets may be darting into the road.

For many, driving represents freedom and independence and no longer being able to drive can feel as if one is being forced into confinement and isolation.  However, being familiar with the signs as to when to stop driving and having a plan in place for that eventuality can make the transition smooth and easier for both the person with dementia and their friends, family, and caregivers.

Ask Kit Kat – Pig Pens

Hook Law Center:  Kit Kat, what can you tell us about how pigs are bred on commercial farms?

Kit Kat:  Well, this is something I was unaware of until I read a recent article in The Virginian-Pilot. Smithfield Foods has made great progress in recently ending their previous practice of narrow stalls for pregnant pigs. The stalls were called “gestation crates,” and they were so small the pigs couldn’t turn around. At a cost of $360 million, their farms now use a system referred to as “group-housing systems.” This means that the pregnant pigs are kept in group pens or can move between pens and individual stalls. This change fulfills a promise the company made 10 years ago. In part, the company made the change as a response to pressure from animal rights groups and from large companies like McDonald’s, Kroger, Burger King, Harris Teeter, and others. There is still work to be done, however. Tyson Foods and Seaboard Foods continue to use the gestation crates.

Gestation crates came into use in the 1960s. There are some advantages—they kept pigs out of bad weather, facilitated medical care, and prevented the pigs’ waste from mixing into the feed. There is conflicting research on the matter. There were some advantages in that there was less aggression among the animals, and the number of litters increased. However, it was inhumane according to the Humane Society, and it led the way to change the practice. The Humane Society started their campaigns in several large states like Florida, California, Michigan, and Ohio, to name a few.

Smithfield Foods uses two types of group housing at its 200 sow farms across the nation. One is called “free-access,” which means that groups of 30-40 pigs live together, with access to individual stalls when they desire it. This accounts for about 25% of their farms. The other type is called “small group housing.” With this latter style, 5 – 6 pigs live together. Stewart Leeth, chief sustainability officer at Smithfield Foods comments, “When you put pregnant animals in together, the sows will have to establish a pecking order. There is some fighting involved, and once that kind of resolves itself…, they typically are fine.”

Smithfield Foods is making the transition at its international farms a bit more slowly. Farms in Romania and Poland have already changed, but other farms abroad are being given the deadline of 2022. If they have not converted by then, their contracts with Smithfield Foods will not be renewed. So kudos to Smithfield Foods! They’ve demonstrated that they are good, corporate citizens! (Elisha Sauers,“Finally, Smithfield’s sows get some relief.” The Virginian-Pilot, Jan. 24, 2018, p.1 & 11)

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Letha Sgritta McDowell

Attorney, Shareholder, CELA
757-399-7506 | 252-722-2890
[email protected]

Letha Sgritta McDowell is a Shareholder of Hook Law practicing in the areas of estate planning, elder law, special needs planning, estate and trust administration, asset protection planning, long-term care planning, personal injury settlement consulting, guardianships & conservatorships, and tax law. Ms. McDowell’s clients range from high-net-worth individuals with over $75 million in net worth to families with limited assets.

Ms. McDowell is a past President of the National Academy of Elder Law Attorneys and was named as a Fellow of the prestigious American College of Trusts and Estates Council (“ACTEC”) in 2020. She is certified as an elder law attorney by the National Elder Law Foundation (“CELA”) and Board Certified as a specialist in Elder Law by the North Carolina State Bar Board of Legal Specialization. Furthermore, McDowell is accredited to prepare and prosecute claims with the Department of Veterans Affairs.

Ms. McDowell is currently the chair of NAELA’s strategic planning committee, a member of the Board of Directors for the North Carolina Chapter of NAELA, and a member of the Board of Directors for the Purdue Center for Cancer Research. She is the former Chair of the North Carolina State Bar’s Elder Law Specialization Committee and is the former Editor-in-Chief of “Gray Matters”, the newsletter for the Elder Law Section of the North Carolina Bar Association. She is a consultant for InterActive Legal and has worked on several law and technology initiatives including IBM’s Watson project. Along with her experience practicing as an attorney, she has dedicated much of her time writing for national publications including, but not limited to: Wolters Kluwer,, the NAELA Journal, Trust & Estates Magazine and many more.

Practice Areas

  • Elder Law
  • Estate & Trust Administration
  • Estate Planning
  • Asset Protection Planning
  • Long-Term Care Planning
  • Special Needs Planning

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