Lynda Crandall tells the story of an elderly gentleman whose family did not want him to drive anymore. Determined to show them he still was capable, he got in the car, prepared to drive off. He became outraged when he found they had removed the steering wheel from the car so he couldn’t drive. He was sitting in the back seat.

“Clearly this gentleman ought not to be in a car with keys,” Crandall said.

Driving is a powerful symbol of competence and independence and taking that away from someone is difficult.

“Everyone remembers the day they got their driving license and everyone remembers their first car,” she said.

Crandall, a registered nurse and geriatric nurse practitioner, spoke to a small group Thursday evening at Living Court. “Driving with Alzheimer’s – When to Put the Brakes On” was the third in a six-part free series on Alzheimer’s disease and dementia hosted by Expressions in Enumclaw.

About 5.3 million Americans have Alzheimer’s, the most common form of dementia, a progressive brain disease causing a variety of mental impairments that include memory loss, inability to recognize objects, problems with reasoning and judgment, and getting lost.

“There are far more cases of dementia than breast cancer,” Crandall said.

As the population ages, the number of Americans with Alzheimer’s is expected to triple to 16 million by 2050.

Although Crandall’s advice was specifically targeted for Alzheimer’s or dementia, it is also relevant to aging.

The skills needed for safe driving include visual acuity, visual perceptual skills, problem solving, decision making, quick reaction time, the ability to process information quickly, the ability to multi-task and memory.

Coincidently, many of those skills become less sharp as people age.

“These are things that happen to all of us as we get older,” Crandall said. “It isn’t all elderly people that get dementia, but the highest risk factor for dementia is age.”

Crandall cited a study recently published in the American Journal of Occupational Health that looked at media stories published between 1998 and 2008 that involved Alzheimer’s patients reported missing.

According to the study, of 207 drivers with Alzheimer’s who went missing while driving, 32 died, 35 were found injured and another 70 were not found at the time the data was analyzed. Some had driven for almost two days and covered more than 1,700 miles while lost. At the time the data was examined, most of the drivers were headed on short trips to places like the post office, store or a relative’s house.

“The older we are the greater we are at risk for driving unsafely,” Crandall said.

Some of the warning signs include: driving too slowly, failing to observe traffic signals, hitting curbs, signaling incorrectly, driving at inappropriate speeds, moving into the wrong lane, confusing the brake and gas pedal, stopping in traffic for no apparent reason, avoiding certain driving situations, aggressive or impulsive personality traits, traffic violations

If a person doesn’t come to his own conclusion to limit or stop driving, it becomes those who observe safety concerns to take action. This, Crandall said, needs to be done with compassion.

“Be aware of how hurtful and how hard it will be,” Crandall said.

Driving presents a person’s lifeline to food, medication and social structure and before taking away the keys it’s important to explore these areas.

Consider “comfort zone” driving, short distances to familiar places, Crandall suggests. She also noted to find ways to reduce their need to drive or transition driving responsibility to others.

If those don’t, she said, friends and family may have to take the keys, disable the car or sell it.

The next session in the series is set for 6:30 p.m. June 16 with social worker Marty Richards presenting Embracing Spiritual Gifts and Dementia Care.