Assessing Fitness to Drive

Table of Contents

6.1.3 Medical standards for licensing

Requirements for unconditional and conditional licences are outlined in the medical standards table.

Due to the progressive nature of dementia and the need for frequent review, a person diagnosed with this condition may not hold an unconditional licence for either a private or commercial vehicle. Private vehicle drivers may be considered for a conditional licence subject to medical opinion and practical assessment as required. Commercial vehicle drivers require specialist assessment including a practical driver assessment (refer to Part A section 2.3.1 Practical driver assessments).

One option available to maintain a driver’s independence despite a reduction in capacity is to recommend that an area restriction be placed on the licence. This effectively limits where the person can drive and is most commonly expressed as a kilometre radius restriction based on the driver’s home address. Drivers should be capable of managing usual driving demands (e.g. negotiating intersections, giving way to pedestrians) as required in their local area. These licence conditions are only suitable for drivers who can reasonably be expected to understand and remember the limits as well as reliably compensate for any functional declines. The ability to respond appropriately and in a timely manner to unexpected occurrences such as roadworks or detours that require problem solving should also be considered. Thus, individuals lacking insight or with significant visual, memory or cognitive-perceptual impairments are usually not suitable candidates for a radius restriction. When advising such a restriction it is also important to remember the following:

  • A driver may not always appreciate the meaning or extent of a specified number of kilometres from home.
  • Potential hazards such as pedestrians, intersections, roadworks, bad weather and detours can still exist in familiar streets close to home and can be a source of confusion.
  • A driver licence is a legal document that demonstrates that a driver has satisfied the driver licensing authority that they are fit to use the road system as it exists – this means they must be competent to deal with unexpected and hazardous situations, even when limited to driving close to home.
  • Restrictions to specified routes are not practicable and should not be advised.

Drivers with a diagnosis of dementia will generally not meet the commercial standards. In some situations a conditional licence may be considered by the driver licensing authority subject to careful assessment by an appropriate specialist. Commercial vehicle drivers must also be subject to a practical driver assessment (refer to Part A section 2.3.1 Practical driver assessments).

Reproduced with permission from Alzheimer’s Australia

It is important that health professionals familiarise themselves with both the general information above and the tabulated standards before making an assessment of a person’s fitness to drive.

Medical standards for licensing – Dementia and other cognitive impairments
Condition

Private standards

(Drivers of cars, light rigid vehicles or motorcycles unless carrying public passengers or requiring a dangerous goods driver licence – refer to definition)

Commercial standards

(Drivers of heavy vehicles, public passenger vehicles or requiring a dangerous goods driver licence – refer to definition)

Dementia

A person is not fit to hold an unconditional licence:

  • if the person has a diagnosis of dementia.

A conditional licence may be considered by the driver licensing authority subject to at least annual review, taking into account:

  • the nature of the driving task;
  • information provided by the treating doctor regarding the level of impairment of any of the following: visuospatial perception, insight,
  • judgement, attention, comprehension, reaction time or memory and the likely impact on driving ability; and
  • the results of a practical driver assessment if required (refer to Part A section 2.3.1 Practical driver assessments).

The opinion of an appropriate specialist may also be considered.

A person is not fit to hold an unconditional licence:

  • if the person has a diagnosis of dementia.

A conditional licence may be considered by the driver licensing authority subject to at least annual review, taking into account:

  • the nature of the driving task;
  • information provided by an appropriate specialist regarding the level of impairment of any of the following: visuospatial perception, insight, judgement, attention, comprehension, reaction time or memory and the likely impact on driving ability; and
  • the results of a practical driver assessment.*

* All commercial vehicle drivers will require a practical driver assessment (refer to Part A section 2.3.1 Practical driver assessments).