Driving is more than just a way to get from point A to point B. It can mean regular interactions with family and friends and the freedom to do what you want when you want. But getting older and conditions such as Parkinson's can affect driving abilities. Understanding how your driving may be impacted can help you continue driving safely and decide if and when you need to stop.

Driving Is a Complex Task
Most of us have been driving for so long that it feels simple and almost automatic. But when you break down all the individual tasks involved, you realize how complicated it truly is. Driving requires multiple brain processes working simultaneously:

• Cognition (memory and thinking): remembering your route, destination and where you parked; making decisions such as when to stop at a light and when to get gas; and reaction time
• Movement: getting in and out of the car, steering, shifting and turning your head when backing up
• Hearing: listening for sirens, beeps and other pertinent alerts while tuning out background noise
• Sensation: feeling the gas pedal and brake, and knowing how much pressure to apply to each 
• Vision: reading road signs and seeing pedestrians and cars in front of and around you

When one or more of these areas isn't working like it used to, driving can be more challenging and impact your and others' safety.

Parkinson's Can Affect Driving Ability
Many people with Parkinson's can continue to drive without difficulty. But for some, especially those who are older and have later-stage disease, movement and cognition problems can reduce driving ability. Tremor, slowness, stiffness or dyskinesia (involuntary, uncontrolled movement) could make it difficult to grip the steering wheel or brake suddenly. Thought problems, which can range from mild to significant, can impair visuospatial skills -- seeing and understanding where you and other objects are in space. This could affect activities such as reading a map, merging into traffic and parking a car.

Some Parkinson's (and other prescription and over-the-counter) medications also may cause side effects, such as sleepiness or confusion. Always talk to your doctor about how medication may affect you and whether you should temporarily stop driving when starting a new drug.

There Are Many Ways to Manage Driving Concerns
If you, your family or your doctor notice problems with thinking or driving (such as getting lost in familiar places, forgetting to signal or having near misses), it may be time to have a conversation about driving. Talking about it doesn't necessarily mean you'll have to stop, but you may need to reevaluate or limit driving. If others raise concerns, it's important to take them seriously. No one wants to take away your independence, but everyone wants you (and your passengers, other motorists, pedestrians and everyone else on the road) to be safe. Some potential considerations:

• Limit driving.
  The long-term solution may be to stop driving, but for now you may be able to continue driving under strict guidelines, such as within five miles of your home, on side roads (no freeways) or only during daylight. This can allow you to keep up usual activities, such as grocery shopping, attending religious services and meeting friends for lunch or exercise.
• Use alternative forms of transportation.
  If accessible, try public transport such as the bus or subway, a shuttle or on-demand ride service (Uber or Lyft, for example). No cost alternatives may include walking, biking, riding with friends or family and, in some towns, even using a golf cart or similar low-velocity vehicle. 
• Assess your driving skills.
  For some people, seeing a driving rehabilitation specialist -- an occupational therapist who can evaluate the ability to safely operate a vehicle and recommend ways to limit risks -- may be beneficial. This evaluation can be essential to helping you become a safer driver or deciding to stop driving. Your doctor may make a referral or you can find one in your area. Insurance coverage varies so if this is cost-prohibitive, another option may be to take a written or road test through your Department of Motor Vehicles or another organization, such as The American Automobile Association (AAA). 
• Plan for future "driving retirement."
  If possible, talk about when and why you would want to stop driving and what alternatives you'd use long before it's an issue. Discussing this with your family, spouse or doctor will ensure your preferences are clear and plans are in place, even if they never become necessary.

Deciding whether to continue driving can be difficult for patients and their loved ones. But if you're noticing that driving is more challenging than it used to be, the time to address it is now. Your doctor can help talk through concerns and alternate options.