Many people with Parkinson’s disease (PD) worry whether they’ll be able to continue driving with their diagnosis — and their loved ones sometimes share this concern. Symptoms such as slowed reaction time, drowsiness, and muscle tremors can all impair a person’s driving ability and increase the risk of dangerous accidents.

That said, deciding whether to drive with Parkinson’s is a very personal choice. It requires taking many factors into account, including the severity of your symptoms, your comfort level, and your health care team’s advice.

Here, we will explore what you need to know about driving and PD, including how Parkinson’s affects driving abilities, when you should discuss driving with a loved one with Parkinson’s, and how to make the right decision for yourself and those you care about.

How Can Parkinson's Affect Driving?

PD is a progressive neurodegenerative disorder, meaning it causes a loss of neurons in parts of the central nervous system. This can lead to symptoms of motor, visual, or cognitive function impairment, which can make driving difficult or unsafe.

These impairments can happen even in the early stages of Parkinson’s when symptoms start appearing gradually. A minor resting hand tremor (shaking) is often the first symptom of Parkinson’s.

Tremors

PD frequently causes tremors in the hands and legs, among other body parts. As many MyParkinsonsTeam members have shared, these tremors can get in the way of safe driving. “I have reduced my driving considerably,” shared one member. “I have tremors in my right hand and foot. Sometimes, my foot goes tap-tapping on the accelerator or on the brake pads.”

Another member who said they experience tremors while driving shared that adjusting their hand position on the steering wheel helped. “When I put my hands in the 5 and 8 position, tremors are eliminated.”

Dizziness

Many people with Parkinson’s experience dizziness and vertigo. These sensations, which can be related to problems with balance, may affect a person’s ability to drive. One MyParkinsonsTeam member shared, “My wife had to drive me to a doctor’s appointment because of the dizziness.”

Bradykinesia

Bradykinesia is a common symptom of Parkinson’s that refers to slowed movement. This slowed reaction time can prove dangerous for a driver, as driving sometimes requires a person to make quick changes or decisions. One member said of their spouse with Parkinson’s, “He knows my concerns regarding hesitation moving his feet and quick decision-making.”

Drowsiness

Medications used to treat PD can cause a person to feel drowsy or tired. Research has found that the dangers of drowsy driving are comparable to those of driving while intoxicated. One member shared their approach to dealing with tiredness while driving long distances: “I pull over every two hours if on a long trip and have a nap or just rest away from the car. If I feel tired in between stops, then I pull over ASAP and rest/nap.”

Cognitive Changes

People with Parkinson’s can experience impairments in their cognition. Changes in executive functioning, for instance, may affect their ability to multitask. They may also have problems with visuospatial processing — the ability to judge where they or their car are located in relation to the external environment. These problems can make driving with external stimuli (such as music) a challenge. They also can cause a person to weave in their lane while driving, have trouble parking their car, or clip other motor vehicles or objects around them.

Memory impairment is another cognitive change that may impact driving. Having an impaired memory may cause a person with Parkinson’s to have difficulty focusing — especially when driving in a new or unfamiliar area.

Vision Changes

Parkinson’s can affect a person’s contrast sensitivity, causing them to have difficulty differentiating objects from the background. This can be particularly dangerous when driving at night or in conditions with reduced visibility, such as fog.

Are There Laws Against Driving With Parkinson’s?

There are no laws in the United States specifically regulating those driving with a Parkinson’s diagnosis, although many states have laws requiring clinicians to report diagnoses of drivers with cognitive impairment and/or seizure disorders. Anyone who knowingly drives with impaired driving ability due to motor, visual, or cognitive impairment and causes an accident could face legal consequences.

Deciding Whether To Drive With Parkinson’s

Deciding to forgo driving is difficult for many people with Parkinson’s. It requires taking many different factors into account, including the severity of your symptoms and feedback from loved ones. One member said deciding not to drive was a “hard pill to swallow for a motorhead like me,” but it “took a motorcycle accident to put me straight.” Another shared that they “hate the thought of not being able to drive.”

One member put it this way: “I know that giving up driving is one of the hardest things to deal with, but if you have delayed reaction time, even mild issues with spatial distances, or have trouble when under pressure or when faced with the need to make an immediate decision, you should not drive. The feeling you have over losing driving privileges is nothing compared to the feeling you would have if you were the cause of an accident that injured or killed someone else.”

Another member shared their experience of realizing that it was not safe for them to drive: “I surrendered my license no sooner than I realized that I was a danger on the road. Sometimes, my hands used to shake uncontrollably, and my right foot went tap-tapping on the accelerator or the brakes — especially when there is a jam-up near the stop sign or the traffic lights. This caused undue stress on me and my life.”

One member offered the following advice: “The question I always ask myself is: ‘Would I drive with my grandchildren in the car?’ (Or even: ‘Would I drive ON THIS ROAD or IN THIS RUSH HOUR TRAFFIC or IN THIS WEATHER with my grandchildren in the car?’) I’m not going to do anything to risk injury to any of them, and when my answer becomes, ‘No,’ then I will either refuse to drive or hand over my license.”

Many members have expressed fear of losing their independence by being unable to drive. “I’m reluctant to give up driving because I want to hang on to the last bit of independence I have!” a member shared.

However, many members share that they have found ways to adapt to this change. One said, “I avoid the highway and don’t drive at night.” One member switched to a car that was easier to drive: “I had to purchase a new vehicle because I have always driven a stick shift. Now I have an automatic.”

Notably, a person’s risk when driving doesn’t just depend on their symptoms. Other factors should also be taken into account, including age, as older drivers often have decreased visual acuity and slower reflexes.

Driving Ability Tests

Taking a driving ability test can help you get a better sense of your safety while behind the wheel. The Rookwood Driving Battery (RDB) is a driving assessment that correlates best to driving ability in those with Parkinson’s. The RDB is a series of neuropsychological tests designed to evaluate basic neuropsychological functions critical for safe driving.

A poor score on the RBD can mean the person has impaired driving ability, but the results depend on several variables. One member advised that a regular road test does not take into account all the different situations a person may find themselves in while driving. “You need to be honest with yourself when making your decision,” they wrote.

One member shared their experience taking a driving ability test: “My occupational therapist referred me to a driver testing facility to have a test. They do not report the results to your Department of Motor Vehicles (DMV), so when you find out the results, you can decide whether or not to keep driving… .”

The member explained their reasoning for taking the test. “In case I was ever in an accident, the other party would not be able to blame the accident on my PD because I’d been tested as a safe driver in spite of my PD.”

Ultimately, each individual living with Parkinson’s has a different level of driving risk at different times throughout their disease. Thus, in general, there is no standard clinical assessment that can be counted on to consistently predict driving risk in those living with Parkinson’s.

However, some researchers are working on assessment aids to help potentially impaired drivers and their clinicians make more effective decisions about whether or not to drive. Talk to your doctor and ask your family and friends how they feel about your driving. It can be helpful to see if they’ve noticed anything that might indicate that Parkinson’s has affected your ability to do so safely.

When To Talk to Your Loved One About Driving With PD

Friends and family members play an important role in deciding whether their loved one with PD should keep driving. Your parent or other aging loved one may not notice that their driving skills are deteriorating.

If you have a loved one living with PD, look for signs of problems with completing basic tasks. These may indicate that the person’s driving skills have been compromised. Things to watch for include:

• Disorientation in places they know
• Lack of personal care
• Short-term memory loss
• Difficulty making decisions or solving problems
• Reduced coordination

As tremors, fatigue, and other symptoms make it hard to drive safely, family members, caregivers, and friends may urge loved ones with Parkinson’s to stop driving. “My wife and kids pleaded with me to give up my keys last fall for fear of me CAUSING an accident as much as getting in one,” explained one member.

Some things to watch for while your loved one is driving are:

• Drowsiness behind the wheel
• Increase in traffic tickets
• Parking inappropriately
• Forgetting to signal turns
• Ignoring or not seeing traffic signs
• Losing their way in familiar locations
• Stopping unexpectedly

While discussing the subject can be difficult, staying safe while driving is critical. It’s important to discuss your concerns with your loved one and their neurologist to keep everyone safe. There may be ways to help keep your loved one driving safely for a while longer. Their neurologist should be able to provide a referral to a driving rehabilitation specialist or occupational therapist who can help your loved one improve their driving skills.

Other Options for Getting Around With Parkinson’s

These days, there are many options for getting around without having to drive yourself. Some alternative forms of transportation include carpooling, ride-share apps like Uber and Lyft, and public transportation. One member even shared that they leased a Motability scooter as a mode of transport.

Giving up the keys can mean saving a lot of money — no more car payments, car insurance, gas, maintenance, toll roads, or parking fees.

Take some time to reflect on the benefits of giving up driving and see how you can make the most of this transition. You may find that you enjoy the new perspective you gain by navigating the world in different ways.

Find Your People

On MyParkinsonsTeam — the social network for people living with Parkinson’s and their loved ones — more than 86,500 members from around the world come together to discuss life with Parkinson’s, ask questions, share tips, and meet others who understand what they’re going through.

How has Parkinson’s affected the way you drive or get around? Did you have to stop driving? Share your experiences and tips in the comments below or by posting on MyParkinsonsTeam.