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DEAR DR. ROACH: A former neighbor who’s experiencing a gradual cognitive decline from dementia recently received a letter from our state’s DMV saying that her driver’s license was being revoked because of a letter she received from her neurologist. She steadfastly maintains that she’s fine and there’s nothing wrong with her, although those of us who know her are very aware of her diminished capacities. Fortunately, she reluctantly moved into assisted living a few months ago and will be able to get rides provided by the facility to doctor’s appointments, for shopping, etc.
Eight years ago, my own 95-year-old father began experiencing a rapid onset of dementia. This was coupled with a near complete loss of vision from a herpes infection that was very difficult to treat. Despite our pleas to his doctors and the local police, no one was willing to take the step to inform the DMV and ask them to revoke his license.
It led to a very ugly scene with me, him and my siblings, where we literally had to grab the keys from his hands and physically disable his vehicles. Until then, we lived in fear that he’d cause a bad wreck or possibly kill someone. Within a few weeks, his condition deteriorated, and he passed away in a memory care unit several months later.
Both of these incidents occurred in the same state (about 100 miles apart), so we’re puzzled as to why, in my father’s case, none of his doctors would take the initiative to assist in having his license revoked. But in our neighbor’s case, her neurologist readily initiated the process to have her license revoked.
Are doctors reluctant to get involved, thinking they have legal liabilities, or are there other remedies that we could’ve taken to get an obviously incapable driver off the road? -- A.O.
ANSWER: Only six states have mandatory reporting laws (California, Delaware, Nevada, New Jersey, Oregon and Pennsylvania). For the rest, reporting is left to the discretion of the physician. Only three states accept anonymous reports, and in many states, the person can learn which physician reported their impairment. Thirty-seven states protect physicians from legal liabilities; the rest don’t.
I suspect that many physicians are unaware of their responsibility to notify authorities about impaired drivers (whether it’s due to dementia like Alzheimer’s, epilepsy, or some other condition). Others might think that a different physician would do so (a primary care physician versus a specialist, for example). Some may be concerned for their legal liability, as you suggest. (They may not think about their legal liability if they don’t report it and their patient has a collision that injures someone else.)
Some physicians may not know how, as several states don’t provide instructions on how to do so. (I’m leaving a link with complete instructions for each state on my Facebook page: Facebook.com/KeithRoachMD.) However, I think the major reason is a fear of eroding the trust that’s necessary for an effective relationship.
Family members can help in this situation. Not only do most states accept unsafe-driver referrals from family members, they can provide their loved one’s physician with factual information about collisions, near-miss events, getting lost, aggressive driving, etc. The physician can then use this knowledge to provide accurate information to the DMV. Physicians don’t decide whether a license is revoked (although only 4% of drivers who get reported by a physician retain their licenses).
Physicians who are in the situation of deciding whether they need to report a case should consider:
• Whether there are any medications that impair driving
• Treating any conditions that might affect driving (sleep apnea, cataracts and others)
• Having a frank discussion with the patient and their family
• Requesting a formal driving evaluation, if the physician’s unsure
• “Prescribing” driving cessation both verbally and in writing prior to reporting, if the physician’s sure that their patient is impaired
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.(c) 2026 North America Syndicate Inc.
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