A dementia diagnosis doesn't automatically mean someone has to stop driving. But it does trigger a legal requirement to notify Queensland Transport and Main Roads (TMR), and in most cases, a process to determine whether driving is still safe.

Understanding how this works can make things much less stressful for everyone involved. This article explains the process in Queensland.

Dementia must be reported to Queensland Transport

In Queensland, drivers are legally required to notify TMR of any permanent or long-term medical condition that may affect their ability to drive safely. This includes dementia.

The fine for not reporting can be significant, more than $9,600, and your licence may be cancelled.

In practice, the notification is usually handled by the person's GP or specialist, who completes the Medical Certificate for Motor Vehicle Driver (Form F3712) and submits it to TMR.

What your doctor decides

When completing Form F3712, your doctor makes a clinical judgement about fitness to drive. The three possible outcomes are:

The dementia is not currently affecting driving, and the person can continue to drive. This is less common, as most doctors prefer a formal driving assessment to be certain.

It's unclear whether the dementia is affecting driving, and an OT driving assessment is recommended. This is the most common outcome. Your doctor may indicate on the form that you should not drive until the assessment is completed.

The dementia is clearly affecting the person's ability to drive safely, and the doctor recommends licence cancellation. This is reserved for cases where the dementia is at a later stage and the risks are obvious.

For most people with a recent or early-stage diagnosis, the doctor will refer for an OT driving assessment.

Why an OT assessment, not just a doctor's opinion?

Driving is a practical skill. Your doctor can assess your cognition in the clinic, but they can't observe you driving. A driver-trained OT bridges that gap by assessing your functional abilities and then watching how those abilities play out on the road.

This is especially important with dementia, because the condition can affect driving in subtle ways that aren't obvious in a clinical setting. Someone might perform adequately on a basic memory test in the doctor's office but struggle with the divided attention and rapid decision-making that driving demands.

What the OT driving assessment involves

The assessment has two parts and takes approximately 2 to 3 hours.

Part 1: Off-road (clinical) assessment

This is conducted at your home and covers:

Medical and driving history. A conversation about the person's diagnosis, when symptoms started, what they've noticed, their driving habits, and any concerns raised by family. Family members are welcome to be present and their input is often very helpful.

Vision screening. Visual acuity, visual fields, and other visual skills needed for driving. Some forms of dementia can affect visual processing even when eyesight itself is fine.

Cognitive assessment. This is the core of the off-road assessment. The OT uses validated tools such as the DriveSafe DriveAware (DSDA) to assess the cognitive skills most relevant to driving: attention, processing speed, decision-making, spatial awareness, and the ability to follow instructions.

Physical assessment. Strength, coordination, range of motion, and reaction time.

Part 2: On-road assessment

The person drives for approximately one hour in a dual-controlled vehicle with the OT and a specialist driving instructor, in their local area.

The OT is specifically watching for the signs that dementia may be affecting driving. Common things that show up on the road include:

• Confusion at roundabouts or complex intersections

• Driving well below the speed limit without reason

• Delayed responses to changing traffic conditions

• Difficulty navigating familiar routes

• Forgetting to check mirrors or blind spots

• Inappropriate responses to road signs or traffic signals

• Difficulty managing multiple tasks at once

The OT isn't looking for perfect driving. Minor nervousness-related errors are expected. The focus is on whether the dementia is causing consistent, safety-relevant problems.

Possible outcomes

Fit to drive. The dementia is not currently affecting driving, and the OT recommends the person retains their licence. Because dementia is progressive, regular reassessments will be required, usually annually.

Fit to drive with conditions. The person can drive, but with restrictions such as daytime driving only, local area only, or automatic transmission only.

Driving lessons recommended. Less common for dementia specifically, but possible if the OT identifies specific issues that could improve with targeted lessons.

Not fit to drive. If the dementia is significantly affecting driving safety, the OT recommends licence cancellation. The OT sends their report to TMR, who makes the final decision.

The reassessment cycle

Because dementia is a progressive condition, even people who pass their assessment will need to be reassessed periodically. Your doctor will continue to complete Form F3712, usually annually, and further OT assessments may be recommended over time.

This isn't unusual or alarming. It's the standard process for monitoring conditions that change over time. The goal is to keep the person driving safely for as long as possible, while recognising the point at which it's no longer safe.

When it's time to stop driving

This is the hardest part, for the person with dementia and for their family.

If the OT recommends licence cancellation, some things that can help:

Acknowledge the grief. Losing a licence is a significant life change. It's okay to be upset about it.

Plan alternative transport. Family members, community transport services, taxis, and rideshare services can all help maintain independence. Many local councils on the Gold Coast and in Northern NSW offer community transport for older residents.

Arrange home delivery services. Grocery delivery, pharmacy delivery, and online shopping reduce the practical impact.

For more on this topic, see our article on helping a parent stop driving.

A note for families

If you're worried about a parent or loved one's driving and you suspect a medical condition (such as dementia) may be the cause, the best first step is to raise your concerns with their GP. The GP can assess whether a referral for an OT driving assessment is appropriate.

This takes the pressure off you to be the one "taking the keys away" and puts the decision in the hands of a clinical process.

An OT driving assessment is an independent, objective evaluation. If there's disagreement within the family about whether someone should still be driving, the assessment provides a clinical answer.

Cross-border note

If you live in Northern NSW (Tweed Heads, Byron Bay, Ballina, Lismore and surrounds), the OT assessment process is the same, but the referral goes through Transport for NSW rather than Queensland TMR, and the medical form is different. Steer Driving covers both the Gold Coast and Northern NSW.

How to get referred

Your GP, geriatrician, or neurologist can refer you for an OT driving assessment. They'll need to complete the Queensland Transport Medical Certificate (Form F3712) for Queensland residents, or the Transport for NSW Fitness to Drive form for NSW residents.

If you already have a referral, you can start the process at steerdriving.com.au/referral.

Ready to book an OT driving assessment on the Gold Coast? Steer Driving is a mobile assessment service covering the Gold Coast and surrounding areas. Whether you already have a referral or you're just getting started, get in touch and we'll guide you through the next steps.

This article was written by Elise, an AHPRA-registered Occupational Therapist and driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice.

FAQ Section

Can you drive with dementia in Queensland? A dementia diagnosis doesn't automatically disqualify you from driving. However, the condition must be reported to Queensland Transport and Main Roads, and most people will be referred for an OT driving assessment to determine whether driving is still safe.

Do I have to report dementia to Queensland Transport? Yes. Dementia is a long-term medical condition that may affect driving, and you are legally required to notify Transport and Main Roads. The fine for not reporting can be more than $9,600.

How often do you need an OT driving assessment with dementia? Because dementia is progressive, reassessments are typically required annually. The timing is guided by your doctor and the OT based on how the condition is progressing.

What form does my doctor need to complete in Queensland? Your doctor completes the Medical Certificate for Motor Vehicle Driver (Form F3712) and submits it to Queensland Transport and Main Roads.

Can a family member request an OT driving assessment? Family members can raise their concerns with the person's GP, who can then determine whether a referral for an OT driving assessment is appropriate.

Do you cover Northern NSW as well as the Gold Coast? Yes. Steer Driving covers the Gold Coast and Northern NSW. If you're in Northern NSW, the referral goes through Transport for NSW rather than Queensland TMR.