The diagnosis is new. The car keys are still on the hook by the door. And nobody has said anything about driving yet.
This is one of the most common situations we are called into on the Gold Coast. A family knows something has to change, but nobody is sure what the rules actually are, who is supposed to do what, or how fast any of it has to happen.
This guide walks you through it. It is written for the family member doing the worrying, not for the person with the diagnosis. If you are looking for the assessment process itself, we have covered that in dementia and driving in Queensland.
Does a dementia diagnosis mean the licence is gone?
No. Not automatically, and not straight away.
A diagnosis of dementia does not cancel a licence. What it does is change the type of licence a person can hold. Under the national medical standards that Queensland follows, a person with dementia cannot hold an unconditional licence. They can, in many cases, hold a conditional licence, which means the licence continues but with a review date attached, and sometimes with limits on where or when they can drive.
Whether that conditional licence is granted depends on how the person is actually driving now, not on the label of the diagnosis. Some people in the early stages of dementia drive safely for a period of time. Others do not. That difference is what an assessment is for.
What we can say honestly is that dementia gets worse over time, and driving does eventually stop for everyone with the condition. The question is when, and how well the family handles it.
Who has to tell Transport and Main Roads?
In Queensland, the legal duty sits with the driver.
Anyone with a long-term medical condition that is likely to affect their driving must report it to Transport and Main Roads (TMR). That is a legal responsibility, not a suggestion. You can read the official wording on the Queensland Government's reporting page.
In practice, this is where families get stuck. The person with dementia may not accept that they have a condition affecting their driving, so they do not report it.
You have three realistic options.
Ask them to report it, with support. This works more often than people expect, particularly soon after the diagnosis while the person is still processing it. TMR has an online notification service, or they can submit a medical condition notification form (F4355) by email or post.
Raise it with their doctor. Their GP or specialist can complete a Medical Certificate for Drivers, which goes to TMR. Doctors in Queensland are able to report a patient directly if they believe the person is not safe and will not report themselves.
Report your concern yourself. A family member can contact TMR's Medical Condition Reporting Unit. This is not something we suggest lightly, because it can damage trust badly, but it is available when the risk is serious and nothing else has worked.
Our general advice is to start with the doctor. It keeps the decision clinical rather than personal, and it takes the weight off you.
What actually happens after it is reported
The sequence in Queensland is fairly consistent.
The doctor completes a Medical Certificate for Drivers (Form F3712) setting out the diagnosis and their opinion on fitness to drive. TMR reviews it. In most dementia cases, an occupational therapy driving assessment will be requested before a decision can be made, because it is considered the 'gold standard' for assessing someone with a medical condition.
The assessment happens, the report goes back, and the GP/TMR makes a licensing decision. That decision is usually one of: a conditional licence with a review date, a conditional licence with restrictions on it, or cancellation of the licence.
Timeframes vary. Expect several weeks from the doctor's appointment to a decision, sometimes longer.
Can they keep driving while all this is happening?
Usually yes, unless their doctor has told them to stop.
This surprises families, and it is worth being clear about. Reporting a condition does not suspend a licence. If the doctor has said "you should not drive until this is sorted out", that instruction stands and should be followed. If the doctor has not said that, the person is generally allowed to continue driving while their paperwork is being processed.
If you believe they are unsafe right now, do not wait for the process. Speak to the doctor and say so plainly.
What the driving assessment involves
An occupational therapy driving assessment has two halves and takes around three hours in total.
The first half happens at home. We go through medical history, medications, vision and physical movement, then some pen-and-paper and iPad-based tasks that look at the thinking skills driving relies on. Not memory for its own sake, but things like divided attention, planning, reaction speed and the ability to switch between tasks. We have explained what these actually measure in how cognitive skills affect driving.
The second half is on the road, in a dual-control car, with a specialist driving instructor alongside the occupational therapist. It runs in the person's own local area, on roads they know, because that is where they will actually be driving. Nobody is trying to catch them out with unfamiliar territory.
You can read a fuller walkthrough in what to expect on the day.
Should you be in the car?
No. Families sometimes want to come along, and we understand why, but having a relative in the back seat changes how someone drives, and usually not for the better.
What is genuinely useful is talking to us beforehand. If you have noticed specific things, getting lost on a familiar route, kerbing the car, hesitating at intersections, becoming aggravated more easily behind the wheel, tell us. That information helps us assess properly. It is treated as clinical background, not as evidence against them.
If the outcome is that they have to stop
This is the part families dread, and it is worth preparing for.
Losing a licence is not a small administrative event. For someone in their seventies or eighties on the Gold Coast, the car is often the difference between an ordinary week and an isolated one. The grief is real and it is usually bigger than families expect.
A few things help.
Have the alternatives ready before the outcome arrives, not after. Look into the Queensland Taxi Subsidy Scheme, council community transport, and what family and neighbours can realistically cover. A plan that exists on paper on day one lands much more softly than a conversation that starts with "well, what are we going to do".
Let the report be the messenger. One of the reasons families use an independent assessment is that it moves the decision away from the dinner table. It is much easier to be sad together about a decision made by an assessor and TMR than to be the person who took the keys.
Expect some anger, and do not take it personally. It is almost never really about you.
We have written more on the emotional side in worried about a parent's driving on the Gold Coast, and on the outcomes themselves in what happens if you fail an OT driving assessment.
Frequently asked questions
Can I book the assessment on my parent's behalf?
You can make the enquiry and organise the logistics, and most of our bookings come from family members. The person being assessed does need to consent to it, and they need to hold a current licence.
Do we need a referral from the GP first?
Not to talk to us. You can get in touch at any point and we will explain the process. A GP referral and the medical certificate are needed for the licensing side of things, and we can tell you what your doctor needs to complete. There is a guide written for GPs at a GP's guide to referring in Queensland.
My parent refuses to be assessed. What can we do?
You cannot force an assessment. What you can do is involve their doctor, who can decline to certify them as fit to drive, which puts the matter in front of TMR regardless. Refusing an assessment does not preserve a licence.
What does it cost, and can it be funded?
Fees depend on the assessment type and location. Dementia assessments are most often paid privately, and occupational therapy driving assessments are GST-free. We have set out the funding options in OT driving assessment cost in Queensland.
How often will they be reassessed?
If a conditional licence is granted, TMR sets a review date, and for dementia this is typically annual. Because the condition progresses, a licence granted this year may not be renewed next year.
Is it worth doing at all if dementia only gets worse?
Often, yes. An assessment can give someone a documented, safe period of continued driving rather than an abrupt stop, and it gives the family a clear timeline instead of an argument. It also means that when driving does end, the decision has been made properly.
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.
References
Austroads. (2022). Assessing fitness to drive for commercial and private vehicle drivers (6th ed.). Austroads. https://austroads.gov.au/publications/assessing-fitness-to-drive/ap-g56/neurological-conditions/dementia
Queensland Government. (2024). Reporting your medical condition. Department of Transport and Main Roads. https://www.qld.gov.au/transport/licensing/healthy-to-drive/report-medical-condition
