The Keys in the Bowl Are an Exit: How to Tell the Car Has Become a Way Out at Dusk

A car is a door that moves. For someone with dementia who is trying to leave the house at dusk, a set of keys in a bowl by the entry can look like a plan, even when she has no clear destination. The problem is not the car itself. The problem is that the keys are the easiest way to act on an urge she may not be able to explain.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

What the car looks like as an exit

Think about what the keys mean to her. They are a familiar object tied to a skill she once had, and touching them can feel like getting ready to go somewhere. That feeling can start before she knows where she wants to go. If the keys sit in plain sight by the door, the car is one motion away, and the motion is easy to take in a moment of restlessness.

Signs you are seeing it

Look for a pattern rather than a single event. You may be seeing a shift if she:

• goes to the key spot first, before anything else, when the light starts to fade,
• asks where the car is, or says she needs to get to a place she cannot name,
• sits in the car in the driveway or on the street, with or without the engine running,
• finds keys in odd places, such as a coat pocket, a purse, or a drawer, or has a spare set you did not know about.

If you see two or three of these in the same week, treat it as a signal to change the setup now, not after the next incident.

Who holds the keys

Decide who owns the keys, and say it out loud to everyone who visits. The person who holds them should keep them out of sight, not only out of reach, because a visible key can still start the urge. Put them somewhere your household agrees on and check that the spare set is in the same place or with the same person. Do not hide keys in a way that leaves her searching and upset, and do not argue about where they are. A calm answer such as that the car is being serviced, or that the keys are with a neighbor for the evening, is often enough to move the moment along.

When to ask for help

Whether she should keep driving is a question for her doctor, and the state licensing office is the place to ask about the legal side of a license. This article cannot answer that for her. What you can do is write down the signs above, bring them to her next appointment, and ask her doctor what to watch for at home. If she is already trying to drive or has taken the car out without you knowing, call her doctor the same day and ask what to do next.