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Letting him continue to drive when you know he has dementia is the wrong thing to do (and could end up killing him or other people).
He stops driving today! Please make it happen.
https://www.agingcare.com/topics/44/driving
Why didn't the neurologist "see the MRI? " This was the 1st visit. Was he or she given copies of the MRI imaging &/or written report before or at this 1st visit?
Or are you referring to a previous MRI that that this neurologist does not have information about? If yes, then do everything possible to provide the neurologist a copy of the written report regarding the MRI. OR if you cannot obtain the MRI report, ask the neurologist to order a new MRI.
In my experience it is usually the patient's neurologist who decides whether the patient is neurologically able to drive safely.
Once the neurologist has reviewed all the available medical test results & imaging ( such as an MRI of the brain, etc) other medical records, and results of the neurologist's own office exam, he or she can give a diagnosis or at least a " working diagnosis" of the type if neurological issue the patient has.
At that point the neurologist can usually make an informed opinion regarding whether the patient has any neurological impairments that could interfere with driving safely.
In some states ANYONE (not just a doctor) can report a driver as unsafe to the state agency that determines whether to issue people a drivers licenses. This agency probably investigates the validity of the report and tests the reported driver if necessary.
Check into whether anonymous reports of unsafe drivers can be made. Remember that these reports are only for the purpose of protecting the driver and other drivers and people on the road. So complaints should never be made to harass someone for non-driving related matters and there may be bad repercussions for false reports.
Finally, if a person is concerned about their parent's or other family member's or loved one's driving, they can also seek a driver's safety test from an occupational therapy department at a hospital or at a private business (sometimes a driving school) that routinely tests people's driving competency. The private business will of course charge for the test. The occupational theorapy office MAY accept payment by private insurance companies if the service is covered by the driver's policy. If you are on Medicare I suggest the driver check whether Medicare will pay for it.
Good luck keeping your loved one and other people on the road safe. It is very noble of you.