The results of a previous study indicate that in general, older drivers who recognise cognitive problems show realistic self-assessment of changes in their driving skills and that driving-related discomfort may function as an indirect monitoring of driving ability, contributing to their safe driving performance. The aim of the present study was to examine whether these findings also apply to cognitively impaired older drivers. Structured face-to-face interviews were conducted with 25 cognitively impaired older drivers. The results showed that the participants were most likely to report their driving skills as unchanged. There was an association between level of discomfort and avoidance of driving situations, but not between cognitive status and discomfort or avoidance. The results suggest that cognitively impaired older drivers constitute a unique group; while cognitively impaired older drivers may recognise cognitive problems, they tend not to recognise changes to their driving, which may reflect reluctance to acknowledge the impact of cognitive impairment on their driving. Furthermore, the results suggest that driving-related discomfort plays an important role in the self-regulation of driving among cognitively impaired older drivers. However, it is less clear what triggers driving-related discomfort among cognitively impaired older drivers indicating that it may be a less reliable aspect of their self-monitoring of driving ability.