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Driving After a Stroke

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Beyond convenience and necessity, driving is important for a feeling of independence. Unfortunately, stroke can affect the areas of the brain that control the abilities necessary for driving, from perception and decision- making to reflexes and motor control. The ability to react quickly may be lost. Peripheral vision may be limited. Paralysis, partial paralysis or weakness, and difficulty coordinating muscle movement (spasticity and ataxia) are some of the stroke conditions that can make it difficult to drive safely.

Because of these problems, driving after a stroke may be dangerous. Survivors and caregivers should carefully consider whether it would be safe for the survivor to drive again.

Safety is the primary concern, so it's important for you to be able to spot the signals that indicate driving may be unsafe. The American Stroke Association has identified these warning signs. Driving is dangerous when the survivor:

  • drives too fast or too slow for road conditions or posted speeds
  • needs help or instructions from passengers
  • doesn't observe signs or signals
  • makes slow or poor decisions about distance
  • gets easily frustrated or confused
  • gets lost often, even in familiar areas
  • has accidents or close calls
  • drifts across lane markings into other lanes

NOTE: Survivors may have difficulty noticing any difference in their driving ability since their stroke, even if the warning signs are obvious to others. Don't expect them to agree immediately to give up the keys.

Who To Talk To

If driving is determined to be a possibility for your survivor, here are some suggestions as to what to do to next.

  • First step, talk to an occupational therapist. She can provide up-to-date information and a professional opinion on the survivor's capabilities.
  • Next, contact your state's Department of Motor Vehicles (DMV). Ask for the office of driver safety to get the requirements for survivors who want to drive.
  • Finally, have your survivor tested. Professionals such as driver rehabilitation specialists can perform a reliable assessment of driving ability. A typical test will evaluate perception, functional ability, reaction time, and performance behind the wheel. Depending on your state's laws, your survivor may need to apply for a new driver's license.

Tip: When a survivor has completed physical and occupational rehab but still hasn't regained his or her driving abilities, a driver-retraining program may help. These programs can provide driving assessments, classroom instruction, and suggestions for modifying a vehicle with adaptive equipment. Check with your local rehab center or contact the Adaptive Driving Alliance (623-434-0722 or www.adamobility.com) to locate a program in your area.

Adapting a Vehicle

Your survivor may be able to drive safely if his vehicle is properly adapted. Some adaptive innovations include:

  • A spinner knob for the steering wheel, which enables one-handed driving (Check with the DMV to make sure it's legal to use a knob in your state.)
  • A left-foot gas pedal for survivors who cannot use their right foot
  • Hand controls
  • Wheelchair lifts and restraint systems for minivans

Tip: If your vehicle needs modifying, research costs and ask dealers about financial assistance programs. Nonprofit agencies sometimes offer grants to pay for modifications, and some health-insurance plans and workers' compensation programs offer financial assistance. Check with your state's department of vocational rehabilitation.

Once the vehicle is adapted, there are training requirements for operating an adapted vehicle. The equipment provider typically gives information on the use of your adapted vehicle, but the survivor will also need instruction from a qualified driving rehabilitation specialist. To locate a specialist in your area, contact the Association for Driver Rehabilitation Specialists at 1-800-290-2344 or www.aded.net.