After having a stroke, many survivors are eager to start driving again. Driving offers independence and the ability to go where you want to go on your own schedule, so it is no surprise that survivors want to get back behind the wheel rather than rely on someone else for their transportation needs.

Unfortunately, having a stroke can have lasting effects that make driving more difficult. A survivor might not be aware of all of the effects of their stroke and could misjudge their ability to drive safely. Driving against a doctor’s orders after a stroke is not only dangerous, it may even be illegal. Many stroke survivors successfully regain their ability to safely drive after a stroke, but it is important that they do not attempt to drive until they are cleared by their healthcare provider.

How Stroke Affects the Ability to Drive

Having a stroke can affect an individual's ability to drive in numerous ways, whether it be because of physical challenges, cognitive changes, or other challenges.

Physical Challenges

After a stroke, it’s common to experience weakness or paralysis on one side of the body, depending on which side of the brain the stroke occurred. More than half of all stroke survivors also experience post-stroke pain. Minor physical challenges may be overcome with adaptive driving equipment, but severe challenges like paralysis or contracture can seriously affect an individual's ability to drive.

Cognitive Effects

Driving requires a combination of cognitive skills, including memory, concentration, problem solving, judgement, multitasking, and the ability to make quick decisions. A stroke can cause cognitive changes that limit the ability to do many of those things.

Vision Problems

As many as two-thirds of stroke victims experience vision impairments as a result of a stroke. This can include vision loss, blurred vision, and visual processing problems. Stroke survivors with vision problems should not drive until their problems are resolved and they have been cleared by a doctor.

Fatigue

Fatigue is a common physical condition after a stroke that affects between 40 and 70 percent of stroke survivors. Fatigue can arrive without warning, so it is dangerous to drive when suffering from post-stroke fatigue.

Warning Signs of Unsafe Driving

Stroke survivors are not always aware of how their stroke has limited their ability to drive. If they are choosing to drive after their stroke against their doctor’s advice, it is important for them and their loved ones to look out for warning signs that they might not be ready to start driving. Here are some of the common warning signs to look out for:

• Driving faster or slower than the posted speed or the wrong speed for the current driving conditions
• Consistently asking for instruction and help from passengers
• Ignoring posted signs or signals
• Making slow or poor decisions
• Becoming easily frustrated or confused
• Getting lost in familiar areas
• Being in an accident or having close calls
• Drifting into other lanes

If you or your loved one is showing any of these warning signs, immediately stop yourself or them from driving until your or their driving is tested.

Driving Again After a Stroke

Before a stroke survivor begins driving again, they should speak with their doctor or therapist to discuss whether or not it would be safe for them to continue driving. Many states require mandatory reporting by a physician to the DMV if their patient has impairments that may affect their driving after a stroke. Even if their doctor clears them to drive, they still will likely need to be evaluated by the DMV before they regain their driving privileges.

Driver rehabilitation specialists are available to help stroke survivors evaluate their driving ability from behind the wheel. There are also driver’s training programs that provide a driving evaluation, classroom instruction, and suggestions for modifying a car to the individual driver’s needs. For instance, an occupational therapist can provide a comprehensive in-clinic evaluation of a client's current skills and deficits relative to driving.

From there a client could be sent for an in-vehicle assessment for further evaluation by a certified driver rehabilitation specialist (CDRS). They can assess driving skills in a controlled and safe environment. An in-vehicle driving test is the most thorough way to gauge a driver's abilities. Each assessment takes about 1 hour and involves driving with a trained evaluator or driving in a computer simulator.

The "behind-the-wheel" evaluation will include testing for changes in key performance areas such as attention, memory, vision, reaction time, and coordination. After this assessment the CDRS can determine if the client is safe to drive, can not drive at all, or may drive with additional recommendations.

Often times clients may require certain modifications to their car in order to drive safely. In addition, some clients may benefit from on-going classroom training and simulation training in order to meet safety standards. These are all services that a driver rehabilitation specialist can provide. To help find these resources, The Association for Driver Rehabilitation Specialists has a directory of certified driver rehabilitation specialists, driver rehabilitation specialists, and mobility equipment dealers and manufacturers.

Get Back Behind the Wheel

Many stroke survivors successfully drive after a stroke; however, not all are able to. While reclaiming independence is important, staying safe is the greatest concern. It is important for stroke survivors to listen to their doctors and wait until they are fully ready before attempting to drive again. With some hard work and patience, getting back behind the wheel is possible.

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All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.