Driving After A Stroke: For the Survivor

Author: Peggy Gannon

If you are a stroke survivor and did not read my last posting…do it now! The tips I wrote were more for family members, but you could benefit yourself from reading and taking them to heart. It is always good to have an idea of what our caregivers may be thinking and going through.

With that in mind, I want to address to address a few areas that I have seen over the years that either help or hinder, depending upon how you are affected, a safe return to driving. Most people are able to return to driving following a stroke. Some may do it very quickly, while others may take years. I am always amazed at a person’s desire to return to this task and the work they will put in to achieve it.

Some of the areas affected that you may need to address are:

vision driving rehabilitation stroke recoveryVision

Following a stroke, it is not uncommon for someone to have a change in vision. It may be their acuity (how clearly they see things), it may be their visual fields or it may be a perceptual issue. It is important that if you have had changes in your vision that you address them prior to driving. A new pair of glasses may be a quick fix for some. If you have more significant changes or problems with your vision you may need to address it in therapy. Unfortunately, some visual issues, such as a field loss, can’t be changed by therapy. It may or may not resolve and improve. Therapy can help you learn to compensate, but it cannot change the problem. Florida has some specific rules regarding driving and peripheral vision. If you have questions on this, your vision specialist should be able to provide more information.

reaction time driving rehabilitation stroke recoveryReaction Timing/ Processing Speed

When we think about driving, we can’t help but think about speed. It is a fast task. I have met many people who, following their stroke say to me, “ I am not as fast as I used to be. It is hard to focus on multiple things.” Well, driving demands that you do all that and more. It is hard to tell someone how to think quicker. It doesn’t work that way. You can, however, try to engage in tasks and activities that force you to think quicker. Computer games, some board games, sports etc…can all push us in that direction. If you are still in therapy, let your therapist know you feel this is an issue for you and they should be able to incorporate tasks that address it. If you try to visualize how this can affect driving, think about going up the ramp to merge onto the interstate. You know how frustrating it is to have someone ahead of you going slow and not merging like they should. That is a prime example of someone with slowed processing. They can’t take in the cars approaching, keep their car moving rapidly and get into that traffic. It can be dangerous for all drivers, not just the one going slowly.

decision making stroke recovery driving rehabilitationDecision Making

Should I go or should I not? This ties in somewhat to processing speed, but it is also making the decision to whether or not it is safe to enter into traffic. The above two areas can greatly affect one’s ability to make a sound decision, but it can also be that the stroke has affected the frontal lobes where our executive skills are maintained. Making a bad decision can be very dangerous and can cost lives.

Spatial Awareness

To put that in words we can sink our teeth into, it means knowing where you, your body or the car are in relation to each other. I can’t tell you how many times I have been in the car and the person is driving off the road, on the other side or down the middle. They may or may not be able to find the pedals easily. Sometimes, it is not totally evident that a person has a deficit in this area until they are actually driving. I had a gentleman that I saw several years ago who had a stroke that affected the right side of his body. He went through inpatient and outpatient therapy and progressed well. He walked, talked and for all outward appearances, you could not tell he had had the stroke. When he got behind the wheel, however, for his driving evaluation, we both discovered that he had no idea where his right leg was unless he could see it. So, he had a lot of difficulty getting back and forth to the gas and brake. He scared himself enough to realize that this was not the way he should be driving. His future goal was to use a left foot accelerator.

I must restate again…prior to returning to driving, you must be released by your physician. It is extremely important that this is done so there is documentation that states you have his/her approval. You can not operate off the assumption that just because you have a license you are able to do so. The thought behind it is that you have been ill enough to require an extended hospitalization. The brain has been affected by the stroke and although you may feel great, your physician is responsible for giving his approval on this. One last thought…I use this analogy all the time when speaking. You are like a cake that is not quite baked after your stroke. Your batter is still a little wiggly. Given time and therapy, your cake begins to “bake” and you become solid again. Driving is the icing on the cake. It takes all the other areas to be fully baked before you should attempt it. So…go get cooking!

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