Driving after Stroke

DRIVING AFTER STROKE

Driving is an important part of many people’s lives. When a person is no longer able to drive, it can greatly affect the individual’s life. Work, social activities and daily movement in the community may all be affected. Often, people who have had a Stroke wish to resume driving. It is an important step in re-establishing independence in daily activities.

Driving is a complex task requiring integration of visual, mental and physical capacities. After a Stroke, the ability to drive safely can be impaired. Physical weakness, altered sensation, reduced speed in responding to information, problems with memory and concentration, damage to vision, reduced reaction time, difficulties with reading, and other consequences of a Stroke will affect driving ability.

Many people will be able to return safely to driving following a Stroke. However, considering the seriousness of the decision to resume driving, an assessment may be required to make sure the person who had a Stroke is able to drive safely. Someone who would be putting themselves or other road-users at risk if they continued to drive, will not be able to resume driving. According to the Austroads Draft Guidelines (May 2021), you should not drive for at least 1 month after a Stroke and returning to driving depends upon your doctor’s assessment. This is to allow time to recover from the Stroke and for your condition to stabilise. Some people may require a longer period and specialist assessment before they resume driving. Others may require further driving training and to undertake a further driving assessment test with the relevant government authority prior to being reissued with their license.

What you should do before resuming driving

When you feel you are ready to resume driving you should:

1. Consult your rehabilitation specialist or local doctor and be guided by his or her advice. A medical report for driving needs to be completed and sent to the Roads and Maritime Services at your local Service NSW office. When making the assessment, the doctor will consider the stability of your condition and any likelihood of a recurrence.
2. Inform the RMS (Roads & Maritime Services) of your medical condition.
3. Inform your insurance company of your medical condition to ensure that you are adequately covered in the case of an accident.
4. You may require a review by an eye specialist to assess any visual damage resulting from the Stroke.
5. If you have any problems in function following the Stroke, it is recommended that you undergo an assessment by an occupational therapist trained in driver assessment and rehabilitation. A clinical examination by your doctor may not detect subtle problems which could affect your ability to drive. The driving assessment is not free but will include an off-road assessment and an on-road driving assessment. Following the assessment, a report is written giving recommendations as to your fitness to drive and a rehabilitation plan for driving, if appropriate.

Rehabilitation

If the assessor recommends rehabilitation, this may include:

• Advice about appropriate vehicle modifications.
• A program of lessons to enable you to develop driving skills and regain confidence in driving.
• Referral to other health professionals (eg, ophthalmologist, psychologist).

Cancellation of your license

Cancellation or suspension of your license may occur if the deficits caused by your Stroke make driving dangerous for you and other road users. This can be reviewed if your function improves. If you are not satisfied with the outcome of your assessment, you have the right to seek a second opinion and you can appeal to the local court.

If you wish to have a driving assessment, please contact OT Australia NSW to obtain a list of service providers.

Acknowledgements: Australian Brain Foundation (Victoria) Ltd. Pamphlet for driving after a Stroke. Neurocare Australia. AUSTROADS (Draft Guidelines 2021) 3rd Edition. Assessing fitness to drive: Guidelines and Standards for Health Professionals in Australia. Austroads INC: Sydney.

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Using Electric Vehicles (EV) after Stroke

Across Australia, there are currently over 445,000 people who are living with the effects of a Stroke. Experiencing a Stroke is a life changing event, and you’ll likely have to adapt to new ways of doing many different things. Particularly if you’re eager to maintain your independence, one area you may have to address is your car and the way you drive. Getting back on the road can be a daunting prospect, and you’ll want to ensure you’ve taken every possible precaution to make sure that you can continue to get around safely.

By now you’ll be familiar with the eco benefits that come with driving an electric vehicle (EV). They have gained popularity in recent years as a green vehicle alternative, as the world tries to reduce the effect of climate change. But did you know that they can also offer plenty of additional benefits for drivers who have experienced a Stroke? In this article, the potential impacts that Stroke can have on your driving ability and the potential advantages that an EV could offer you are discussed.

How can a Stroke affect driving ability?

As with any medical issue, there is likely to be varying levels of severity between Stroke survivors, meaning people will be affected in different ways. However, there are a few typical effects of Strokes that can impact a person’s ability to get back behind the wheel. One of the most prevalent is pain and weakness in arms and/or legs, which can make driving a standard car more uncomfortable.

Eyesight is also often affected by a Stroke, and people may experience double or blurred vision. They might also find that their cognitive abilities have been negatively impacted, which can affect many different aspects of their ability to drive safely. These include making quick decisions, navigation and concentration.

As such, it’s crucial that you take the time to understand how the effects of a Stroke may influence your driving, allowing you to make informed decisions around how to best keep yourself and other road users safe.

Benefits of an EV post-Stroke

There are many different features that come as standard in the majority of electric vehicles that can each offer their own advantages to drivers who have experienced a Stroke. Here are some of the assistive features that can create a smoother, more comfortable driving experience:

• Automatic gears – Particularly for drivers who commonly experience pain in their arm(s), having automatic gears as standard will make it easier to get behind the wheel, particularly over prolonged journeys. Having one less thing to worry about (changing gears) can give drivers more freedom to concentrate on other aspects of driving, such as speed control or their position on the road.
• Spacious interior – With internal combustion engines being replaced by electric motors, EVs are typically far more spacious, allowing for a more comfortable ride for both the driver and their passengers. A Stroke can affect mobility, making it difficult to get in and out of a car. As such, the additional space inside an EV could help to make this process easier, and improve comfort throughout your journey.
• Compatible with assistive modifications – After doing some research, you may find that the safest way to get back behind the wheel is by making use of some assistive technologies. There are many different modifications that can be made to EVs to support drivers, such as hand controls and steering aids. Check out all of the available options and you’ll be sure to have the reassurance that you’re fully equipped to drive safely once again.

Accessible adaptions for EVs

EVs are capable of being fitted with a number of adaptations to make them more accessible to drivers. Here are some of the best options that can be added to your vehicle:

• Hand controls – Introducing something like a push or pull device to help with accelerating and braking can be useful for drivers who aren’t able to freely use the lower half of their body.
• Pedal modifications – If you still want to use pedals as they are traditionally intended, you can extend them to reach up to your feet. This makes driving more comfortable and simple for those who cannot reach them at the standard distance.
• Electronic accelerators – For those who aren’t able to freely use pedals when driving, but also lack the strength to use a push and pull lever, there are a series of electronic accelerators available. Each of these will come with a hand-operated brake device. These can be placed throughout different areas of your vehicle:
  • Trigger accelerator – pull this forward to accelerate and push away to brake.
  • Over ring accelerator – placed on the steering wheel, pushing down to accelerate.
  • Under ring accelerator – put behind the wheel, with speed controlled by you pulling it towards the wheel.
  • Ghost ring accelerator – fitted behind the wheel, with a driver controlling speed by moving it from side-to-side.

This article was developed and provided by Auto Traders (https://www.autotrader.co.uk/cars/electric/ev-drivers-with-disabilities/)

© Stroke Recovery Association NSW 2023