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Can You Drive After A Stroke? Safety Considerations and Rehab Techniques

senior man driving for the first time after his stroke, his wife is in the passenger seat smiling at him

Driving after stroke is a complex issue because everyone experiences side effects differently. The severity of the stroke and unique side effects that follow will determine whether or not you can immediately get back behind the wheel.

Many people that sustained mild strokes are able to drive immediately after stroke. However, those experiencing moderate to severe side effects, such as impaired mobility or vision, may need rehabilitation before passing a driving test.

You’re about to learn what signs to look for when determining if you can drive again after stroke. It’s essential to work closely with your medical team and your local driving agencies before driving again. Not just for your safety, but for everyone else on the road.

At the end of this article, you’ll discover steps you can take with rehabilitation to help improve your chances of passing a driving test and getting back behind the wheel.

You can use the links below to jump straight to any section:

When Can You Drive After a Stroke?

close up of elderly woman behind the wheel, smiling because she can drive again after a stroke

Many guidelines for driving after a stroke recommend waiting at least one month before trying to drive again. This allows your brain enough time to heal.

However, for those who have suffered a massive stroke, the wait will most likely be longer.

After you have waited the recommended time, you should consult your doctor, who will assess your driving fitness.

Your doctor will look for any lingering physical or visual problems that can impair your driving skills. There are five major challenges that your doctor will consider before allowing to get behind the wheel after your stroke.

1. Physical impairments

Hemiplegia, which causes paralysis on one side of the body, is one of the most common stroke side effects and perhaps the biggest obstacle to driving after a stroke. In addition, if a stroke occurs in the motor cortex, it can cause severe weakness in your hands, arms, or legs.

Other physical effects which can make it unsafe to drive include pain, sensory problems, and dizziness. Spasticity is another common side effect of stroke, and can greatly restrict movement.

Fortunately, many of these challenges can be overcome with adaptive driving equipment and therapy. A solid exercise regimen can help you regain muscle movement and strength and let you get back on the road sooner(more on this later).

2. Vision problems

senior woman holding glasses and rubbing her eyes

About two-thirds of stroke survivors suffer from some sort of vision problem. Since, visual acuity can allow you to drive safely again, treating visual problems after stroke is imperative.

Some of the various vision problems you might experience after stroke include:

  • Blurred or double vision
  • Problems with depth perception
  • Loss of central vision
  • Loss of peripheral vision

Vision therapy can often treat these issues, but it’s critical to wait until you have been cleared by a medical professional and your local driving agency (DMV) before attempting to drive after a stroke.

3. Cognitive effects

Driving a car not only requires physical strength and endurance, it also takes a significant amount of mental agility. Cognitive skills needed to drive safely after stroke include memory, concentration, problem-solving and multi-tasking.

Unfortunately, a stroke can damage all these skills, which will make driving too dangerous for some stroke survivors. However, by practicing cognitive training, you can improve your mental skills and become one-step closer to driving again after stroke.

4. Fatigue

elderly woman resting on couch because she has fatigue, which can impair her ability to drive after a stroke

Another common side effect of stroke that could impair your driving abilities is fatigue.

Post-stroke fatigue can make it difficult to stay focused on the road or make quick judgments. In severe cases, it may even cause you to fall asleep at the wheel.

Therefore, it is important to make sure your fatigue is under control before you start to drive after a stroke. While it may seem impossible at first, there are effective ways to overcome fatigue after stroke and regain more control of your life.

5. Epilepsy

Finally, about 5-10% of stroke patients will experience a seizure after stroke. Some will go on to experience multiple seizures and develop post-stroke epilepsy.

If you only experience one seizure after stroke, you can still drive, as long as you have no other impairments. But if you have epilepsy, it will be more difficult to get a driver’s license approved.

Self-Assessing Signs that a Person Should Not Drive After a Stroke

Strokes often impair a person’s self-awareness about how their abilities have changed. As a result, the patient might not realize that they are not fit to drive anymore.

Therefore, family members and caretakers should watch carefully for signs that the person is not ready to drive after stroke. Some of these signs include:

  • Needing instructions from passenger
  • Easily frustrated or confused
  • Drifting across lanes
  • Getting lost in their own neighborhood
  • Driving faster or slower than the posted speed
  • Making slow or poor decisions

If the person displays any of these signs, prevent them from driving until they can get their skills evaluated by a driving rehabilitation specialist.

How Your Doctor or Driving Instructor Tests Your Ability to Drive

woman taking a driving test while driving instructor writes on his clipboard

Your doctor or therapist can perform a few quick tests in the office to gauge your driving abilities. These tests include:

  • Road sign recognition test, which assesses visual comprehension and traffic knowledge.
  • A compass task, which examines visual acuity, cognitive agility, and attention skills.
  • A trail marking test that measures visual-motor tracking and visual scanning abilities. For example, your therapist might have you draw a line across the page connecting various letters and numbers.

Depending on the state you reside in, a doctor’s approval might be all you need. But some states do require a stroke patient to also pass an on-road driving test.

Fortunately, according to a review of 30 studies involving over 1,700 stroke patients, more than half of all stroke patients will pass a driving safety test. However, most patients waited until about 9 months after their stroke to take their test, which allowed them time to recover their skills.

If you do not pass your initial test, you may be eligible to use adaptive equipment, which can help restore your ability to drive.

Adapting Your Car for Driving After Stroke

If you have chronic physical limitations after your stroke, that does not mean you will never drive again. In fact, it’s possible to adapt your car in ways that can allow you to drive after a stroke.

There are a variety of tools available that can help make driving easier for those with physical complications. Some examples of car adaptations include:

  • Spinner wheels, which attach to your steering wheel for one-handed steering
  • Left-foot accelerators, for those with right side impairments
  • Swivel seats, that help you get in and out of the car

Besides these tools, there are many other ways to adapt your car to meet your needs. Talk to your occupational therapist for a full list car of adaptations that are right for you.

Rehabilitation Techniques for Driving Again

While adaptive equipment might help some stroke survivors immediately get back on the road, it’s important to recognize that they are compensation strategies. Therefore, rehabilitation should be pursued to prevent overreliance on adaptive techniques.

Fortunately, the brain possesses a remarkable ability to repair itself and recover lost function through a process known as neuroplasticity. Neuroplasticity helps the brain actually rewire neural pathways, which allows undamaged portions of the brain to take over functions from damaged ones.

Therefore, even if you have lost strength in your arm or leg, or you have difficulties with attention or vision, it is still possible to regain those abilities and recover the skills you need to drive.

You can activate neuroplasticity through intensive, therapeutic exercise. Some therapies that can explicitly address the abilities needed to drive again after a stroke include:

  • Vision therapy. Eye exercises can help restore visual clarity and scanning skills after a stroke. Work with a vision therapist who can diagnose your unique vision problems and recommend targeted exercises.
  • Cognitive exercises. Practicing certain cognitive exercises such as memory games can engage neuroplasticity and the mental abilities you need in order to drive.
  • Foot drop exercises. Foot drop can significantly impair driving skills. Fortunately, foot drop exercises can help you overcome this issue, which will allow you to use your car gas and brake pedals again.

Finally, physical therapy exercises can help you recover motor function in your arms and legs, but it’s important to practice these exercises every day. In fact, research indicates that it takes about 400-600 repetitions to effect changes in the brain, which is more than a patient can perform if they only exercise once or twice a week at therapy.

That’s why home therapy devices such as Flint Rehab’s FitMi home therapy are helpful for patients who wish to drive after their stroke. FitMi engages the whole body, and helps the patient accomplish 23 times more repetitions than traditional therapy. This can allow to get back behind the wheel even faster.

Ensuring You Can Safely Drive After a Stroke

elderly grandma sitting behind the wheel of her car with the passenger door open, smiling at the camera and giving a thumbs up because she can drive again after a stroke

For many people, driving after stroke represents the ultimate goal of recovery. The ability to go where you want, when you want, is a crucial piece of independence that everyone wishes to hold on to.

We hope this article has shown you that, with the right rehabilitation and preparation, driving again after a stroke is a definite possibility.

But it’s also important to remain realistic. Driving is a dangerous activity, and if your cognitive or physical abilities are too impaired, you can endanger the lives of both yourself and others.

That’s why the best way to ensure that you can safely drive again after a stroke is to work with an occupational therapist. They can identify the areas where you need to improve and walk you through the entire driving rehabilitation process.  

Featured Image: ©iStock/monkeybusinessimages

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Get Inspired with This Stroke Survivor Story

Mom gets better every day!

When my 84-year-old Mom had a stoke on May 2, the right side of her body was rendered useless. In the past six months, she has been blessed with a supportive medical team, therapy team, and family team that has worked together to gain remarkable results.

While she still struggles with her right side, she can walk (with assistance) and is beginning to get her right arm and hand more functional. We invested in the FitMi + MusicGlove + Tablet bundle for her at the beginning of August.

She lights up when we bring it out and enjoys using it for about 20 to 30 minutes at a time. While she still doesn’t have enough strength to perform some of the exercises, she rocks the ones she can do!

Thanks for creating such powerful tools to help those of us caring for stroke patients. What you do really matters!

David M. Holt’s review of FitMi home therapy, 11/09/2020

5 stars

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