When can a Stroke Survivor drive?
When it came to driving, Rick was a “rebellious teen”. The return to driving is a big step that not only affects your loved one and you, but also everyone sharing the road. He felt that he had been driving for years and now this vital part of his independence was gone. The location of the stroke and the subsequent recovery is a determining factor on their ability to drive again. This may be an ongoing argument, and you need to remain strong.
During inpatient therapy and for about six months after, Rick understood he was not healthy enough to drive. The impairment of his reflexes, decision making, coordination and memory was acute. With each improvement, we had hoped that he would be back to 100 percent. Unfortunately, he was not, and adaptations had to be made. He was determined to drive as soon as possible. He thought he was ready long before I felt he was. Stand firm when you hear:
I feel so much better. I can run to the store for you.
You have been doing so much. Let me run some errands.
There are guys at rehab that drive themselves and they are in worse shape.
I can drive. How can I get better if you never let me try? You are so overprotective.
To others - She won’t let me drive even though I can with no problems.
Where are the keys? I just need to run out for a minute.
I am not an invalid. I can drive.
Being his caregiver was tiresome, the constant battle over driving, I felt like the bad guy. There were times when I wanted to throw the keys at him and let him go because his behavior exhausted me. But I didn’t. I had a responsibility to Rick and others to keep them safe. Remember, saying no is the right choice, but as with the teen, they are relentless.
How to determine they are ready to drive
For the caregiver, this is one of the hardest determinations I would make. We had been through a very difficult life change, and I was overprotective. With Rick, we did not know the cause of the stroke, and therefore, did not know if another stroke could or would happen. I needed to rely on several resources in making this decision, such as our healthcare team and family.
Many stroke survivors return to driving with no type of formal safety assessment. An on-road driving test is the most thorough way to gauge a driver’s ability. The test takes about forty-five minutes and involves driving with a trained evaluator or driving on a computer simulator. Driving provides a sense of independence and freedom, but safety takes on greater importance poststroke.
One of the best resources for driving after a stroke was the stroke.org site. For more information, please visit your state’s department of motor vehicle website.
At the nine-month mark poststroke and many requests from Rick to drive, I started to reintroduce driving. His physician recommended a slow start, and he was not allowed to drive alone, so we did things in steps like how we taught our teens to drive.
Step 1: Practice in an empty parking lot.
The most arduous tasks are starting and stopping the car both easily and then abruptly. The major concern was reaction time behind the wheel.
Step 2: Set guidelines for driving.
Initially, only during the day and only during low traffic times. We live in a neighborhood with children and have a responsibility to keep them safe.
He had to demonstrate good reaction time before being allowed on the roads.
The physical therapist had approved that he was ready to drive before we drove on the road.
Step 3: Practice driving to places that are very familiar.
We practiced driving to church, the store and to our friend’s house. When practicing, I recommend that only you and your spouse are in the car with no distractions (no radio or conversation at first, as well).
Step 4: Practice driving to places that require more thought and directions to get to the location.
Warning: Your loved one will likely get lost. Be patient and see what they can do before you jump in. We had a twenty-minute trip that took an hour at first, but we arrived safely.
Step 5: Once approved to drive alone by the physician and/or by meeting your state’s driving requirements.
Start with small trips to well-known places alone. Rick stayed within a five mile radius from home and there were no highways.
A key component is communication. Rick needed to always have his phone with him and to call when he arrived and then when he left to come back home. I found he was ready to drive long before I was ready to hand over the keys.
Finally, letting go:
Rick has been driving independently for some time without issues. During this time, we both learned a few tips to ensure safe driving. Rick has been driving independently for some time without issues. During this time, we both learned a few tips to ensure safe driving.
Assess fatigue level prior to operating a vehicle.
Signs of fatigue for Rick are slow or slurred speech, difficulty finding words or difficulty walking. He does not always recognize fatigue and will want to continue to drive. This remains my ongoing role.
After any outing or social event lasting over three hours, Rick would not drive and agreed to be the passenger.
Have a plan before you leave the house.
We determine how long he will drive and when I will be the driver.
We continued with the code word “Albert Einstein” to alert me when he was tired and needed to go home.
I drive when we are going to an unfamiliar location for the first time.
We always use a navigation device when driving. These are great verbal cues for Rick on where to go and early alerts on when a direction changes. I have become the navigator on trips.
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