Stroke is a medical condition that impacts people in various ways and differs in severity between individuals. It occurs when an artery becomes blocked or bursts, preventing the brain from receiving its essential supply of blood. This then results in the death of brain cells, as the brain becomes starved of nutrients and oxygen. There are two sorts of strokes: haemorrhagic and ischaemic.
- Haemorrhagic: When bleeding occurs in the brain due to a burst blood vessel
- Ischaemic: When an artery in the brain becomes blocked due to a blood clot
Driving after a stroke is a serious issue as this medical condition can be life-threatening and requires urgent medical attention, especially for those about to take the wheel. If a stroke incident occurs, they are required afterwards by law to notify the RMS of their medical condition. Many drivers in NSW are unaware that they have a fundamental responsibility to inform the RMS of any medical condition or disability that may affect their ability to operate a vehicle. For many people after experiencing an incident, this notification is usually attended to by their treating specialist or GP, through the completion of the RMS medical ‘fitness to drive’ form. On this form, the doctor makes a clinical decision regarding the person’s functional capacity to get back on the wheel.
Once the RMS is made aware of the individual’s medical condition, they notify the person (usually by post) of the requirement to have undergone an Occupational Therapy (OT) driving assessment, as recommended by their treating doctor. Usually, doctors allow for a 3–6 month time period before recommending that the person completes the OT driving assessment after a stroke.
At Modified Driving, we provide a comprehensive driving assessment after a stroke to make sure you are able to get back on the road as safely as possible.
Driving after a stroke is never a good idea as it can affect the person both cognitively and physically. While the person’s doctor performs various medical assessments and tests to monitor their recovery after the incident, they do not witness the person operating a vehicle. Thus, the OT driving assessment serves to determine if there are any ongoing effects that this medical condition has caused on the person’s vehicle operation skills.
The OT driving assessments examines the 3 areas that are required for operating a vehicle: vision, cognition and physical capacity. Unfortunately, this medical condition can affect all 3 of these areas, causing reductions in a person’s capacity to operate a car safely and to proper standards. Our Occupational Therapists will go to the individual’s home and assess all 3 of these areas. Any deficits that are detected are documented and discussed with the person (and their family). Once this is completed, the individual completes a 1-hour drive in their local area with the Occupational Therapist and a Driving Instructor. The instructor utilised has completed specific training to work with people with medical conditions. The focus of the driving assessment is to determine if any of the deficits that were detected earlier, or the symptoms of their medical condition, impact the person’s ability to drive competently. It is important to note that the assessment is primarily concerned about how their medical condition has influenced vehicle operation ability, and is not majorly concerned about minor errors made due to poor habits, being unaccustomed to the car, or because of nervousness due to testing conditions. After the assessment, the OT will explain to the individual the outcome of the test and their recommendations moving forward.
There are 4 potential outcomes of the Occupational Therapy Driving Assessment.
1. It is determined that the stroke does not impact the person’s ability to drive safely and to RMS standards. The Occupational Therapist will send a report to both the RMS and the individual’s referring doctor. The individual will then be able to operate a vehicle with an unrestricted licence.
2. It is determined that the person requires vehicle modifications, which the OT will prescribe. This generally occurs when the individual has sustained physical deficits due to the incident e.g. weakness in a limb. In this case, the individual will require additional lessons with an instructor to learn how to drive with the modifications, and then complete an RMS Disability Driving Assessment before they can continue using the vehicle. The OT will outline a lesson plan to best assist the person to become proficient with using the modification. The specific modification will then be endorsed on the individual’s licence (meaning that they will not be legally able to operate a vehicle without the modification).
3. It is determined that the stroke is impacting the person’s ability to operate a car and is resulting in some errors that require lessons with an instructor to rectify. With this outcome, the Occupational Therapist will state that the individual will require a certain number of lessons with an instructor to overcome the assessed deficits or errors. A lesson plan will be developed, outlining specific goals that the person is expected to complete. The Occupational Therapist may also request that the individual completes another on-road driving assessment with the Occupational Therapist, depending on the severity of the identified errors. Once the individual completes the lessons and can drive safely, a report is sent to the RMS and the individual’s doctor, and the person can continue to operate a car with an unrestricted licence.
4. It is determined that the person can no longer drive safely and their licence will be canceled. This outcome generally occurs when an individual is unable to rectify or show improvement with any of these deficits noted, where further lessons or vehicle modifications will not help the individual to return to using their vehicle. This is generally when the effects of the stroke are cognitive e.g. severe issues with concentration, attention or decision-making.