Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, February 28, 2022

Driving after a stroke - UK

 

 I thought the driving simulator was worthless.

My return to driving was with an occupational therapist; Drive right now with no practice and see if you pass, almost guaranteed for 90+% to fail. And since they never pulled my license I just started driving after having to buy a new automatic transmission car.

Driving after a stroke - UK

You're not legally allowed to drive for a month after a stroke or transient ischaemic attack (TIA). Some people have to stop driving for longer, or will not be able to drive again. This page explains what to do if you are a driver, including when to tell the DVLA (DVA in Northern Ireland).

This web page gives you general information about driving after a stroke. You should always get individual advice from your doctor about your stroke and any other health conditions that affect your driving. 

The information on this page can be accessed in the following formats: 

On this page:

Key points 
How can a stroke affect my driving? 
Do I need to tell the DVLA/DVA about my stroke? 
Starting to drive again 
If you drive for a living 
What if I can’t go back to driving? 
Alternatives to driving 
Worried about someone's driving? 

Key points

  • By law, you must not drive for a calendar month after a stroke or transient ischaemic attack (TIA).
  • It is your responsibility to tell the DVLA (DVA in Northern Ireland) about any medical condition that affects your driving.
  • If you have a licence to drive a large goods vehicle (LGV) or passenger carrying vehicle (PCV), you must tell the DVLA/DVA about your stroke or TIA straight away.
  • Car and motorbike drivers don’t usually need to tell the DVLA/DVA about a stroke in the first month, but there are some exceptions.
  • If you have a car or motorbike licence, and you can drive safely, you may be able to start driving again after a month. But it depends on what type of stroke you had, and other health conditions like epilepsy.

Not sure what to do?

The team of stroke professionals involved in your care may help with assessing the skills you need for driving. They can also advise whether it is safe for you to return to driving.

You might need some more information about your own condition before you decide what you need to do. It can be helpful to speak to your doctor to check what type of stroke you had, and how many strokes or TIA you had.

You can find detailed information about how your medical condition affects your driving in the guide for medical professionals on the DVLA website.

What if my doctor says I should not drive?

If your doctor tells you to stop driving for three months or more, you should contact the DVLA/DVA to tell them about your medical condition. You might need to send back your driving licence, but wait until you speak to the DVLA. They will tell you what to do next.

How can a stroke affect my driving?

After a stroke, your ability to drive safely can be affected in various ways. You may have physical or visual problems, or you may have difficulty concentrating for long periods of time or making quick decisions.

Physical effects
Weakness in your arm, leg or both is common after a stroke. You may also experience other physical effects which include pain, changes in sensation, weakness and problems with balance.

Vision problems
A stroke can cause a variety of problems with your sight. These include double or blurred vision, loss of central vision in one or both of your eyes, and visual field loss.

Cognitive effects
Driving requires many different cognitive skills. You need to be able to concentrate, navigate, multitask and make quick decisions. After a stroke you may have difficulty concentrating, understanding, solving problems, or making decisions. Your perception of space and distance may have changed, or you may have problems with your memory.

Fatigue
After your stroke, you may find that you lack energy and feel extremely tired. This may affect your ability to concentrate and maintain alertness while you drive.

Seizures and epilepsy
If you have any seizures after your stroke, you must stop driving and need to tell the DVLA/DVA. Depending on the type of seizures you might be able to start driving after six months or a year, but the DLVA/DVA could decide on a longer period.

Do I need to tell the DVLA/DVA about my stroke?

No, if:

If you drive a car or motorbike and you had a single transient ischemic attack (TIA) or stroke with no brain surgery or seizures, you can usually start driving again after one calendar month. You only need to tell the DVLA/DVA if your stroke affects your ability to drive. 

The exception is that you must tell the DVLA/DVA if you had a stroke due to a bleed in the brain known as a subarachnoid haemorrhage (SAH). This is a type of haemorrhagic stroke, sometimes called a brain haemorrhage or brain bleed. Your GP or stroke team can tell you what type of stroke you had, and you can read our information about haemorrhagic stroke.

Yes, if:

  • You are a Group 2 driver (lorry and bus).
  • Your ability to drive has been affected.
  • You had several TIAs.
  • You had more than one stroke in three months.
  • You had a subarachnoid haemorrhage (a type of brain bleed).
  • You had any seizures.
  • You had brain surgery.
  • Your doctor tells you not to drive.
  • If your disability or health gets worse.
  • If one calendar month after a stroke or TIA, your stroke has affected your driving.
  • If you need to drive a vehicle with adapted controls.

Large vehicle drivers
If you drive a large vehicle such as a lorry or bus, you must tell the DVLA/DVA about your stroke or TIA as soon as possible. You can’t drive for a minimum of one year after the stroke or TIA. Whether you can drive again will depend on the type of stroke you had, and how the stroke has affected you. If you are unsure, ask your GP or a member of your stroke team, and speak to the DVLA/DVA.

If you don’t tell the DVLA/DVA about a medical condition that affects your driving, you could end up with a criminal conviction. You could be fined up to £1000, and you could be prosecuted if you have a collision.

If you are not sure what to do, always get individual advice about your stroke or effects of stroke from your stroke team or GP.

How do I tell the DVLA/DVA I've had a stroke?

Step 1

  • England, Scotland and Wales: car licence holders can report a medical condition online. Car and lorry drivers can download a form at gov.uk/health-conditions-and-driving.
  • Northern Ireland: you can contact the Drivers Medical Section of the DVA by post, phone or email (see the end of this guide for details).

Step 2
Where possible, the DVLA/DVA will make a decision using the information you provide. If the DVLA/DVA requires more information they may:

  • Contact your GP or consultant.
  • Arrange for you to be examined by a medical officer or specialist.
  • Ask you to take a driving assessment.

Step 3
Once the DVLA/DVA has received all the relevant information they will make a decision about whether you can drive again.

The DVLA/DVA may make one of the following decisions:

  • You may be able to keep your licence.
  • You may be issued a licence for a fixed period of one, two, three or five years, (one, two or three by the DVA) after which time your medical fitness will be reviewed again.
  • You may be issued with a licence to drive a vehicle with adapted controls.
  • Your licence may be taken away. If this happens, you will be given a reason for this decision. You will be told whether you can reapply for your licence, and you will receive a notice explaining how you can appeal the decision.

The DVLA aims to make a decision within six weeks. You will be notified if the decision is going to take longer.

If the DVA are making the decision, they will aim to decide within three to four weeks. If further information is required about your medical conditions or you have a LGV or PCV licence, the decision may take longer.

Starting to drive again

If you are able to return to driving, the choice of when and how to do it is a personal one. 

If you have an occupational therapist, talk to them about it. They can tailor your therapy to help prepare you to return to driving. An automatic car can be easier to drive than a manual.

Before you start driving again, you may find it helpful to have a few refresher lessons with a qualified driving instructor. You can find driving instructors in your area by looking in your local phonebook or on the internet. Check that they are registered with the Driving Standards Agency (DSA). Mobility centres can also provide advice about returning to driving.

Insurance
Before you start driving again you must tell your insurance company about your stroke or TIA. If you don’t do this, it might invalidate your insurance. Insurance companies have their own processes, so talk to yours to find out more. Check your policy carefully. They might want confirmation that you are safe to drive.

Having a medical condition can make insurance more expensive. Try shopping around for a competitive quote, or look for a specialist insurance provider when you need to renew.

If you drive for a living

If you drive as part of your work, a stroke can affect your income and way of life.

You might have to take a break from your usual work until the DVLA/DVA allows you to return to driving. Some people will not be able to go back to work and may need to re-train or look for new types of work or a new career. People tell us that this can be a huge challenge. Seeking work at the same time as dealing with fatigue or other effects of stroke might feel hard to cope with. 

Seek advice from your local Job Centre Plus, which has advisors for people with disabilities. Ask your GP if there are occupational health services in your area that can support you. 

Licensed taxi drivers must tell their local authority licensing department about their stroke and any medical conditions. Drivers of larger vehicles (lorries or buses) have a minimum of a year away from driving after a stroke or TIA. If you drive a police or health service vehicle, your employer may follow the same rules as for larger vehicle licences.

Sick pay and benefits
If you are off work while recovering from a stroke or TIA, you might get sick pay from your employer. If you are self-employed you may be able to claim Employment and Support Allowance or Universal Credit. Find out what benefits you can claim.

Returning to work as a driver
If you're able to go back to driving, you may need to change your working hours or shift pattern to avoid fatigue. You might need to use different equipment for some tasks. If you are employed, speak to your employer about how the stroke could affect your work and discuss a ‘return-to-work plan’. This could include regular chats with your manager to check if there are any problems, and agree any changes needed to help you return to work. It may be possible to do a different type of work with the same employer.

Driving to get to work
If you rely on a car to get to work, and you find it difficult to use public transport due to mobility problems, you may be able to get funding for taxis to work via the Access to Work scheme. Your employer might be able to support you working from home some or all of the time.

If you can get to work by public transport you might be able to get reduced price travel such as a Disabled Person’s Railcard. If your licence has been revoked for medical reasons, you are entitled to a free bus pass in most areas. In Northern Ireland, you can get a SmartPass giving you half price travel. In London, you can get a Freedom Pass. Apply through your local council.

What if I can’t go back to driving?

If you are unable to drive, you may feel that you've lost some of your independence. You may have to rely on others to get out and about, particularly if you live in a rural area and public transport is hard to access. You might feel isolated, frustrated, or low.

Talk to your family and your healthcare professionals about how you're feeling. They can help you to look at other options that will help you do the things that are important to you.

There could be ways of getting around in your area, such as using bus, train, taxis or community transport schemes.

Many people recover from some of the effects of their stroke over time. If you improve, you might be able to have a repeat driving assessment at a later time. When your licence has been returned, refresher driving lessons can help you regain confidence.

If you are feeling very low or anxious, speak to your GP, or contact our Helpline for ideas about how to get emotional support.

Alternatives to driving

Community transport
In some areas, local councils provide community transport schemes for people who have disabilities and are unable to use public transport. The services vary, but they may be able to take you door-to-door to places in your local area or on shopping trips. Contact your local council to find out more about schemes in your area. There are also dial-a-ride services in many parts of the UK where you can book wheelchair-accessible transport.

Access to work
If you are can’t use public transport because of your disability, the Access to Work scheme may be able to help you with the cost of getting to and from work. Speak to a Disability Employment Adviser at your local Jobcentre Plus (Jobs and Benefits Office in Northern Ireland).

Trains
You may be able to buy a Disabled Person’s Railcard. This entitles you to a third off the cost of most rail fares in England, Scotland and Wales. It also gives you a third off pay-as-you-go Oyster fares on Transport for London trains. If you live in Northern Ireland, you could be entitled to a half-fare SmartPass which can be used for bus and rail travel – contact Translink.

Bus
If you can’t get a driving licence for medical reasons, you can get a free bus pass, a Freedom Pass in London. You may be entitled to a free bus pass if you have a disability. In England and Scotland contact your local council or local authorities in Wales. In Northern Ireland, you may be entitled to the SmartPass, which gives you half price travel, if you receive the mobility component of Personal Independence Payments (PIP) or Disability Living Allowance (DLA). 

Shopmobility
Many towns and shopping centres in England and Wales also offer Shopmobility schemes that hire out manual wheelchairs and powered scooters to anyone who needs help with getting out and about.

Motability scheme
If you are receiving certain benefits you might be able to exchange some or all of your benefit to lease a new car, powered wheelchair or scooter through the Motability Scheme. To be eligible you need to be on a disability benefit such as the higher rate mobility component of Disability Living Allowance or Personal Independence Payments. Others include the War Pensioners' Mobility Supplement and Armed Forces Independence Payment.

Even if you can’t drive, you can still get a Motability vehicle and choose other people to drive for you. A Motability car could be used to drive you around, and also for journeys to support you even if you’re not in the car, such as doing your shopping.

The Blue Badge scheme
The Blue Badge scheme lets you park in convenient spaces in car parks and on-street parking areas. You can use your badge in any car, as a driver or passenger. Your local authority will be able to tell you if you are eligible for a badge, how to apply and more details about the scheme.

Specially adapted cars
There are various vehicle adaptations and motoring accessories that can make driving possible and more comfortable with a physical disability.

Specialist mobility centres can carry out assessments and provide advice about making adaptations to your vehicle which can enable you to return to driving. They can also provide assessments for passengers with disabilities, and information on how to safely lift wheelchairs in and out of a car. There are centres across the UK.

Worried about someone’s driving?

If you are worried about the safety of someone’s driving, it can be a tricky subject to talk about. But it’s vital to make them aware of your concerns, not just for their safety, but for the safety of others on the road.

If a person has been driving for many years it can be hard to suddenly stop, and it can change the way they see themselves. So they may need support and guidance from family, friends and professionals.

Sometimes stroke survivors find it difficult to recognise the effects of stroke. Stroke can also affect your judgement and, in rare cases, someone can be unaware they have a disability. This is called anosognosia.

Family members and professionals may need to remind them that they can no longer drive because of the potential risk to themselves and others. You could read this guide together and talk about the other ways of getting around, and plan some of the journeys they might want to make using alternative types of transport.

If you feel that the person is not safe to drive and they refuse to stop driving, you can write to the DLVA in confidence online.

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