Driving After a Stroke: What You Need to Know

How long after a stroke can I start driving again?

Most stroke survivors can return to independent, safe driving eventually, according to the NHTSA. But each case is different and “it really depends on how the stroke affected them,” says Joel Stein, M.D., chair of the department of rehabilitation and regenerative medicine at Columbia University and a spokesperson for the American Stroke Association. 

“There are some patients whose effects of stroke are so minimal and so transient, that maybe all they need is sort of a green light and reassurance,” he says. But he adds, “there are a lot of people who are in that sort of unclear zone.” Stein gives the examples of patients with uncontrolled seizures or left-side neglect, a visual impairment where the patient does not pay attention to things on the left side. “Those kinds of things put driving off the table, at least for the short run.”

In addition to visual and cognitive abilities, for some patients it may take time to regain adequate physical function to use the steering wheel, foot pedals and navigation controls, says Preeti Raghavan, M.D., a professor of stroke treatment, recovery and rehabilitation at the Sheikh Khalifa Stroke Institute at Johns Hopkins Medicine in Baltimore.

“If any one of these abilities is compromised, rehabilitation specialists can help in both assessing the degree of compromise and with retraining. Some therapists are certified to perform driving assessments as part of routine therapy.”

Where can I test my driving to see if I’m OK? 

If you find yourself driving too fast or too slow for road conditions or posted speeds, getting lost in familiar areas, making slow or poor distance decisions, or having close calls, working with an occupational therapist who specializes in driver rehabilitation can be an important first step in getting back on the road safely. Training sessions not only assess if you’re road-ready, but also help you get the skills you need to drive safely. 

To find a driver rehabilitation provider in your area, visit the American Occupational Therapy Association.

You can also try the AARP Smart Driver Course. It’s one of many programs offered by AARP Driver Safety. It’s the nation’s largest classroom and online driver safety course, and it’s designed especially for drivers age 50 and older.

Is it legal to drive after stroke? 

It’s also important to know the laws in your state. Contact your State Department of Motor Vehicles and ask for the Office of Driver Safety. Ask what rules apply to individuals who have had a stroke. In some states, it is illegal to drive after a stroke without your doctor’s consent. Maryland law, for example, requires drivers to “self-report” medical conditions such as traumatic brain injury and stroke. 

Be proactive by alerting your doctor to changes 

Talk to your doctor about any changes in cognition such as memory, attention, problem solving and organization, and make a list of questions and concerns prior to the appointment to ensure that you cover everything, Jaywant says.

Request a comprehensive neuropsychological evaluation, often completed by a neuropsychologist, that assesses cognitive strengths and weaknesses and helps inform your treatment plan. 

Early cognitive therapy is a crucial component and is typically carried out by an occupational therapist, speech-language pathologist, and occasionally by the neuropsychologist themselves.  

In my case, returning to driving took patience, work and a bit of good fortune, but the brain is an amazing organ. After a lot of language therapy and the time it took for my brain to heal — a natural process called neuroplasticity — I have been driving for the past 12 years.