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Motoring after a brain injury

Here we outlines some of the key things for people who have had a traumatic brain injury to consider when choosing or adapting a car. The model of car that you own or buy will make a big difference to how easy it is to use, whether you are a passenger or a driver. This guide also directs you to the sections of our website that have the detailed information you'll need.

You can also download this as a complete guide: Motoring after a brain injury (PDF). Or you can receive printed publications by post (UK only). A related guide that may be useful is Motoring after a stroke.

Acknowledgements: This guide was produced by Rica with funding from Motability and in partnership with the Forum of Mobility Centres and Headway.

Introduction

Over 134,000 people are admitted to hospital each year with a brain injury. Most are the result of an accident - on the road, at home, at work or from an assault. Other causes of brain injury include infection, stroke, haemorrhage and surgery.

Below, we give details of how a brain injury might affect your driving and what you can do to meet these challenges, as well as legal and insurance requirements you need to know about. 

More detailed information on choosing, adapting and using a car can be found in the following guides:

Choosing a car

This guide covers a range of things to think about if you have a disability. It includes details of features that may help you and ways of adapting a car to suit you. However, you may be able to continue driving an unadapted car, particularly if it has automatic transmission and power steering. Also, the less a car has to be modified to suit your needs, the higher its resale value.

Car controls

There is a range of adaptations that make motoring easier for drivers who have difficulty operating a standard vehicle. See this guide for in-depth information on types of adaptations and how to get them.

Getting into and out of a car

Sometimes, just the right technique is all you need. The guide also covers helpful equipment and details of various lifting systems if you need more help:

  • hoists that lift and lower you on to a car seat
  • lifting seats that swing out and into the car, lowering and locking into a position to suit you

Getting a wheelchair into a car

A run-down of equipment to help you stow or carry a wheelchair:

  • hoists that lift a manual or powered chair into a vehicle
  • rooftop hoists that lift a manual chair up and on to the roof of a car
  • racks that carry a wheelchair on the back of a car
  • trailers and ramps

Driving after a brain injury

Although you may feel able to carry on driving after a brain injury, don't be in a hurry. It can take time to recover and to discover what are the long-term effects of the injury.

One symptom is that you may not be a good judge of what you're able to do. Some people have an unrealistic understanding of the effects of their injury and may not even realise they have a problem. On the other hand, you may find that your family and friends are over-protective and discourage you from driving when you may be able to do so safely. In either case, it is important to understand the legal matters relating to driving after a brain injury.

For these reasons, the most important piece of advice we can give you is to get an independent assessment. This will tell you what can be done and provide reassurance, as well as pointing you towards expert tuition, sources of adaptations and any financial help.

When driving, remember:

  • alcohol can have a greater effect on people who have had a brain injury - don't drink and drive
  • ask your doctor if any medication you take will affect your driving
  • you may get tired more quickly than you used to - allow for breaks

Effects of brain injury

Driving involves judgement and thought, as well as physical action. Brain injury can affect all of these, and any injury may affect your ability to drive.

Choosing a car with the right features or fitting the right adaptations can overcome any difficulties that result from your injury. See the guides to Choosing a car and Car controls for more information.

All of these can improve with time. Although most people keep many of the driving skills they had before the injury, specialist driving lessons may be needed. These will help you learn how to deal with the effects of the injury and how to change the way you drive. Be prepared for this to take time - the injury may mean that you need short, frequent lessons over a longer period than you might expect.

Epilepsy

Epilepsy stops many brain-injured people from driving. Some types of injury mean there's a high risk of epilepsy, particularly if it has required brain surgery. If your injury puts you at risk, you won't be allowed to drive for at least a year, even though you might never have had a fit. If you have had a fit, you can't be licensed to drive for a year afterwards. Medication can control fits, but if your medication is changed, you should stop driving while you adjust to it.

Sight

Brain injury can affect your sight. To drive, you must be able to read a standard-size number plate (with glasses or lenses if you normally wear them) from 20.5 metres (67 feet) away or 20 metres (65 feet) where narrower characters are used. You must also have a sufficiently wide field of vision - some people who have a brain injury have to turn their head to see to the side. The injury can also cause double vision (you may have to wear an eye patch), jerky eye movements (Nystagmus) or other symptoms that can affect your judgement of speed, distance and depth. Often people with these problems are unaware of them. An orthoptist or ophthalmologist (they specialise in injuries to and diseases of the eye) will need to assess and treat any visual impairment you have.

Physical disabilities

Brain injury is unlikely to result in physical disabilities alone, although you may have these too, particularly if you've been injured in a road accident. These physical effects can include paralysis of part of the body, loss of feeling and you may have less control over some movements. Some people become less coordinated. These are very unlikely to stop you driving.

Thinking

Symptoms that affect thinking can make a difference to your driving. These can include:

  • gaps in concentration - you may be easily distracted, get muddled when there's a lot going on or just lose track
  • patchy memory
  • reduced ability to read the road or work out what's happening in complex situations - for example, you may not notice a stop sign
  • reduced ability to reach the right decision in time, or to correctly gauge speed and distance - some people can't foresee the consequences of actions or situations
  • slow reactions
  • reduced ability to control your temper

Legal matters

Driving if you are unfit to do so is illegal. You must tell the Driver and Vehicle Licensing Agency (DVLA) and your insurance company about your injury.

It is likely that your licence will be withdrawn for six months or a year. After that, you can reapply. Your condition will be monitored during this time. With your permission, the DVLA will consult your GP or hospital consultant. From this, the DVLA decides if you are fit to drive. Possible outcomes are:

  • keeping your full licence
  • being issued with a time-limited licence, which would be reviewed after this period
  • being issued with a licence to drive only automatics or suitably adapted vehicles
  • the DVLA may ask you to take a driving test or go to a Mobility Centre for an assessment
  • if your full licence is withdrawn, you may be given a Provisional Disability Assessment Licence, for taking an assessment and training

If the DVLA do not think it would be safe for you to drive, they will withdraw your licence - they will tell you how to appeal. If you are a professional driver, more demanding medical standards apply.

You must tell the DVLA if your condition gets worse or if anything else affects your ability to drive.

For further information on getting a driving licence, go to the DVLA website or get 'What you need to know about driving licences' (D100) from a post office.

Driving ability assessment

Many people are unaware of some of the ways in which a brain injury has affected their driving. If there is any doubt at all about this, an expert assessment is essential. Mobility Centres provide impartial assessments. These generally include driving on local roads. The centre will tell you:

  • if your injury means you should drive or not
  • the effect that your injury has had on seeing or thinking, how this might affect your driving and how to modify it accordingly
  • what car adaptations will help overcome any physical impairments

If you can drive, the assessment should reduce any anxiety you or your family may have about your ability to do so competently and safely. If your injury means that you feel less confident about driving, the centre may advise you about how to build it up again. If you are over-confident, they may work out a programme that will help you develop a more realistic view and safer approach.

If you've never driven, an assessment will tell you if your injury is likely to affect your ability to learn, before going to the expense of having specialist lessons. If you can learn, the assessment will provide information that will help the instructor. If you get the Higher Rate Mobility Component of the Disability Living Allowance, you can apply for a driving licence when you are 16.

 

You can also download this as a complete guide: Motoring after a brain injury (PDF). Or you can receive printed publications by post (UK only).

Last updated: 2011


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