Driving After Stroke

After David McNabb had a stroke at age 67, life for the Seymour, Indiana, retiree went through several changes. For about three months afterwards, he went to speech therapy sessions to improve his memory and cognition. He regained some of his strength and flexibility in his right hand and arm. His vision, however, was affected permanently; the stroke left him with vision in only his left eye.

Per his doctor’s orders, David gave up driving. He sold his pickup truck and learned to rely on his wife, Marla, and friends, to take him to doctor appointments and the local Lions Club meetings.

Little did David know that a meeting with a health care provider at the Franciscan Health Center for Hip & Knee Surgery Mooresville would lead to regaining his driver’s license.

Driving Simulation A New Option

During a pre-surgery consultation for a second knee replacement at Franciscan Health Mooresville, David was told about driving simulation training at the Indianapolis hospital. He was given a referral to a Physical Medicine and Rehabilitation physician, and after his knee surgery, he met Johanna Dix, an outpatient occupational therapist.

Dix had just begun working with patients on a driving simulator to assess patients with neurological issues such as stroke, traumatic brain injury or diseases like Parkinson’s. The simulator, which includes a steering wheel, gas and brake pedal, and three video monitors, can be used to retrain some patients to drive again.

“On the simulator, we can assess vision, visual reaction time, cognition and safety judgement,” said Dix. A driving screen can take up to three sessions because of the extensiveness of the testing. However, it’s an excellent way to measure a person’s potential for returning to driving.

David hadn’t driven for more than a year. In fact, he and his wife hadn’t considered additional therapy because they had been given the impression David’s capabilities would remain as they were. “We thought we were done with therapy,” said Marla.

Still, Dix was encouraged by what she saw when she first started working with David.

“People don’t usually grasp the nature of brain injury and its impact on normal daily skills like driving,” she said, noting patients will see changes — and sometimes improvements — over time. “Brain injuries, like stroke, can change how your brain processes basic information, and although you may have been an excellent driver before, you need to be assessed for your safety so that you don’t harm yourself or someone else.”

Regaining Skills For Daily Living

David trained on the driving simulator at Franciscan Health Indianapolis with Johanna once to twice a week for almost a year. He also went to speech therapy to improve his memory and cognition.

One of the important things he worked on with Johanna was learning to compensate for the loss of his peripheral vision. “She kept reminding me, ‘Turn your head to the right, turn to look to the right,’” he said.

David continued to reach the benchmarks Johanna had set for his training.

“She didn’t give up on me, so we kept going,” said David. “She knew I could do it.”

When it was time, Dix gave David the green light to go in for a new driving test. Because he had been restricted by his doctors to drive, David needed to take a formal driving evaluation, about two and a half hours, conducted by a local sponsoring hospital. The exam involved a 90-minute oral test and a one-hour road test.

“I smoked it,” said David, grinning. “Johanna was elated.”

For now, David has limited his driving to daytime around Seymour and still accepts rides from friends for evening Lions Club meetings. But he has a plan: to buy another used pickup truck and drive to Illinois for a weekend hunting trip.

“As an occupational therapist, my goal is to help patients get back to living life to the fullest,” said Dix, “and driving is so key to our independence, it’s rewarding to see people like David get back on the road and back to life.”