When to drive after a TBI

(Before It's News)

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Driving is an important piece maintaining an independent lifestyle and integrating back into the community. We often take our ability to drive for granted and it’s easy to forget that driving is one of the most dangerous things we do in our every day lives. Once an individual has sustained a traumatic brain injury that skill can become even more dangerous.

A brain injury can affect the skills which are required for an individual to drive safely. The injured person, family members and health care professionals should all be included in the important decision of whether or not the individual is able to return to driving and when. Driving is the ultimate multitasking experience.

Drivers are expected to watch the road in front, the road behind, anticipate what other drivers will be doing, factor in the weather, the radio and the passengers all at the same time.

Brain injury can affect many of the physical, cognitive and behavioral skills that are needed in order for an individual to drive appropriately and safely. For example, an individual who has suffered from a brain injury may have difficulty coordinating speed, breaking and steering the vehicle all at the same time.

Brain injury can also affect vision. This does the main just clarity which might be corrected through glasses or corrective lenses. This really addresses central vision which means the ability of the brain to process the information which is being fed to it through the eyes. Drivers also need good peripheral vision to be able to detect movement on either side of the vehicle. Perception of spatial relationships between the vehicle and its surroundings help the driver to avoid crashing into other vehicles by staying between the lines. By being able to picture the vehicle in space the driver is able to judge distances when changing lanes, stopping or preparing to enter or exit a highway.

A brain injury can also compare reaction time which is required after the brain has process information. Drivers are also called upon to make judgments whether trying to merge into flowing traffic or to drive through a heavy rainstorm. These judgments involves weighing the skill of the drive for and the conditions of hand, which requires self-awareness, something many individuals with brain injury lack.

Much of the research that has been done to date tells us that it’s individuals with brain injury may not be able to recognize even some of the mild cognitive difficulties that can lead to an increased risk of driving. Skills that are often disrupted include the ability to maintain a constant position in the lane, accuracy of visual perception, eye hand coordination and reaction time. More recent research also shows that individuals who have suffered from a brain injury can experience difficulties understanding visual stimulation from the peripheral vision. This can be a problem related to driving performance. But the same research also gives hope that these skills can be improved through rigorous training.

In a study published in the Archives of Physical Medicine and Rehabilitation researchers looked at 71 pairs of adults who cannot suffered a dramatic brain injury and their significant other. Driving status was evaluated based on whether they resumed driving, frequency of driving and postinjury driving records which were compiled by the Department of Motor Vehicles. Using logistic and hierarchical regression analysis the researchers found that the significant other’s perceptions of the patient’s fitness was the strongest predictor of the patient’s ability to drive and driving frequency. But, other factors such as the years post injury, disability at discharge and their current neuropsychological functioning with the best predictors for driving safety.

Individuals who have suffered from a brain injury will give off warning signs of being an unsafe driver such as driving too fast or too slow for conditions, not observing signs and signals, in accurately judging distance when stopping returning, making decisions slowly, becoming easily distracted or confused, having near misses were several accidents, drifting across lane markings or getting lost easily and familiar areas.

Individuals who wish to continue to drive after sustaining a severe brain injury must check with the laws in their particular state before assuming that there are drivers license continues to be valid. In some states it is the responsibility of the physician to report a brain injury to the Bureau of Motor Vehicles. In other states this reporting process may not be required or the state may not have the ability to take such report at all.

In many instances both the physician and the family will ask the patient to take a driving evaluations test in order to determine if the individual is fit to remain on the road. A typical past has two parts: a preliminary evaluation which is a written test and a review of thinking abilities and the road tests which is a review of mechanical operations of the vehicle using driving simulator or driving an actual vehicle on the road.

The time it takes to go from actual trauma and injury to returning to the road actually is dependence upon the severity of the injury, previous helps, overall health and support systems which may be available for the individual to become a trained driver once again. In some cases vehicle modifications such as the hand controlled gas and brake system, spinner knobs or left foot accelerator may be necessary in order to make the driver fully functional on the road.

Before making a decision family and patients should have a discussion with their physician or other health professionals, get a professional evaluation and make their determination based on the advice of the professionals and the results of their test. Patients should remember that they are first tests is not their last test. These driving tests can be performed at any time the doctor or therapists believe that the abilities of the patient has improved.

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