Driving is often affected adversely by a TBI, even a “mild” one, because TBI is associated with visual impairments, slowed perception and reaction times, distractibility, poor memory, irritability and impaired judgment, amongst other deficits. Driving is important on a practical level for access to employment, education, medical services and social activities. It is also a symbol of independence and a source of self-esteem. Fear of losing their driving privilege, leads some people with a TBI to deny their driving skills are impaired or that they have been in a number of near-miss collision situations. Sometimes a family member will urge them to stop driving and will point out that they would rather have their loved one alive than let him risk death or injury by driving for some period of time after his TBI.
Statistics indicate that between 40-78% of persons with acquired brain damage will be re-licensed. A comprehensive review of driving and TBI in the June 2000 Journal of Head Trauma Rehabilitation at 15(3):895-908, indicates there is no clear, consistent match between impairments of vision, cognition, motor skills or behavior which are diagnosed by paper and pencil tests in a doctor’s office and actual fitness to drive in the real world. In the absence of a model which can predict fitness, or lack thereof, with a high degree of accuracy, it is best to have the person with TBI evaluated by a skilled specialist in what is called “adaptive driving.” Physicians may overpredict or underpredict lack of fitness to drive and either unnecessarily deprive his patient of driving privileges or place the public at unnecessary risk of calamity.
For persons living in northern California, one place they can go for a comprehensive evaluation of driving fitness after a TBI is the Occupational Therapy Department of the John Muir Hospital in Walnut Creek. Adaptive driving schools also exist, and are listed in the Yellow Pages. Anyone who feels unsure about their own capacity to drive safely while recovering from a TBI should err on the side of caution. At they very least they should get evaluated. Sometimes, only a few sessions are required to boost skills back to the safe range.
For anyone who is not sure if he can drive safely, it would be best to wait until the evaluation can be done. Meanwhile, TBI people who live in big cities can use public transportation, which can double as a form of therapy, because it requires working on memory, using maps, looking for visual cues, making change, etc. People in rural areas do not have the same access to public transportation, but they can seek rides from friends or seek a driver through state agencies or volunteer organizations such as the Family Caregiver Alliance. There are also post-acute TBI treatment and rehab firms which provide in-home care visits.
One example in California is Rehab Without Walls located in San Jose at 1101 S. Winchester Blvd, Suite M-250. Remember that human beings lived and flourished for 99% of human history without cars. Foregoing driving for a while, will not ruin anyone. Once your doctor feels you have made sufficient recovery to consider driving again, you can get an adaptive driving evaluation through the occupational therapy departments of certain hospitals.