Driving and Multiple Sclerosis
Driving is the most complex activity most people do every day. It requires good vision, motor control, memory, and thinking skills - and multiple sclerosis (MS) can affect all of these areas. It is important not to underestimate the demands of driving or overestimate your abilities behind the wheel.
How MS Can Affect Driving
MS symptoms that may affect driving include:
Vision changes - blurred vision, poor night vision, blind spots, double vision, loss of color vision, and difficulty with visual searching and scanning.
Thinking and memory changes - short-term memory problems, confusion about vehicle operation or your location, difficulty with motor planning and multi-tasking, slowed reaction time, stress intolerance, fatigue, and heat intolerance.
Physical changes - difficulty getting in and out of the car, muscle weakness, stiffness or spasms, reduced sensation in your hands or feet, pain, and problems with coordination.
A key challenge with MS is that symptoms often change throughout the day and from one day to the next. During a relapse, driving may be unsafe but may return to normal once the relapse ends. Over time, however, driving ability can become permanently affected.
Driving Evaluations
If you, your loved ones, or your health care provider have concerns about your driving, a driving evaluation by a driver rehabilitation specialist can help. The evaluation identifies specific challenges and determines whether adaptive equipment could keep you safely on the road.
The VA maintains 50 driver rehabilitation clinics nationwide. An evaluation takes up to two hours and includes a cognitive assessment, vision exam, tests for muscle strength, movement, coordination, sensation, and reaction time, plus a behind-the-wheel evaluation in a VA-owned vehicle. After the evaluation, the specialist makes recommendations about driving safety.
Adaptive Equipment
If adaptive equipment is recommended, there are many options depending on your needs. These include hand controls to operate the gas and brake, a spinner knob to help turn the steering wheel, power transfer seats to help you get in and out of the vehicle, digital driving rings, and high-tech equipment for reduced-effort or zero-effort steering and braking. The driver rehabilitation specialist will train you and your family on using the equipment and on safely entering and exiting the vehicle.
Tips for Safer Driving
Being aware of how your MS symptoms fluctuate can help you stay safer on the road:
- Do not drive if you are having a bad day.
- Avoid driving when you are sick - MS symptoms often worsen when your body is under extra stress.
- Keep trips short if you experience fatigue, and do not drive when fatigue is severe. (See also: [MS-Related Fatigue] for more on managing fatigue.)
- Avoid distractions like phone calls, texting, eating, or arguing with passengers.
- If you are heat intolerant, carry a cooling vest.
- Plan errands and appointments to avoid heavy traffic times or congested areas.
- Avoid driving in bad weather.
Planning for Changes
Just as you might plan to make your home more accessible, it is wise to plan for the possibility that driving may become unsafe. When that time comes, knowing your options can ease the transition from driver to passenger.
Transportation alternatives include asking friends, family, or neighbors for rides; looking into volunteer driver programs through your community center, place of worship, or Veteran service organization; contacting city and state public transportation agencies; and talking to your VA social worker about transportation options in your area.
Driving can feel like a symbol of independence, and it can be hard to think about limiting or giving up that freedom. A professional evaluation and adaptive equipment can help keep you safe on the road for as long as possible. And if the time comes to stop driving, your family, friends, and health care team are here to support you through that change. If you are having difficulty accepting or adjusting to changes in your driving ability, talking with a VA health care provider may help.
Based on an article by Pat Niewoehner, OTR/L, CDRS and Florian Thomas, MD, MA, PhD.
