Driving With ALS

Coming to terms with being diagnosed with ALS can be very difficult. Its progressive loss of muscle function means slowly losing many abilities, including the ability to drive. With this comes a loss of independence, which can impact one’s job, family, and social life. Just because you have been diagnosed with ALS doesn’t mean you need to give up the keys just yet. It may still be possible with adaptive driving devices to extend your time on the road.

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What is ALS?

Amyotrophic Lateral Sclerosis, also known as ALS or Lou Gehrig’s Disease, is a rare but often fatal disorder that impacts around one to two out of every 100 thousand people. It has two forms. Familial ALS, which only occurs in about 5% of cases, is one that seems to be hereditary. The remaining 95% of cases appear randomly throughout the population and are known as sporadic ALS.


The exact cause of the disease is unknown, but for some reason, the motor neurons that help the brain communicate with the body’s muscles begin to deteriorate. As they break down, the muscles no longer receive impulses from the brain. The affected body parts being to lose function, and the muscles begin to atrophy from lack of use.


There is currently no treatment for the disease, but newer medications and therapies may help to slow its progression and extend both the duration and quality of ASL victim’s lives.


The Progressive Nature of ALS and Driving

Since ALS is a disease that worsens with time, the effects you feel, and the ways that they impact your driving, will continuously increase. It can be difficult to forfeit your driver's license, but you do not want to wait too long and cause harm to others. When the time comes for retirement, you can continue to have independence through other transportation methods, and we can help you develop a new plan for your mobility. 

In an effort to keep your license and safely drive longer, more serious physical therapy may be needed to minimize weakness. Both strength training and stretching can help minimize muscle cramps and stiffness. As with any health problem, proper diet and adequate sleep can help lessen symptoms. There is some debate on what sort of diet is best, so consult your physician for their recommendations. Some research also recommends massage and swimming as ways to minimize symptoms. This translates into maximizing your physical abilities to help you drive to the best of your potential.

How a Stroke Affects Cognitive Abilities

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  1. Difficulty reading and comprehending road signs, recognizing locations, or remembering routes.
  2. May forget where they are going and fail to recognize hazards in the road or slow down for pedestrians.
  3. Difficult for them to concentrate or cope with multiple stimuli, such as mirrors, oncoming traffic, and weather.
  4. Slower response times or have more difficulty solving problems, such as who has the right of way at a four-way stop or how to respond to construction detours.
  5. May have problems telling their left from their right, or accidentally move the car in the opposite direction they intend.
  6. Also possible that they will have problems speaking and understanding speech. This can be dangerous if they become lost and cannot communicate, or if they are pulled over by police and respond incorrectly.

Who is responsible for determining if I can still drive with ALS?

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Because ALS progresses rapidly, you may feel fine to drive early on, but within the coming months to years, you will slowly lose function and need to first modify your driving before eventually giving it up altogether. In some cases, a person with ALS may feel so uncomfortable with their ability to drive that they choose on their own to give it up. Other times, their loved ones or healthcare provider may be concerned that the disease has progressed to the point that it is no longer safe for them to be behind the wheel.

In Connecticut, there are no laws that mandate medical professionals report patients who may be unable to drive due to medical conditions. The state does, however, encourage physicians, law enforcement, or concerned family members to submit documents to the Department of Motor Vehicles identifying such individuals and triggering a process that would suspend their driver’s license until such a time as they could be tested and found safe to drive. 

If you are concerned that your own or your family member's driver’s license should be in question, you should consider a visit with our Certified Driver Rehabilitation Specialist (CDRS) for a Comprehensive Clinical Assessment, and if possible, an actual Driving Assessment. You should also help the patient create some sort of transportation plan for the time until they have completed their evaluation. This might mean helping them make arrangements with friends or family or looking into ride services like Uber and Lyft or other forms of public and specialty transit. 


What Next Street Looks For When Assessing

Whenever possible, we try to meet with you in the comfort of your own home to carry out an assessment of your abilities. All you need to do to prepare is to get a good night’s sleep and eat normal meals so you have the strength and energy to get through the visit, which can take up to two hours. Don’t worry about needing to memorize anything, this isn’t a test of your knowledge, it is an assessment of your motor skills and your cognitive and visual abilities.

We start out by taking the time to get to know you and your unique situation. Then we evaluate your visual, physical, and cognitive abilities. We check your visual acuity, peripheral vision, and your ability to move your eyes about and scan your environment. We check your physical flexibility, strength, and coordination. This includes both muscle coordination and hand-eye coordination. There will also be several exercises we do to evaluate your memory, awareness, judgment, and ability to follow directions. If this all goes well, we will recommend you for a behind-the-wheel evaluation at a later date where we will observe your practical driving skills and make recommendations for your safe future behind the wheel. 

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Want to read and learn more?

Check out the Driver Rehab blog to learn more about driving with ALS.

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