by Wendy McBrair, MS, BSN, CHES
Most of us can remember the day we first got a license to drive. Nothing was more exciting than our newfound ability to go wherever we wanted. It was a major milestone in most Americans’ lives. Driving a car remains a very important activity throughout life for many of us. And for people who don’t live in cities, driving can be a necessity, providing the only way to get to the doctor’s office, the grocery store, the pharmacy, and even to work. Driving gives us both physical and mental independence. It allows us to come and go as we please without having to be dependent on others to drive us around.
In some cases, however, arthritis can threaten to take away the freedom driving gives us. It can make aspects of driving, from pressing the pedals to getting in and out of the car to changing lanes, more difficult and even potentially dangerous. A few helpful strategies can make driving safer (and easier) for people who find themselves in this position.
The most important consideration when you are driving is safety. To drive safely, you need to be able to operate all the car’s systems and maneuver the car with confidence. The problem is, when you have arthritis, your neck can get stiff, your hands can be painful, and your legs may be slow to move. Stretching and strengthening exercises can help you counter these problems. If your neck feels stiff, doing a stretching exercise each day can help you stay flexible enough to comfortably turn your head to the left to see approaching cars or trucks. You should exercise at home before you drive to be sure that you don’t tighten up when you are in the middle of traffic. If a stiff neck continues to be a problem for you, consider taking an exercise class that focuses on flexibility, such as yoga, water exercise, tai chi, or the Arthritis Foundation’s exercise program.
If arthritis affects your hands, they may feel more painful when you open the car door, turn the wheel of the car, turn the key, or shift gears. Warming your hands in paraffin wax or running them under hot water before driving can help. Some people cover the steering wheel with flexible leather to add more padding, which makes the steering wheel feel more comfortable. For those whose hands are sensitive to cold because of Raynaud disease, a cover also keeps them from having to touch a cold steering wheel and is especially important in the winter or in the summer when the air-conditioner is going at full blast.
Your legs also need to be strong and flexible for driving. The right leg needs to move effortlessly from accelerator to brake and back. In a stick shift car, the left leg needs to be able to push down easily on the clutch. Doing exercises such as straight leg lifts to keep your thigh (quadriceps) muscle strong is a good way to ensure that you have enough strength to operate the pedals. (To do this exercise, lie on your bed or on the floor. Bend one knee, keeping the foot flat on the bed or floor, and keep the other leg straight. Slowly raise the straight leg a few inches. Hold for a count of six, and then lower. Start off by doing the exercise three times with each leg, and gradually increase to ten repetitions.)
For additional help driving with arthritis, AARP offers a defensive driving course specifically for people dealing with age-related cognitive and physical changes. The course offers basic safe driving tips that can make you a better driver for the rest of your driving years. It might also help you lower your insurance premiums. Go to the AARP Web site or call (888) 227-7669 for more information.
A number of electronic devices can also help make driving easier. Cell phones make it possible to communicate with others in an emergency, for example if you have car trouble and need to contact AAA. A cell phone also allows you to keep family members abreast of your progress. Even if you don’t carry one with you always, you may want to keep one in the car. Remember to use your hands-free phone while driving. (Some cars even have Bluetooth connections or OnStar capabilities built in so that you can make and get calls without using your phone or a headset.) A Global Positioning System (GPS) device can help make your drive easier by “speaking” directions to you as you drive. You can also print directions off the Internet before your trip to make getting to your destination easier. Planning ahead will help give you the confidence to make the trip.
Since a new car is a very expensive and important purchase, you should do a little research and make sure to test out the car before you buy or lease it. (One note: You should of course be just as thorough when buying a used car, and most of the advice given here applies to used cars as well as new cars. However, you will have less of an opportunity to customize a used car to your needs and abilities.) The car should meet your physical needs. Do the seats adjust for complete comfort and ease of driving? Are they designed, or can they be adjusted, to support your lower back? Make sure the seat is soft enough for long trips but not so soft that you have trouble getting out of it. Also make sure that you can see the traffic behind and next to you, using all three mirrors. Most people with arthritis look for cars with an automatic transmission, power steering, and electric seats and windows. All the controls should be easy to use. Is it easy to shift gears? To turn on the air-conditioning or windshield wipers? Some people prefer a larger car with a softer ride. Others prefer a smaller car that they feel is easier to maneuver. SUVs can fit a lot of people and haul or pull more things, but they can be more difficult to enter, exit, or drive for someone who is short or who has physical limitations such as pain, weakness, or limited range of motion. On the other hand, they may be easier to load up with groceries.
There are many other car features that may appeal to people with arthritis. Some of them are factory options you have to select when buying a new car; others are standard. The following are some you might look out for.
For people who are in wheelchairs or need more extensive accommodation, there are modifications available that go above and beyond the factory options offered by the manufacturer. For example, a van can be fitted with ramps, lifts, and hand controls to help people in wheelchairs get in and out. If you feel that you are in need of these kinds of modifications, an occupational therapist can help advise you. However, customized equipment can be costly. To help ease the burden, most major carmakers have a “mobility program” that can help pay for outfitting cars and vans with these types of modifications, offering a rebate of up to $1,000 for adaptive devices added to a new vehicle. You can contact your local dealership for more information on their mobility programs.
There are other ways to get help paying for modifications to your car. You can contact your state’s vocational rehabilitation services to see whether you qualify for help paying for modifications (although for these benefits, you must use your car for work or work training). If you are a veteran, the Department of Veterans’ Affairs (VA) may reimburse you for mobility adaptations. Finally, you may be able to write off modifications to your car on your federal income tax form. Download Publication 502, “Medical and Dental Expenses,” as a pdf; view it on the Web; or contact the IRS for more details.
For many of us, buying a new or used car or leasing a car isn’t in our plans. We have to make do with the car we have. Fortunately, there are many ways to make an old car more user-friendly if your arthritis makes driving difficult. The following are some devices that can allow you to adapt your car to your changing abilities. You can find these devices and more at companies such as Aids for Arthritis (800-654-0707) and North Coast Medical (800-821-9319). For illustrations, see "Arthritis-Friendly Car Devices."
Gas cap turner. In most states, buying gas means pumping it yourself. If you can go to a full-service gas pump, you should. If not, a gas cap turner allows you to more easily twist the gas cap open and closed.
Seat belt handle. Pulling the seat belt over your chest and lap and attaching it by your side is difficult for some people with arthritis. A seat belt handle attaches on to the seat belt, making it easier to pull the belt across your body. It is very helpful for those with limited range of motion in the elbow or shoulder.
Key turner. Turning the key to start the car can be painful and difficult for hands with arthritis. The key turner fits onto your key and provides a large, wide handle to help turn the key.
Swivel seat cushion. The best and safest way to get into your car is first to sit on the seat and then to swing your legs over. The swivel seat cushion, which is placed on top of your normal seat, allows you to swivel your body around more easily.
Lumbar back support. If your car’s seat does not support your lower (lumbar) back, a curved supportive back pillow can make long drives more comfortable.
Handybar. This hand-held support handle inserts into your car’s door frame and helps you support yourself as you get in and out of your vehicle. It can also be used in an emergency to cut your seat belt or break a window.
Mirror add-ons. There are a couple of modifications you can make to standard rearview and side mirrors to make it easier to see the road behind you without turning around. A panoramic rearview mirror attaches on to a standard rearview mirror but offers a broader picture of the road. Similarly, mirror extenders sit on top of your side mirrors and eliminate “blind spots” that can make changing lanes or merging hazardous.
Most people will have some kind of surgery at some point in their lives. For people with arthritis, joint replacement surgeries are especially common. Although you are usually able to drive right up to the time of surgery, many doctors will ask that you not drive for a period after surgery. This could mean being off the roads for a few days or even a few months, and getting back behind the wheel may not be as easy as you think. You should make sure to get permission from the doctor before you start driving again. You should be off any pain medicines that could interfere with your reaction time or ability to assess a driving situation, and your body (hands, arms, and legs) should be in good enough shape for you to drive safely. This will be a particular concern after hip or knee replacement surgery. You should only return to driving when you and your doctor have determined that pain and reduced mobility will not interfere with your concentration.
When you do return to driving, start slowly. The first day you may want to simply get in and out of the car. The next day, perhaps, drive the car out of and back into the garage, making sure you feel comfortable doing it. The next trip could be on back roads near your home. Finally, you can make your way onto busy roads and then highways. After surgery, energy comes back slowly. Keep this in mind when planning excursions after you get permission to drive. If you drive a long way from home, you still need to get home. Take someone with you who can drive if you get tired, feel too much pain, or are overwhelmed. Your first field trip after surgery should not be a marathon drive to a far-off destination. In general, start with a short trip and build slowly.
Fortunately, parking for people with limited mobility has become more available in recent years. Close, easy parking can make it possible for you to drive your car and shop independently and is always helpful when you’re coming out of the mall with packages or the grocery store with food. If you need handicapped parking, you should apply to your state Department of Motor Vehicles (DMV) for handicapped license plates or a handicapped tag to place on your dashboard or hang on your mirror. Even if you don’t usually need to use handicapped parking, it may be a necessity after some surgeries. In this case, you should apply for a temporary disabled parking permit from the DMV.
The following are some general tips to keep in mind.
And most importantly, enjoy the independence driving a car can give you.
Last Reviewed on March 21, 2012
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