You have not driven since the hospital stay. Or you drive, but only to the shops, only in daylight, only on roads you know. The car sits in the driveway more than it used to.

Losing confidence after an illness, an injury or a long break is common. This article helps you work out whether your nerves are a confidence problem, a safety problem or a bit of both, and what to do about each.

Why does confidence drop?

It can drop after a stroke, a brain injury, a surgery, a fall, a crash or a long time away from the wheel. Sometimes it drops for no clear reason at all.

Confidence is a feeling. It does not tell you whether you are safe. That cuts both ways. Some people feel nervous and drive well. Others feel fine and miss things they do not notice. Austroads, the national guidance, lists awareness of your own limits as one of the key things that makes driving with a physical condition safe. The point is to find out which one applies to you.

Has anything about your health changed?

Start here, before anything else. If a medical event or diagnosis has changed how your body or mind works, talk to your doctor before you drive. Your doctor can tell you whether it is safe to start thinking about driving, and whether you need to tell Transport and Main Roads (TMR).

In Queensland you must tell TMR about a permanent or long-term medical condition that is likely to affect your ability to drive safely. Our guide to reporting a medical condition to Queensland Transport explains how.

If you have had a stroke or brain injury, these guides cover the specifics: driving after a stroke in Queensland and driving after a brain injury in Queensland.

What if nothing has changed medically?

If your doctor sees no health reason that affects your driving, your confidence may simply need rebuilding. Here are some steps.

• Start in quiet places at quiet times, such as a local street early on a weekend.

• Take someone you trust, who stays calm and does not coach.

• Add one thing at a time, such as a longer trip, a busier road or a roundabout.

• Keep a note of what feels better and what does not.

A refresher lesson with a driving instructor may also be all you need. Instructors teach skills. They do not assess how a medical condition affects driving.

When is an OT driving assessment the right next step?

Consider one when your nerves and your health overlap. For example:

• you feel unsure and there has also been a diagnosis or medical event

• you have started avoiding driving situations and you are not sure why

• family has raised concerns, and you are not sure whether they are right

• your doctor wants more information before they sign your medical certificate

An assessment can tell you what is working and what is not. That may be a relief. It may also be hard to hear. We will not promise the result you hope for, but we will be honest about what we saw. Our post on what to expect on the day shows how it runs, and our guide to how to prepare can take some of the worry out of it.

The on-road part is in a driving instructor’s car with dual controls, which means a second set of pedals is available if needed. Many people find that makes it easier to relax.

What are the warning signs that it is more than nerves?

Some changes point to safety, not just confidence. They include:

• near misses or small scrapes you cannot explain

• getting lost on familiar routes

• other drivers sounding their horns more often

• family or passengers feeling uneasy

Our post on how do you know when it is time to get your driving checked lists 12 signs worth paying attention to.

What if I decide to stop?

Choosing to stop driving is not a failure. Some people make that call themselves, and it can be a relief. If that is you, our guide to getting around the Gold Coast without driving covers practical alternatives.

What if I am the family member?

If you are reading this for a parent or partner, avoid arguing about the keys. Describe what you have seen and suggest a check with their doctor. Our guide for Gold Coast families worried about a parent’s driving gives ideas for starting the conversation.

Ready to book an OT driving assessment on the Gold Coast? Steer Driving is a mobile assessment service covering the Gold Coast and surrounding areas. Whether you already have a referral or you’re just getting started, get in touch and we’ll guide you through the next steps.

This article was written by Elise, an AHPRA-registered Occupational Therapist and driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice.