Safe Driving With Hearing Loss

Key Takeaways

• Older adults with hearing loss can drive safely by taking proactive measures and being mindful of potential challenges.
• Regular hearing and vision assessments, along with proper use of hearing aids or assistive devices, are helpful for optimal driving abilities.
• Vehicle modifications and using assistive technologies can enhance driving comfort and safety.
• Planning drives to avoid rush hour traffic and inclement weather and staying alert are fundamental for a confident driving experience.

Driving, a symbol of freedom and independence, is a skill many cherish. But as we age, it becomes crucial to address potential safety challenges. Older adults may experience changes in vision, hearing, reaction time, cognitive function, mobility, or medication which can all impact the ability to drive safely. In this comprehensive guide, we shed light on an often-overlooked aspect of safe driving: hearing loss.

It’s expected one of every four licensed drivers will be an older adult by 2050. ^[1]Pomidor, A. Clinician’s Guide to Assessing and Counseling Older Drivers. American Geriatrics Society. 2019. Found on the internet at https://www.safemobilityfl.com/pdfs/CliniciansGuide/CliniciansGuideOlderDriversComplete4thEdition.pdf A study found people with moderate to severe hearing impairment had poorer driving performance in the presence of distractions than those with normal to mild hearing loss. ^[2]Hickson, Louise, et al. Hearing Impairment Affects Older People’s Ability to Drive in the Presence of Distracters. Journal of the American Geriatrics Society. June 2010. Found on the internet at https://www.researchgate.net/publication/47385857_Hearing_Impairment_Affects_Older_People’s_Ability_to_Drive_in_the_Presence_of_Distracters But research is limited, and there are resources available and modifications you can make to ensure you’re driving safely even with hearing loss.

This guide explores the challenges of driving with age-related hearing loss, its impact on driver safety, and, most importantly, the knowledge and resources needed to confidently continue your journey on the open road. Remember, the key to a fulfilling life on wheels lies not only in recognizing challenges but also in taking the necessary steps to overcome them.

Can I drive safely with hearing loss?

Many people who are hard of hearing can still drive safely, and there are no laws against driving with hearing loss or full hearing impairment. ^[3]Feldman, Joel. Yes—The Deaf (And Those With Hearing Loss) Are Allowed To Drive And Do So As Safely As Hearing Drivers. Dec. 12, 2023. End Distracted Driving. Found on the internet at https://www.enddd.org/end-distracted-driving/enddd-blog/yes-deaf-are-allowed-to-drive/

The prevalence of hearing loss among older adults

Hearing loss is a common issue as we age, affecting approximately one in three people 65 and older in the United States alone. ^[4]Age-Related Hearing Loss (Presbycusis). National Institute on Deafness and Other Communication Disorders. Updated March 17, 2023. Found on the internet at https://www.nidcd.nih.gov/health/age-related-hearing-loss#:~:text=It%20is%20one%20of%20the,than%2075%20have%20difficulty%20hearing. While the natural aging process is a significant cause, other factors, such as exposure to loud noises, genetics, and certain chronic diseases, can contribute to hearing loss as well. And not all drivers with hearing loss are aware their hearing ability has declined.

Is driving with hearing loss safe?

Yes, driving with hearing loss is generally considered manageable, though some states may require certain conditions to be met, including:

• Ability to hear essential sounds, such as sirens, horns, and other vehicles: For reference, ambulance sirens are about 120 decibels, while profound hearing loss is 90 decibels and higher. No specific hearing level requirements are set for drivers of private vehicles, but the U.S. Department of Transportation (DOT) requires drivers to hear a forced whisper from 5 feet away in order to obtain a commercial driver’s license (CDL). ^[5]Hearing Q&A. DOT Physical Doctors. Found on the internet at https://dotphysicaldoctor.com/faq/hearing. In 2013, the National Association of the Deaf (NAD) challenged this requirement and successfully gained exemptions for deaf or hearing-impaired drivers with safe driving records to obtain a CDL. While the hearing exemption can be waived in these circumstances, NAD continues to work toward removing the hearing standard in full. ^[6]Commercial Driver’s Licenses. National Association of the Deaf. Found on the internet at https://www.nad.org/commercial-drivers-licenses.
• Clearance from a health care professional: Anyone experiencing hearing loss should undergo evaluation and advice from an audiologist or ENT doctor. Again, while there is no standard required level of hearing set for private drivers, 40 decibels seems to be the cutoff for commercial drivers (unless exempted from the standard). Those with hearing loss at higher than 40 decibels are not prohibited from driving commercially but need an evaluation and approval from a doctor basing their decision on medical history, driving history, the type of driving, functional design of the driving cab, and any other medical challenges the driver may have. ^[7]Cottingham, Darren. Can You Drive When You’re Deaf? Driver Knowledge Tests. Found on the internet at https://www.driverknowledgetests.com/resources/can-you-drive-when-you-are-deaf.

Rachel Magan Faivre, AuD, owner of Oklahoma City-based Ash Audiology, added: “Another concern is people who have a dead ear, or no usable hearing in one ear. Even if the other ear has normal hearing, if one ear doesn’t work, then you lose the ability to localize sounds, which becomes important when locating sirens, horns, or a person or animal calling out.”

It’s important to note driving while deaf is legal in all 50 states, though some states may enforce some requirements, including requiring deaf and hard of hearing people to inform their local motor vehicles department of their impairment, have full-view mirrors in and outside their cars, take driving lessons after obtaining their permit, and wear hearing aids. ^[8]Can Deaf People Drive? San Diego Magazine. June 7, 2023. Found on the internet at https://www.sandiegomagazine.com/guides/can-deaf-people-drive/article_c3ad3dfc-0587-11ee-ba1e-279d410a83cb.html.

Sue Keiss, 59, of Denver, Colorado, has moderate hearing loss in both ears due to chemotherapy medications. She feels her hearing aids make her a perfectly safe driver. “I always wear my hearing aids when driving and have not had any issues. I can hear horns and sirens,” she said. “My doctors have not mentioned or asked me about driving.”

The NHTSA assessment:

The National Highway Traffic Safety Administration (NHTSA) offers an online self-assessment tool to evaluate a person’s fitness to drive safely. This comprehensive evaluation covers hearing and vision capabilities, physical fitness, and reaction time. Taking this assessment can provide valuable insights into your driving abilities and potential areas for improvement.

How age impacts driving ability

While driving is a skill honed over years of experience, it’s essential to be aware of the various factors associated with aging influencing our capabilities on the road, including:

1. Vision changes: Aging can lead to changes in vision, such as decreased visual acuity, sensitivity to glare, and reduced peripheral vision. Difficulties detecting road signs, recognizing pedestrians, or seeing objects in low-light conditions can pose challenges while driving. Night vision declines with age, making driving at night more challenging for older adults.
2. Reaction time: As we age, our reflexes may slow down, affecting our ability to respond quickly to unexpected situations on the road. This slower reaction time can increase the risk of accidents, especially in high-traffic or complex driving scenarios.
3. Cognitive function: Aging can also affect cognitive abilities, including memory, attention, and decision-making, making it important to minimize distractions while behind the wheel.
4. Mobility and flexibility: Physical changes, such as reduced muscle strength and flexibility, can impact our ability to control a vehicle effectively. Turning the steering wheel, pressing pedals, or looking over your shoulder when changing lanes may become more challenging.
5. Medications and health conditions: Certain health conditions become more prevalent with age, and the medications used to manage them can have side effects affecting driving ability. For example, drowsiness, dizziness, or impaired coordination can compromise road safety.

The importance of adaptive strategies:

Despite these age-related changes, it’s important to emphasize many older adults can continue driving safely by employing adaptive strategies. Regular health check-ups, vision tests, and hearing assessments are essential. Furthermore, staying physically and mentally active and attending defensive driving courses can help compensate for many age-related challenges.

How to drive safely with hearing loss

As we prioritize safety on the road, especially for older adults with hearing loss, taking proactive steps can significantly enhance driving abilities and confidence. Let’s explore a checklist of essential actions to ensure safe driving with hearing loss. ^[9]Clason, Debbie. How Does Hearing Loss Affect Driving? Updated Dec. 29, 2021. Healthy Hearing. Found on the internet at https://www.healthyhearing.com/report/52756-Tips-for-driving-safely-with-hearing-loss.

Talk to your doctor

Have an open conversation with your doctor about your hearing level and any concerns you may have regarding your ability to drive safely. Maintain regular check-ups at the recommended intervals to monitor your overall health and fitness for driving.

Check your eyes and ears

All drivers should be mindful of their vision and hearing health. Some strategies to increase your driving safety include:

• Ensure your prescription glasses or contacts are up-to-date to optimize your vision while driving.
• If you have hearing aids, regularly inspect and maintain them to ensure the batteries are fresh and the volume is adjusted appropriately. If you don’t have hearing aids yet, there are lots of affordable hearing aids and over the counter hearing aids on the market.
• If advised by your doctor, consider obtaining a personal sound amplifier (PSAP) to enhance your auditory perception. Note: PSAPs should not be used to treat hearing loss, but they can help amplify sounds and are often used in this way recreationally.

Review your medications

Schedule periodic medication reviews with your doctor to assess for any interactions or side effects with the potential to affect your driving abilities, such as drowsiness or heightened anxiety.

Optimize your vehicle for your eyesight

Sight is the most important sense for driving. You can optimize your vision by following these tips:

• Adjust your vehicle’s mirrors to provide an optimal field of view, reducing blind spots.
• Install wide-angle or blind-spot mirrors to enhance visibility.
• Keep your windshield and windows clean to minimize glare and improve vision.
• Choose vehicles with advanced safety features, such as lane departure warning systems or rearview cameras.
• Use window visors and wear sunglasses on bright sunny days.

Control noise and distractions

Reducing distractions is a key to safe driving at any age. Ways to reduce excess noise and distractions include:

• Reduce noise inside the car to enhance your ability to hear important auditory cues while driving.
• Keep conversations at a comfortable volume and limit excessive noise from radios or devices like smartphones.
• Minimize distractions by avoiding using mobile phones or other electronic devices while driving.

Plan for hearing fatigue

Recognize hearing loss can be mentally fatiguing, requiring extra energy to pay attention to signals and surroundings. You can help manage hearing fatigue by:

• Planning scheduled stops on longer drives to rest and recharge during extended journeys.
• Setting a maximum trip drive time to avoid driving when fatigue will likely impact your abilities.
• Opting for driving at times of the day when you feel most alert and energetic and/or will experience less traffic that can contribute to hearing and general fatigue.

Take a safe driving course

Enroll in a driving safety course designed for older adults to refresh your driving skills and learn valuable strategies for safe driving. AAA offers a RoadWise Driver course for older adults, which covers driving techniques and the latest technologies. The National Safety Council offers an Online Mature Defensive Driving Course. Individual states also often offer driver safety courses for older adults. Course fees may depend on your location, and completing the course usually leads to discounts on insurance premiums.

Go to a CarFit event

CarFit events are specifically designed to help older drivers achieve a better fit with their vehicles for increased comfort and safety. Trained technicians will check the vehicle settings and provide recommendations for adjustments to accommodate individual needs.

Car modifications for easier driving

These car modifications and technologies can be valuable tools for older adult drivers to enhance their driving experience and overall safety on the road: ^[10]Adapted Vehicles. National Highway Traffic Safety Administration. Found on the internet at https://www.nhtsa.gov/road-safety/adapted-vehicles#right-vehicle-1611.

• Hand controls: Install hand controls, so drivers can operate the brake and accelerator pedals using hand movements, which can be beneficial for those with limited leg mobility or strength.
• Steering wheel spinner knob: Attach a spinner knob to the steering wheel to provide better grip and control, reducing the effort required to steer the vehicle.
• Swivel seat: Incorporate a swivel seat to make it easier for drivers with mobility challenges to enter and exit the vehicle.
• Extended mirrors: Install extended mirrors, such as panoramic or blind-spot mirrors, to enhance visibility and reduce blind spots, especially for those with limited neck mobility.
• Pedal extensions: Add pedal extensions to adjust the position of the pedals, ensuring a more comfortable and ergonomically suitable driving position.
• Auto-dimming rearview mirror: Replace the traditional rearview mirror with an auto-dimming one to reduce glare from headlights, enhancing night driving safety.
• Assistive parking devices: Install parking sensors or a backup camera to aid drivers in maneuvering their vehicles during parking, providing additional assistance and confidence.

Some programs may help pay the costs of vehicle modifications. For information, contact your state’s department of vocational rehabilitation or another agency providing vocational services and, if appropriate, the U.S. Department of Veterans Affairs. You may also check with NCOA BenefitsCheckUp under “Disability Services” for assistive technology programs in your area.

Technologies for older adult drivers

As assistive technologies continue to evolve, they hold the potential to empower drivers with disabilities and older adults alike, ensuring inclusivity and accessibility for all road users. ^[11]Top 10 Vehicle Modifications for Mature Drivers. The Hartford. 2023. Found on the internet at https://www.thehartford.com/resources/mature-market-excellence/vehicle-technology. Some technologies to consider are:

• Collision avoidance systems: Advanced driver-assistance systems, such as collision warning and automatic emergency braking, can help prevent accidents by alerting the driver and even applying the brakes in critical situations.
• Lane departure warning system: This technology alerts drivers when they unintentionally drift out of their lane, reducing the risk of lane departure-related accidents.
• Voice-activated controls: Voice-activated features allow drivers to perform various tasks, such as adjusting climate control or navigation, without taking their hands off the wheel.
• Adaptive cruise control: Adaptive cruise control adjusts the vehicle’s speed based on the traffic flow, maintaining a safe following distance and reducing the need for constant acceleration and braking.
• GPS navigation systems: GPS navigation systems provide clear and audible turn-by-turn directions, assisting drivers in finding the best routes and destinations.
• Blind spot monitoring: Blind spot monitoring systems use sensors to detect vehicles in the driver’s blind spots, alerting them through visual or audible signals to avoid potential collisions.
• Gesture control interfaces: Emerging technologies may offer gesture control interfaces and allow drivers to interact with in-car systems through simple hand movements, reducing the need for complex button presses.

Safe driving tips for older adults

In addition to using technology, many common-sense defensive driving strategies can increase road safety for people of all ages: ^[12]Stefanac, Meg. Top 20 Safe and Defensive Driving Tips. Trusted Choice. Nov. 4, 2022. Found on the internet at https://www.trustedchoice.com/insurance-articles/wheels-wings-motors/defensive-driving-tips.

1. Time your driving wisely: Whenever possible, plan your trips during off-peak hours to avoid heavy rush hour traffic. Reduced traffic can make driving less stressful and minimize the likelihood of aggressive driving encounters.
2. Avoid inclement weather: Poor weather conditions, such as heavy rain, snow, or fog, can significantly impact driving safety. If bad weather is forecasted, consider postponing your trip until conditions improve.
3. Research your route: Before setting out on a journey, familiarize yourself with the route and potential road hazards. Use GPS navigation systems to receive real-time traffic updates and alternative route suggestions.
4. Maintain a safe following distance: Allow for ample space between your vehicle and the one in front of you. A greater following distance provides more time to react to sudden stops or emergencies.
5. Observe speed limits: Adhere to posted speed limits, especially in unfamiliar areas. Driving at an appropriate speed allows for better control and reaction time, reducing the risk of accidents.
6. Stay focused and alert: Minimize distractions inside the car and keep your focus on the road ahead. Avoid using mobile phones or other electronic devices while driving. Keep hydrated and well-rested before embarking on a journey. On longer trips, schedule breaks to rest and stretch your legs.
7. Use turn signals: Signal your intentions clearly and in advance when changing lanes or making turns. This helps other drivers anticipate your movements, promoting smoother traffic flow.
8. Be cautious at intersections: Approach intersections cautiously, even if you have the right of way. Look for potential hazards, such as vehicles running red lights, to avoid collisions.
9. Adjust to changing light conditions: Be prepared for changing light conditions, such as transitioning from daylight to dusk or night driving. Keep your headlights on when visibility is reduced.
10. Be patient and tolerant: Stay patient and avoid aggressive driving behaviors. Remain courteous to other road users, and avoid confrontations with aggressive drivers.

Chad Shepperd, associate director of operations and training at Drive Safe Colorado, told us, “Anyone driving with hearing loss will need to rely more on their vision. It’s important that they limit visual distractions, increase visual scanning at intersections (even at green lights), and check mirrors more frequently.”

Older adult licensing by state

Rules regarding renewing driver’s licenses vary by state. You may visit your particular state’s Department of Motor Vehicles website or NOLO’s Driving Laws for Seniors and Older Drivers page for details.

While most states require a vision test past a certain age, typically 65 but sometimes younger or older, written and road tests usually are only required if specific impairments are documented. Below is a general overview of the requirements. ^[13]Driving Laws for Seniors & Older Drivers. NOLO. Found on the internet at https://www.nolo.com/legal-encyclopedia/driving-laws-seniors-older-drivers.

For a full summary of the key features of each state’s rules, download this Older Adult Licensing by State Packet.

Bottom line

Recognizing how hearing loss can impact driving abilities, you can take proactive measures to ensure safety on the road. From regular assessments of hearing and vision to embracing modern technologies and adapting driving habits, older drivers can continue to navigate our roads with confidence and enjoyment. Remember, the goal is not to discourage or limit your freedom, but to ensure the safety of yourself and others on the road. By honestly evaluating your hearing abilities and taking necessary precautions, you can continue to enjoy the open road with confidence and peace of mind.

Have questions about this article? Email us at reviewsteam@ncoa.org.

Sources

1. Pomidor, A. Clinician’s Guide to Assessing and Counseling Older Drivers. American Geriatrics Society. Published 2019. Found on the internet at https://www.safemobilityfl.com/pdfs/CliniciansGuide/CliniciansGuideOlderDriversComplete4thEdition.pdf
2. Hickson, Louise, et al. Hearing Impairment Affects Older People’s Ability to Drive in the Presence of Distracters. Journal of the American Geriatrics Society. June 2010. Found on the internet at https://www.researchgate.net/publication/47385857_Hearing_Impairment_Affects_Older_People’s_Ability_to_Drive_in_the_Presence_of_Distracters
3. Feldman, Joel. Yes—The Deaf (And Those With Hearing Loss) Are Allowed To Drive And Do So As Safely As Hearing Drivers. Dec. 12, 2023. End Distracted Driving. Found on the internet at https://www.enddd.org/end-distracted-driving/enddd-blog/yes-deaf-are-allowed-to-drive
4. National Institute on Deafness and Other Communication Disorders. Age-Related Hearing Loss (Presbycusis). Updated March 17, 2023. Found on the internet at https://www.nidcd.nih.gov/health/age-related-hearing-loss
5. DOT Physical Doctors. Hearing Q&A. Found on the internet at https://dotphysicaldoctor.com/faq/hearing
6. National Association of the Deaf. Commercial Driver’s Licenses. Found on the internet at https://www.nad.org/commercial-drivers-licenses
7. Driver Knowledge Tests. Can You Drive When You are Deaf? Found on the internet at https://www.driverknowledgetests.com/resources/can-you-drive-when-you-are-deaf
8. San Diego Magazine. Can Deaf People Drive? June 7, 2023. Found on the internet at https://www.sandiegomagazine.com/guides/can-deaf-people-drive/article_c3ad3dfc-0587-11ee-ba1e-279d410a83cb.html
9. National Institute on Aging. Safe Driving for Older Adults. Reviewed Dec. 20, 2022. Found on the internet at https://www.nia.nih.gov/health/older-drivers
10. Clason, Debbie. How Does Hearing Loss Affect Driving? Updated Dec. 29, 2021. Healthy Hearing. Found on the internet at https://www.healthyhearing.com/report/52756-Tips-for-driving-safely-with-hearing-loss
11. National Highway Traffic Safety Administration. Adapted Vehicles. Found on the internet at https://www.nhtsa.gov/road-safety/adapted-vehicles#right-vehicle-1611
12. The Hartford. Top 10 Vehicle Modifications for Mature Drivers. 2023. Found on the internet at https://www.thehartford.com/resources/mature-market-excellence/vehicle-technology
13. Stefanac, Meg. Top 20 Safe and Defensive Driving Tips. Trusted Choice. Nov. 4, 2022. Found on the internet at https://www.trustedchoice.com/insurance-articles/wheels-wings-motors/defensive-driving-tips
14. NOLO. Driving Laws for Seniors & Older Drivers. Found on the internet at https://www.nolo.com/legal-encyclopedia/driving-laws-seniors-older-drivers

Lauren Sherman Author

Lauren Sherman, M.S., is a health content writer with a master’s degree in human genetics from the University of Colorado Anschutz Medical Center, laboratory experience from National Jewish Health, and clinical experience from Children’s Hospital Colorado.

Rachel Magann Faivre Medical Reviewer

Rachel Magann Faivre, AuD, is the owner of Oklahoma City-based Ash Audiology. She currently serves on The Audiology Project’s Board of Directors and on Northern Illinois University’s Advisory Board. Additionally, Dr. Magann Faivre has served for many years on her National Audiology Association's Advocacy Committee to help improve access and coverage of hearing health care. She received her doctor of audiology from Northern Illinois University and has been the recipient of multiple relevant awards.

Kathleen Cameron Reviewer

Kathleen Cameron, BSPharm, MPH, has more than 25 years of experience in the health care field as a pharmacist, researcher, and program director focusing on falls prevention, geriatric pharmacotherapy, mental health, long-term services and supports, and caregiving. Cameron is Senior Director of the NCOA Center for Healthy Aging, where she provides subject matter expertise on health care programmatic and policy related issues and oversees the Modernizing Senior Center Resource Center.