A risk manager recently asked for guidance and resources pertaining to drivers with hearing loss, with an emphasis whether there are safety risks to consider when it comes to a driver with hearing loss transporting residents at a continuing care retirement community.
In our response, ECRI Institute notes that facility-employed drivers may raise a host of risk considerations that are separate from hearing loss, including the individual's driving record and automobile insurance coverage. Some of these issues are covered in Ask CCRM: Staff Driving Resident-Owned Vehicles. Risk managers are also encouraged to consult with their organizations' automobile insurance carriers, which will have information about state-specific requirements.
The Americans with Disabilities Act (ADA) prohibits discrimination against individuals with disabilities. As addressed in the guidance article Americans with Disabilities Act: An Overview, hearing is a "major life activity"; thus any hearing loss would likely fall under ADA's definition of disability ("a physical or mental impairment that substantially limits one or more of the major life activities of such individual").
ECRI Institute Evidence Report
ECRI Institute prepared an evidence report regarding drivers with hearing loss for the U.S. Department of Transportation's (DoT) Federal Motor Carrier Safety Administration (FMCSA) in 2008. The report compiled evidence related to several key questions about drivers with hearing loss, including whether such individuals are at increased risk for a motor vehicle crash compared with individuals who do not have hearing loss. At the time, FMCSA was evaluating its hearing standard for drivers of commercial vehicles.
ECRI Institute did not find evidence to support the contention that individuals with hearing loss who hold a private driver's license are at increased risk for a crash. Nor is ECRI Institute aware of any state limitations on the drivers' licenses of individuals who have hearing loss, although organizations should check for state-specific requirements in the states where their drivers may operate.
DoT cited the findings in 2013, when it granted exemptions from its hearing standard for interstate drivers to 40 individual drivers; the National Association for the Deaf had sought the exemption on behalf of these individuals. DoT continues to address exemptions from its hearing standard on a case-by-case basis and as recently as 2015 cited the evidence report in granting exemptions from the hearing test to 10 individuals.
Vehicle Modifications
With regard to potential accommodations available for motor vehicles driven by individuals who have hearing loss, organizations such as the American Automobile Association (AAA), the National Association of the Deaf, and the Hearing Loss Association of America do not have information available on such devices.
Some online forums for individuals with hearing loss, in addition to emphasizing the importance of close attention to visual cues, reference alert systems to notify a driver of an approaching emergency vehicle. Additionally, some car manufacturers are exploring technology that incorporates built-in dashboard systems that can alert the driver to oncoming sounds.
ECRI Institute recommends that risk managers contact the manufacturer of the vehicle that the driver would be using and ask if the vehicle manufacturer is aware of any accommodations that are available for that particular vehicle. The National Mobility Equipment Dealers Association, which provides information about adaptive transportation, may also be able to help.
Communication with Vehicle Occupants
Drivers' and passengers' ability to communicate with each other is also a source of concern. Organizations should develop a procedure for the driver to inform passengers of his or her hearing limitation before starting the vehicle. The ridesharing service Lyft, for example, informs passengers if a driver is deaf or hard of hearing.
The driver should also inform vehicle occupants of the best method for communicating with the driver while the vehicle is operating. Obviously, every effort should be made to minimize distracting any driver while in transit, but when communication is necessary, occupants should be informed of the appropriate method before the driver and vehicle occupants begin their trip. It may be necessary for the occupants to signal the driver so that the driver can pull over safely for any important conversation. To the extent possible, the driver and vehicle occupants should address issues that could arise before they embark on the trip.
One article on driving tips for individuals with hearing loss references a wireless microphone technology called Roger Pen that can be Bluetooth enabled. Passengers can speak into the wireless microphone, and their voices can be streamed directly into hearing aids with Bluetooth connectivity.
Additionally, organizations might consider outfitting the vehicle with an interior mirror large enough to permit viewing the entire interior of the vehicle and its occupants. Again, the vehicle manufacturer may be aware of other modifications that can be made to the vehicle to promote communication between the vehicle occupants and driver.
The recommendations contained in Ask ECRI do not constitute legal advice. Facilities should consult legal counsel for specific guidance and develop clinical guidance in consultation with their clinical staff.