Farm noise exposure is the major cause of noise-induced hearing loss among farmers. Hearing impairment associated with hearing loss, however, may not adequately represent communication handicap and the impact on quality of life. This descriptive correlational study examines the impact of hearing impairment, perceptions and attitudes about hearing loss, and noise exposure risk patterns on hearing handicap among farm family members. A convenience sample of 56 farmers and family members recruited from community-based agricultural events was studied. A hearing impairment was noted in the majority of the participants (80.4%). Fewer than 10 reported regularly wearing protection during work or recreational activities. High-frequency hearing loss in the left ear (F= 10.30, p < .002), the attitude that wearing hearing protection prevents others from getting one's attention (F= 11.90, p < .001), and the self-reported description of hearing (F= 6.66, p < .013) significantly predicted hearing handicap using multiple regression analysis. Farmers and family members do not use hearing protection because they are concerned they will not hear others who are trying to communicate with them. The findings of this study confirm that this attitude, along with hearing loss in the left ear, is associated with a communication handicap in work settings. Although being able to hear others on a day-to-day basis is important, this attitude may contribute to behaviors leading to hearing loss and decreased communication over time.