I start with the bell because I feel it is more polite. (maybe just my opinion) I try the bell 3 times total if it doesn't work. Because most hearing loss begins with high tones, especially in older adults I am prepared for the inevitable fact that someone might not hear me. I then give my horn a squeeze to announce myself. usually most people hear that. if they still don't, I have no problem slowing down until they realize I am there or passing wide on the grass. I try not to be in a hurry at any point in my life because I believe that more accidents happen and my stress level rises when I rush.