Often, when people start to lose their hearing, they isolate themselves and become alone. This affects them socially, and later in life it is harder to integrate into social gatherings, so they often don't go. If they do go, they struggle so much and feel so out of place, they seldom attempt to go next time. Their perception of the "real world" is going to be different because without sound, the world IS different.
Many people learn to read body language and facial expressions as they become deafened. The world is a conflicting place when dealing with people, because body language and facial expressions often don't fit the words being spoken. Often, body language projects the feelings a stranger has more proficiently than words can.
You should see the children at the school where I volunteer. They are so easy to read. You know when they are happy, sad, curious, or playful because they are open little books. The school does a wonderful job providing an atmosphere of love and respect. The new children that start late in the middle of the year are welcomed and quickly accepted and thriving in no time at all. They know they are safe. They know they can trust you. They know you are there for them and that you want the best for them. They know they can be vulnerable with you. Open your arms, they run to you for a hug.
I've seen the countenance of lonely people change instantly when someone opens their body language toward them, not even conscious they're doing so. It's interesting to observe groups of people together. I've watched couples sit across the table from one another in restaurants hardly speak to each other, but the moment they get up and wander out the door, their bodies are nestled into one another affectionately. I've seen others talking intensely, uptight and uncomfortable with one another, and I've seen large groups where the elderly aren't participating in the conversations, just looking around or down at their plate. Often, I see them with hearing aids. They are not involved most likely because they can't follow what is going on around them, so they zone out. Then someone comes over and opens their arms toward them. What a difference comes over their countenance.
Body language and facial expressions often speak louder than words.