Hearing loss causes distinct gaps in communication, especially in the clarity of sound. While a person with hearing difficulties can often hear that something is being said, it is the understanding of content that makes communicating difficult. This is where active listening comes into play.
As adults especially, we take contextual cues to learn what is being said. Then, by watching the talker, we learn the emotional impact of the message (happy, sad, frustrated, indifferent, etc.) and reinforce the talker by nodding or acknowledging what we understand. If, as a listener, we sit idly by and not respond, the consequence is isolation and misunderstandings. The people who want to talk lose the desire to express themselves if their messages are not validated.
Active listening does not mean a person never has to ask for something to be repeated; it simply means that true effort is being exerted to strengthen communication.