Every thing you are not supposed to do to a hearing impaired person, I am guilty of! My husband is severely impaired from Vietnam noise exposure, and his highs are gone. I have been in the hearing industry for 40 years, have opened 4 clinics myself, worked for ENTs, been VP of a large HA Mfg, so I should know better! I forget that his understanding of speech on his audiogram, with aids in, is only 60%. I should always speak so he can see me because 20% of a person's understanding of speech comes from sight. He is not going to do better than 60%, but with vision, he does pretty well. Also loudness is not clarity! Turn up the TV - up goes the music and special affects which interferes with speech. We have a TV box that connects thru bluetooth to his hearing aids and he hears better than I do! However, adjustments are important, and as we age the hearing instrument adjustments can help because with new technology come improvements that can be dumped into your current aids and upgraded. Makes it easier to get to the speech but the scores don't usually improve, but it is less exhausting for the hearing impaired person who has to concentrate so hard. Hope this helps, Gina