What do you think of the mind-set of people who so OBVIOUSLY need a hearing aid, but refuse to get one?

There is a small business man (small, as in, one-man-business) in town that you have to YELL to talk to. Oh man. I had to place a phone call to him, so I went into another, “private,” room at my office to make the call. Went to VM. I thought “Oh man. He mostly reads lips….” so I lft the message as loud as I could without disrupting the rest of the office.
Twenty minutes later he called back, asking what it was I needed. Again I went to the “private” (read “bathroom with the door shut!”), and I’m having to repeat key words over, and louder, and over and LOUDER again until he repeats those four key words back to me, then I know that he got the message.
I’ve known this person for many years, and his hearing loss just keeps getting worse and worse, and yet he refuses to get a hearing aid.
So, what are your thoughts on people who CAN’T HEAR but refuse to get a hearing aid….?