I too, got into the habit of prefacing everything with "I'm sorry, I have a progressive hearing loss..." I felt like I was explaining myself all the time!
After a while, I decided to say, "Do me a favor, face me when you talk, I need your lips!" Believe me, that gets their attention! If someone is talking too fast, I say, "Time out!" (while making the universal sign) and say, "I don't want to miss anything you're saying..." It tells the other person I am engaged and I value the words coming out of their mouth.
As my loss progressed, communication became increasingly difficult for all parties involved. I try to gauge the other person to see if I should just cut to the chase and ask them to write stuff down or use pidgin-sign. I'm still working on my ASL skills.
As most already know, communication needs depend on the environment. Ours is a world of never-ending adjustments and second-guessing...doesn't mean we have to apologize. We must educate others. And, if we have any strength left over, we remind ourselves why we make the effort to engage our world.
Just wish I wasn't so tired...
p.