Step 1: The key clue is that conversational speech is lost but loud or amplified speech is still perceived. We must map this to the audiometric grading of deafness.
Step 2: Grades by better-ear threshold are roughly mild $26-40$ dB, moderate $41-70$ dB, severe $71-95$ dB, and profound greater than $95$ dB. Normal speech sits near $50-60$ dB.
Step 3: A person needing shouting or amplification has a threshold high enough to miss $50-60$ dB speech yet low enough to catch loud sound, which places them in the $71-95$ dB band, that is the severe category.
Step 4: Functionally these patients lean on lip-reading even with strong hearing aids. Moderate loss would still allow some normal speech, and profound loss would miss even shouting, so both are excluded.
\[\boxed{\text{Severe hearing loss}}\]