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Many older adults have difficulty understanding speech in the presence of background sound. Experiences resulting from such comprehension difficulties include increased listening effort and fatigue, and reduced enjoyment. Social interactions may become less appealing in the context of such experiences, and age-related hearing loss is associated with an increased risk of social isolation and associated negative psychosocial health outcomes. However, the precise relationship between age-related hearing loss and social isolation is not well described. Here, we review the literature on the relationship between hearing loss and social isolation, and propose a framework with different stages along a continuous progression: within-situation disengagement from listening, social withdrawal, and social isolation. We describe the distinct characteristics of each stage and suggest potential interventions to mitigate negative impacts of hearing loss on social lives and health. We close by outlining potential implications for researchers and clinicians.