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Repetitive vocalisation in older people with cognitive impairment in the hospital

What we are doing:

This study followed the natural history of people who call out repetitively in hospital, and their circumstances beyond discharge. A mixed-methods study was conducted across seven wards on two acute hospital sites. An ethnographic case-series of 30 older people who call out were examined. This utilised observations with field notes, family and staff interviews, records of nursing documentation, and baseline and ongoing quantitative measures. 

Why we are doing it: 

On acute medicine for older people hospital wards, staff often care for patients with cognitive impairment who ‘call out’ repetitively. This consists of disruptive vocal behaviours, such as constant screaming, asking repetitive questions or making demands, and bizarre noise-making. This behaviour, combined with acute hospital admission and busy, unfamiliar staff, can cause serious effects on the quality of care provided for people who call out in the acute hospital. There are a number of reports in the literature regarding calling out in nursing homes, however there is very little empirical evidence in the context of the acute hospital. Little is currently known about knowledge or beliefs surrounding this behaviour, and how hospital staff and carers respond to it.

What the benefits will be:

These findings can help us to better understand the cognitive and functional abilities of people who call out repetitively within the acute hospital; alongside recognising why and how staff members in the acute hospital rationalise avoiding their patients who are calling out. This research can help us to develop an intervention for use in the acute hospital.

Who we are working with:

Professor Rowan Harwood, Dr Sarah Goldberg and Dr Alison Edgley, in conjunction with two general hospitals in England.


Jess Beaver, PhD Student, School of Health Sciences