Jul 03, 2018

Letter to the editor: Constant vocalisation and unmet needs – how can we help?

HelloCare has received the following question from one of our readers.

“A contentious question that will no doubt get me some abuse, however I hope some understanding as well. In my wife’s Alzheimer’s section (one area of 20 residents) there is one of our dear friends that screams and make continuous very loud sounds all day (except when eating). Her family won’t visit anymore because of the noise and they have requested that she be medicated however for some reason the Doctor (who only puts up with the noise for 10 minutes) won’t approve this.

“My question is: Who is being abused here: the 19 residents that can’t hear the TV or talk to one another because of the nearly constant noise or the other one patient if she was to be medicated. We pay good money to have a normal residential feel and are being forced to put up with an unbearable ongoing sound. I believe she must be medicated for the sanity of the others who are also suffering with their own private problems.

“You can call me names if you like, however I’d like to invite you into this area for an hour and see if you change your mind.”

Bruce, Spouse of resident


This question was put to us a couple of weeks ago by one of our readers. We have reached out to a number of experts in the field, but so far haven’t received a response.

Situations such as that described by Bruce are by no means uncommon in aged care facilities and different homes have ways of managing and supporting the person experiencing the distress, as well as ways to minimise co-residents from becoming unsettled also.

While we can’t comment on individual situations without knowing all the details, it does appear that the co-resident Bruce describes appears to have unmet needs and is attempting to communicate.

We would like to put this question to our readers, who may have experienced similar situations in their own facilities and how was something like this situation addressed?

How have you helped people living with dementia in situations where ‘constant vocalisations’ are disturbing other residents? And what was done to comfort the person living with dementia?

How can we better support residents so their needs are being met to minimise their own personal stress?

Thank you Bruce for your question.

We encourage and invite comments from all our readers and other industry stakeholders but ask that comments are respectful and questions are asked with a commitment to listen to the respondent’s answer.

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  1. I notice that carers sometimes try massage of the hands to calm residents. and it seems to work. Just a thought.

  2. This could be an attention seeking situation, so one on one time spent with the resident and background information sought. Sadly staff don’t always have a lot of time to spare to do this. The facility I work at has a very good volunteer group who spend a lot of quiet time and one on one time with these kind of residents. It may take a while but patience is the key, unless there is another underlying problem, such as pain. Remember there are so many forms of dementia and so many different areas of the brain affected so there is never going to be one type of solution.

  3. If the occurrence of constant vocalisation is attributed to unmet need, with the greatest respect, massage, being with the person 1:1 will only work when someone is with them. Could it be that the unmet need might be fear, anxiety, feeling abandoned, just as a starting point.
    Looking at physical needs is often a place to start to ensure that pain, hunger, constipation etc. might be impacting on this person’s wellbeing.
    Is it possible to refer to Dementia Support Australia, to assist the staff and the GP to find strategies to decrease the vocalisation, and the distress this is causing to other resident, as well as the person we think has unmet need.
    Sedation will decrease the vocalisation, but it does not address the unmet need.

    Maybe after consultation and investigation, sedation may be needed, but not as a first line strategy, as it does nothing to treat the cause.


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