The person shouts or calls out repeatedly. What are they communicating?

My dad, who is in an advanced stage, spends hours shouting my name or calling 'help', even when I'm right next to him. I don't know what to do anymore, and the exhaustion is immense. What is he trying to tell me?

Repeated shouting is exhausting, especially when you are already with the person and nothing seems to calm them. I want you to know that this is not against you, and your exhaustion is completely legitimate. Behind the shouting, there is almost always a message.

Why it happens

In advanced stages, the person loses the ability to express what they feel with words. Shouting becomes the way to express discomfort, pain, fear, loneliness, or sensory overload. It can also be a search for human contact and security, even if they no longer recognise what they need.

Practical strategies

• First, check for physical causes: pain, dirty nappy, hunger, thirst, cold, uncomfortable position.
• Reduce stimuli: dim lights and noise, and speak slowly.
• Offer reassuring contact: a calm tone, holding their hand, massaging their shoulders.
• Use soft, familiar music, which often calms.
• Maintain a predictable routine, which provides security.

What NOT to do

• Do not raise your voice or respond with irritation, even when exhausted.
• Do not leave the person alone for long periods while they are shouting.
• Do not assume it's "just the illness" without ruling out pain or infection.

When to seek professional help

New or intense shouting can indicate pain, a urinary tract infection, or another acute problem. Contact your GP or the NHS 111 helpline (111). Also, ask for a medication review and support: carer burnout is real and deserves attention.

"I discovered that my dad's shouting was almost always back pain from being poorly positioned. We adjusted his pillow, and it almost disappeared." — Anonymous Carer