Insights from the frontline: How dementia and delirium specialists are revealing the gap between what’s possible in nurse call system technology and what’s available in today’s hospitals.
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We assume every patient can use a nurse call system. In dementia and delirium care, that assumption can create risk.
Before joining Static Systems Group’s advisory board around nurse call system innovation, I had never stopped to fully reflect on the nurse call system.
Every ward has one. Every bedside has one. It is something that exists, so we assume it is doing what it needs to do.
Initially, I wondered whether my role in dementia and delirium care would fit into conversations about nurse call technology. It became clear that this perspective is often missing.
In healthcare decisions around systems and infrastructure, the needs of people living with cognitive impairment are not always considered early enough. Sometimes, they are considered only after a system is in place, and frontline teams work around its limitations.
Yet this is not a small or specialist population. A UK study of more than 50,000 hospital admissions found cognitive frailty was present in 34.5 per cent of patients, across acute specialties and driven largely by delirium and dementia-related conditions.1 Designing systems that assume consistent understanding and recall is increasingly out of step with modern hospital care.
Seeing what is possible changed how I think about what we currently accept
One of the most eye-opening parts was visiting SSG’s demonstration space and seeing technologies I had not realised were possible within a nurse call system.
The integrated communication and data capabilities made me realise how many possibilities aren’t known to frontline clinicians, let alone considered when trusts invest in new systems.
Once you see it, you start asking different questions.
You stop asking whether a nurse call system works and start asking what else it could tell you, prevent, and support.
Access does not always mean usability
For many patients living with dementia or experiencing delirium, being given a nurse call system does not automatically create safety. For some, it creates another challenge in an unfamiliar, confusing environment.
We place a nurse call system beside a patient and assume we have given them a way to ask for help. But for somebody with cognitive impairment, that device may not be understood as we expect. It may not be obvious what it is for, whether it has worked, or who will respond.
In falls reviews, we ask whether the patient had access to their nurse call system. But how do we assess a patient’s capacity to use it?
If they need the toilet, they may try to get up alone. If they become anxious, they may press it repeatedly. If they forget they have pressed it, they may become distressed because they think nobody has heard them. I have also seen patients hold the handset like a telephone and try to speak into it.
These are realities in dementia care.
Connecting data to patient safety
I had never really thought about what data a nurse call system could provide, or whether we could see patterns in response times, repeated calls, or patient need in a structured way.
A ward can become a closed box. Staff may recognise repeated calls for help, missed alarms, or patients struggling to use the system. Yet these signals are rarely considered alongside incident and reporting data.
Together, this information could be valuable, especially for vulnerable patients whose distress is not always verbalised. Repeated calls matter, but so does a patient suddenly stopping. Families often notice these changes first, making their observations an important part of the overall patient safety picture.
The physical environment and digital system cannot be separated
A nurse call system is not just a device. It sits within an environment that may be difficult for someone with dementia to process.
If it blends into bedding, perhaps the icon is not meaningful to the patient. If the environment is noisy, the barrier becomes greater.
In dementia care, we talk about helping patients connect the dots around them. That applies here too. A person may need clearer visual cues, colour contrast, or something that links the button directly to who will respond.
What feels obvious to staff is not always obvious to the patient.
Why collaboration matters earlier
The biggest lesson I have taken from this is that no single team can make these decisions well in isolation.
Clinicians understand behaviour, distress, and vulnerability. Digital teams understand capability. Estates teams understand infrastructure. Finance and procurement teams understand what can realistically be delivered. All these perspectives are needed.
There are more possibilities available than many of us realise, but without early conversations, opportunities are missed.
For many hospitals, the challenge is not simply choosing better systems. It is knowing what questions to ask before decisions are made. For patients living with dementia or experiencing delirium, those questions matter because the difference between a system that works in theory and in practice can directly affect safety, dignity, and daily living.
Created in collaboration with Static Systems Group (SSG) and Onyx Health.
Reference list
1. Boucher E, Gan J, Shepperd S, Pendlebury ST. 2323 Prevalence of delirium, dementia and cognitive test deficits, hospital-wide and by specialty in >50,000 unplanned admissions. Age and Ageing. 2024 Aug;53(Supplement_3).
