Successful integration of volunteers in hospital settings is dependent on many factors and volunteer roles should be clearly defined to prevent tension between staff and volunteers. The objective of this article is to explore staff, patient, and family member’s perceptions of volunteers to work with and advocate for older adults with a cognitive impairment in the acute hospital setting. This research uses a qualitative descriptive design using semi-structured interviews in a medium sized acute teaching hospital in Ireland. The sample consisted of staff (n 25: nurses, porters, care assistants, and relevant line managers), patients aged sixty-five years or older (n 15), and family members of older patients (n 15) from medical, surgical, and geriatric wards and the emergency department. All groups consistently identified psychosocial support as an area that could well be supplemented by volunteers, followed by practical assistance. Concerns regarding confidentiality and the character of volunteers emerged as a strong theme among all groups. A potential advocacy role for patients was found to be a contentious issue among staff and was poorly understood by patients and family members. We conclude that volunteers to work with older adult patients are broadly welcomed by relevant acute hospital stakeholders especially for psychosocial support. Robust selection and monitoring of volunteers is necessary to reassure all involved. A combined support and advocacy role needs further patient/relative explanation and staff education prior to initiation.