Assessing Pain in Someone with Dementia

Eldercare, Elder Care, Parent Care Alliance, Kathy Eynon  It is important to realize that people with dementia experience pain just as much as anyone else does.  It is a common symptom that frequently goes unrecognized and untreated even though treating pain is not a difficult thing to do.  I think all of us would agree that uncontrolled pain can seriously affect a person’s quality of life.

But, when a person with dementia is unable to say they have pain, caregivers need to work extra hard to recognize the signs of pain that might be exhibited.

People with dementia are not immune to the common causes of pain in the elderly:  Stiffness and pain in the joints, pain from pressure if they have been sitting too long in one position, injuries from falls or bumping into things, or just a plain old headache!

And often relief can be as simple as a change in position, gentle massage, a warm compress, an air mattress or special seat cushion, or a dose of Tylenol.

So how do you assess for pain?

You might first, simply ask.  Many people with even moderate to severe dementia can still provide some information about their pain.  Keep the questions simple.  They may not recognize the word ‘pain’.  Ask, ‘Does it hurt?’ or ‘Is it sore?’

But you may also need to be prepared to look for other signs.  If you know the individual well, you may simply notice that, when they are in pain, they shout out or become very withdrawn and quiet.  Other signs that you might observe:

Vocalizations:  whimpering, groaning or crying

Facial Expressions:  looking tense, frowning, grimacing

Body Language:  fidgeting, rocking, guarding a body part

Behavioral Changes:  increased confusion, agitation, refusing to eat

If you observe these types of changes, try some pain relieving measures and assess the response.  When I worked as a nurse on the 3-11 shift, there were a certain number of dementia residents that exhibited increased agitation in the evening which made it difficult for them to sleep.  When other measures didn’t seem to work, Tylenol was often the answer.  Just as I myself am achy at night sometimes, they were too!

Nobody should have to live in pain simply because they cannot tell you that they have pain.  As caregivers, it helps us to help our loved ones if we pay attention to the signs and try to respond.  Good pain management is a quality of life issue that should not be ignored.  We should be careful not to lump the behaviors associated with pain in with those of dementia.

Caring for a loved one with dementia presents great challenges.  Being aware of and helping your loved one to manage their pain may make the job a bit easier for you and certainly makes their life more comfortable!

On the journey with you…….Kathy

Kathy Eynon is an Eldercare Coach and Consultant that works with those struggling to cope with the demands of caring for an aging parent.  She can be reached by email at:


One response to “Assessing Pain in Someone with Dementia

  1. Great article!!

    See you tomorrow!!

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