Pain and the Person with Dementia

People with cognitive impairments may not be able to verbally express that they are experiencing pain.  Whether the diagnosis is Alzheimer’s disease or another form of dementia, due to a decrease or lack in the ability to recognize and communicate with words, there may be greater problematic or negative behaviors as a result.

Pain can come from a multitude of conditions and symptoms.  Being observant as to changes can assist in leaning the signs of discomfort and pain when someone cannot say, “I am in pain!”

The best way to assess pain by family care partners is through their familiarity of the individual, simply knowing and understanding the person whom care is provided for.

For the individual experiencing pain, besides their facial expression and body language, moods, changes in mental status, activity patterns or routines can be a sign that something is happening. Moreover, behaviors and vocalizations, such as grunts and groans, can speak volumes.

Listed are a few pain indicators. Care partners should evaluate their loved one while they are at rest and during movement, noting anything that is out of the norm for that individual:

  • FACIAL – Clenched teeth, furrowed brow, grimaces, scowling look, frowning
  • NON-VERBAL VOCAL COMPLAINTS – Non-verbal noises such as signs, groans, moans, crying, winces, yelling, screaming
  • VOCAL VERBAL COMPLAINTS – Words or phrases such as: ouch, stop, no, that hurts or cursing
  • BODY LANGUAGE – Clenched fists, holding a particular area of the body, rubbing or massaging the affected area. This could include restlessness, rocking, position shifting, inability to remain still, slow movement, or withdrawing the painful body part from touch
  • BEHAVIORS – Hitting, slapping, grabbing, punching, kicking, pushing, pulling, biting, pinching

Other changes in behavior may include disrupted or restless sleep, lethargy or increased sleep. There could be a display of increased irritability, anger, agitation, or aggression.

All because an individual cannot tell us about pain, it does not mean they are not experiencing it.  It is important to have an awareness so that pain can be identified and treated.  As a Care Partner, it is also necessary to recognize any of your own pain you may experience, as well as other health issues.  You can only attempt to do the best you are able to in an effort to care for your loved one, and yourself.

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