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Ann Hollander

Nonverbal signs of pain


Dementia itself does not cause physical pain. But people with dementia still encounter pain, just like anyone else: headaches, arthritis, tummy aches. They just can't describe it. They might even deny having pain when you ask because they don't understand the question.

Learn the nonverbal signs of pain so your loved one doesn't suffer. (Your knowledge of their pains before their memory loss condition will be helpful in identifying pain now.) Nonverbal signs of pain include

  • short, rapid breathing

  • unexplained sweating

  • grimacing, wincing, or frowning

  • moaning, whimpering, crying, or shouting

  • shielding a part of their body, curling up

  • rocking or self-soothing movements

  • tense or rigid body

Other signs include withdrawn behavior, increased confusion, trouble sleeping, inability to be comforted, restlessness or lashing out, refusal to eat. The more frequent these signs appear and the more intense they seem, the more likely there is a high degree of pain.

If you don't see an obvious source of pain—a mouth sore, a reddened or sensitive area, a bleeding cut, or a fever—contact the doctor. Describe what you have been observing.

  • Can you think of a likely cause?

  • Are there patterns, such as time of day?

  • Is there swelling somewhere? A particular location of the pain?

  • Is your loved one constipated?

  • Is he or she urinating frequently?

  • What have you found that seems to help?

You and the doctor together can determine if there is a problem to be treated—and if not, what you can do to effectively manage your relative's pain.

In the later stages of dementia, your loved one may not understand what's happening, but he or she understands comfort. If a medical solution isn't possible, do what you can to provide comforting doses of pleasure and kindness. Perhaps try a foot rub or a favorite song.

Want some help with pain management?

It's difficult when a loved one with dementia is in pain. Let us assist you. As the North Shore and Chicago experts in family caregiving, we at Options for Aging can help you identify your loved one's nonverbal cues. Give us a call at 847-868-1445.

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