Here is a number that should be of concern to all of us: 45-85% of seniors in assisted living and skilled nursing have chronic pain (Stein & Ferrell, 2016). And that number represents only those who are able to recognize and report their pain!

For individuals living with dementia, pain is just as real as for the rest of us. The problem is that they may not be able to convey their pain in ways that cognitively aware individuals can. Often that leads to an ongoing cycle of pain, making their lives more uncomfortable than ever. What are the sources of pain in older adults? Here are some common ones:

• Arthritis, most typically osteoarthritis
• Urinary tract infections (UTIs)
• Pressure sores, from remaining in bed or immobilized for long periods of time.
• Muscle and joint pain

There is an abundance of research into how cognitively impaired people experience pain and how caregivers can better recognize and administer to their pain. Here are some tips for getting better at recognizing pain experienced by a loved one with a dementia.

• Observe. Look for obvious signs of pain as follows:
  • Crying out, cursing, combativeness
  • Pacing and/or restlessness
  • Grimacing and other facial expressions that indicate discomfort
  • Labored breathing
  • Tight fists and rigid body positioning
• Ask. While this can be more challenging when a loved one is struggling with dementia, he or she may still be able to communicate the pain. Of course, as the disease progresses, you will want to use the power of observation to assess the presence and level of pain they are experiencing. But first, ask. One way to keep things simple is to ask, “Mom, on a scale of 1-10 how much pain do you have right now?” Then, after you have taken steps to make her more comfortable, you can check in again, using the pain scale.

Depending on the cause and level of pain your loved one is experiencing, you may want to try one of the following methods to help alleviate their pain. Of course, it is important to check in with your loved one’s physician, as the pain could be emanating from a serious condition that needs treatment. Here are some natural methods of controlling pain that may work for you:

• Repositioning to ease muscle strain and pressure on joints
• Heat/cold therapy, especially useful for muscle and tendon strains
• Massage therapy to loosen muscles
• Aromatherapy to help reduce the tension caused by pain

It goes without saying that there will be times when medication is needed. Always check with your physician to make sure you are using a medication that can be tolerated and that you are administering the correct dosage.

Pain gets in the way of all our lives. It makes doing even simple things more difficult. It hinders our concentration and alters our mood. For those with dementia it is even more important to be prudent in assessing pain experienced by your loved one with dementia and treating it properly.