Pain and dementia

The most obvious way to find out if a person with dementia is in pain is to ask them – but as their condition progresses, they may have difficulty telling you.  

They may not be able to describe where the pain is coming from, and even say “no” if you ask if they’re in pain.  

They might use the wrong words to explain how they feel – for example, saying “injection” rather than “indigestion”.  

It may help to ask specific questions, such as: 

• “Is your arm aching?” 
• “Does it hurt here?” 
• “Does it sting?”  

Signs of pain to look out for include: 

• calling out, groaning or shouting – especially if this is new behaviour, or has increased 
• changes in body language, such as fidgeting, restlessness, twitching, rubbing a body part or tensing up 
• facial expressions like grimacing and frowning  
• seeming frightened or distressed during personal care like washing and dressing 
• sleeping more or less than usual 
• physical changes like sweating, appearing flushed or pale, fast pulse and/or changes in temperature 
• appearing withdrawn or low in mood 
• changes in appetite, like refusing food 

You could also try to think back to how they acted when they were in pain prior to their diagnosis, as you may be able to spot similar signs in their behaviour. 

Possible causes of pain include: 

Health conditions 

People with dementia, especially those who are older, often have other health conditions as well.  It is important to keep up with regular health checks and help the person take any prescribed medication correctly to try to keep them as well as possible. 

Mouth problems 

Gum disease and other mouth problems can be extremely painful. People with dementia may find it hard to maintain good oral health, but with support, they can brush their teeth daily, use a mouthwash and visit the dentist regularly. Read our information on mouth care for more advice. 

Arthritis 

Arthritis becomes more common as people get older, and can cause pain in the hands and feet, limbs, neck, spine, and sometimes torso. If you notice swelling, redness, or stiffness in the joints, speak to the person’s GP or a pharmacist for advice. 

Constipation 

Constipation can cause pain and discomfort, and is more likely if the person has a limited diet and/or is becoming less mobile. 

Try to encourage them to eat a balanced diet with plenty of fresh fruit and vegetables, and ensure they are drinking enough fluid – our information on eating and drinking may be useful.  If constipation is occurring frequently, speak to their GP or a pharmacist. 

Inactivity 

Lack of movement can contribute to pain, so if the person spends long periods in bed or a chair, encourage them to get up regularly if possible and support them to take a walk into the kitchen for a drink, or just around the room. 

Being poorly positioned can also cause pain, so check that the person’s chair is supportive, and use cushions to help them sit comfortably. You can request a free Needs Assessment to identify any equipment or home adaptations that may improve their comfort and mobility. 

The following strategies may also help relieve pain in a person with dementia. 

Heat or cold can help with localised pain. Heat (such as a hot water bottle in a cover) is best for easing aches and stiffness. Cold (such as an ice pack) is better for treating inflammation like sprains and bruises. 

Physiotherapy or massage can be good for soreness, stiffness and general aches and pains, but it’s important to explain what is going to happen and stop if the person seems to be in distress or discomfort. 

Relaxation techniques such as breathing exercises or mindfulness can help.  

It can be useful to keep a diary, recording things like: 

• how often the person seems to be in pain 
• times of the day when they appear to be in pain 
• changes in behaviour that indicate pain 
• whether pain is brought on by particular movements or activities 

If medication is recommended, support the person to take it as prescribed, and to attend any reviews with their GP or a nurse.  

If the person has difficulty taking tablets, speak to the GP about other options, such as patches.