Recognizing Nonverbal Signs of Pain in Loved Ones with Dementia

Caring for a loved one with dementia involves more than managing memory loss—it also requires staying alert to subtle changes that may signal discomfort or pain. Although dementia itself does not cause physical pain, those living with this condition still experience it, just like anyone else. What’s different is how they communicate it—or don’t.

A person with dementia may not have the ability to clearly express when something hurts. In fact, they might deny having pain altogether, either due to confusion or limited verbal ability. That’s why understanding the nonverbal signs of pain is essential for caregivers. Your attentiveness could be the key to relieving unnecessary suffering.

Common Nonverbal Signs of Pain in Dementia

Your loved one may not say "I'm in pain," but their body and behavior may tell a different story. Watch for:

• ‍Short, rapid breathing
• ‍Unexplained sweating
• ‍Facial expressions like grimacing, frowning, or wincing
• ‍Vocalizations such as moaning, whimpering, crying, or shouting
• ‍Protective gestures like guarding a body part or curling into a fetal position
• ‍Self-soothing behaviors such as rocking, rubbing, or repetitive movements
• ‍Tense, rigid posture

Other behavioral indicators can also point to discomfort:

• Withdrawal from social interaction
• Increased confusion or agitation
• Difficulty falling or staying asleep
• Refusal to eat or drink
• Restlessness, pacing, or physical outbursts
• Resistance to being touched or comforted

If you notice any of these signs occurring frequently or with increased intensity, it’s important to investigate further.

How to Assess and Report Potential Pain

Start by observing and documenting patterns. Ask yourself:

• Is there an obvious physical issue (e.g., a sore, swelling, or fever)?
• Is your loved one constipated or urinating more than usual?
• Do certain behaviors happen at specific times of day?
• Is there a noticeable area of tenderness or sensitivity?
• Have any home remedies (e.g., warm compress, gentle massage) helped?

Share your observations with a healthcare provider. You don’t need to diagnose the issue—but your detailed notes can help the doctor evaluate the situation and decide on appropriate treatment or symptom management strategies.

When There’s No Medical Fix: Offer Comfort

In the later stages of dementia, your loved one may not fully grasp the source of their discomfort. Even so, they can still experience and respond to comfort. If no clear medical intervention is possible, focus on delivering compassionate care in other ways:

• A calming foot rub
• Playing a favorite song or soothing music
• Providing a warm blanket or weighted lap pad
• Gentle touch or hand-holding
• Creating a quiet, familiar environment

These small acts of kindness can go a long way in relieving emotional and physical distress—even when words are no longer available.

How Geriatric Care Managers Can Help

Geriatric care managers (GCMs) are trained professionals who specialize in identifying and addressing the hidden needs of older adults, including those with dementia. They understand how pain can manifest nonverbally and work closely with families, doctors, and caregivers to ensure that no symptom goes unnoticed.

At LiveWell, our care managers can:

• Conduct in-home assessments to observe behavioral and physical signs
• Coordinate with medical providers for pain evaluation and treatment
• Educate family members on recognizing and documenting symptoms
• Create personalized comfort care plans
• Recommend adaptive tools and services for improved quality of life

Whether your loved one lives at home or in a care setting, our GCMs act as compassionate advocates—making sure pain and discomfort are managed promptly and effectively.

Worried Your Loved One May Be in Pain? Let Us Help.

Even without words, pain leaves a trace. If you're concerned that your loved one with dementia may be silently suffering, don't wait.

📞 Contact LiveWell today to schedule a free initial consultation and discover how our experienced care managers can support you and your loved ones—during the holidays and beyond.

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