Recognition of Pain

Is the person I am caring for in pain?

Pain can be experienced and expressed differently by each person. Some people are able to talk about their pain and show you where the discomfort is, and other people may show a change in their body language, appetite, or mood. Depending on how well you know the person you are caring for, you may or may not be able to easily recognize changes in them. Regardless of how well you know the person, you can recognize pain if you ask a few key questions and look for key signs.

Ask specific questions

The following are examples of questions that you can ask to find out if the person you are caring for is in pain:

  • Are you feeling any aching/soreness right now?
  • Does it hurt anywhere?
  • Are you having any discomfort?
  • Have you taken any medications/remedies to help ease your pain or discomfort?
  • Are you losing sleep due to aches/pains/discomfort?
  • Are you having trouble getting your day-to-day routine done because of pain? (e.g. showering, cooking, housework, pet care, etc.)

Facts about Pain

Did you know…pain is one of the most frequent causes of visits to the emergency department. Pain is a very common experience for older adults but should not be considered part of the natural process of aging. Pain can impact a person’s quality of life in many ways, including:

  • Poor quality of sleep
  • Less movement
  • Depressed mood
  • Being withdrawn from others
  • Poor quality of life

However these areas can be improved if pain is reduced. Pain can be treated with or without medications, and sometimes treatment can alternate between these approaches.

Proper treatment of pain starts with a full assessment.

Look for indicators and take notes

As a family member or friend caregiver, you will be able to observe small changes in the person you are caring for better than most health care professionals. Never underestimate the knowledge you have of the person you are caring for. You know them best.

If you notice any of the following, it could mean that the person you are caring for is in pain (Use the forward arrow to navigate through the cards):

Activity 2.1 Pause and Reflect

How do you recognize pain in the person you are caring for? Write some of these notes down in your weekly Reflection Journal.

How strong/intense is the pain?

If the person you are caring for tells you that they are in pain, the next step is to identify the severity of the pain. By understanding how bad the pain is, you will be better able to make decisions about the nature of support the person you are caring for might need.

Here are some examples on how to ask this question:

  • Does your pain feel mild, moderate, or severe?
  • Do you have a little, medium, or a lot of pain?
  • On a scale of 0 – 5, with 0 being no pain and 5 being the worst pain you could ever imagine, how would you rate your pain? Try using the Pain Scale with the person you care for!

Identifying pain in a person with advanced dementia may require a different approach to simply asking them. Some ways to tell if a person with advanced dementia is in pain are by:

  • looking at their face and body language for any grimacing
  • monitoring their behaviour, watching for restlessness
  • watching how they move around (e.g. limping or holding their stomach)
  • listening to the sounds they are making (e.g. yelling out or vocalizing)

Activity 2.2 Try a Tool

Complete the Pain Scale for the person in your care.

Types of Pain

You now have a better sense of the pain the person you are caring for is experiencing. You have identified that there is pain and how bad it is impacting their daily life. The next step is to identify the type or source of pain. There are many terms to describe the type and sources of pain. Knowing the type or source of pain that your person is experiencing may make it easier for you to:

  • understand their pain
  • help provide ideas for comfort
  • help them talk with a health professional
Pain TermDescription
New (acute)An unpleasant sensory and emotional experience associated with injury or obvious disease process. Usually short in duration (i.e. one week to 10 days).
Long-term (chronic)Prolonged pain lasting at least 3 months beyond the time of new injury or obvious disease process. Other terms often used with chronic pain include:’intractable’ (not able to go away with ordinary treatment), or’refractory’ (unable to manage with traditional treatments)
ReferredSometimes, pain can be felt in another part of the body. An example of this would be when someone feels arm pain with a heart attack. Referred pain can occur with acute and chronic pain.
NeuropathicPain that is primarily caused by a problem in the nervous system rather than obvious injury. Some examples may include:’burning’ or ‘tingling’ or numbness shooting pains”pins and needles”typically feels worse at nightpain felt from something that does not usually cause pain (allodynia). An example of this is when a person feels pain on their feet with bed sheets on them or pain with clothing touching the skin.
BreakthroughFor chronic pain, treatment may require using a long acting pain medication for constant pain management. Sometimes, even though a person is taking pain medication, their pain still ‘breaks through’; and requires another pain remedy to help ease the pain.
Adapted from RGP of Toronto. (2018). SF7 toolkit.
Retrieved from

Activity 2.3 Test Yourself

Try this short matching exercise to see if you can match the accurate pain terms to the examples provided.

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