Pain is a deeply personal experience — and for individuals living with dementia, it becomes even more complex. As cognitive function declines, so does a person’s ability to recognize, process, and express pain, which can lead to undetected or undertreated suffering.

Understanding how dementia impacts pain perception is essential for families and healthcare providers alike.

Can People with Dementia Still Feel Pain?

Yes. Most individuals with dementia do feel pain, but the way they perceive and respond to it may change. Some research suggests that people with Alzheimer’s may have a reduced ability to recognize pain, while others may feel it but struggle to describe it accurately.

Brain regions responsible for pain awareness, memory, and language — all affected in dementia — can alter how pain is interpreted and communicated.

Why Is Pain Often Missed in Dementia Patients?

• Verbal limitations: People may not be able to explain where it hurts or how intense the pain is.
• Behavioral masking: Instead of saying “I’m in pain,” someone might show signs like agitation, restlessness, grimacing, or withdrawal.
• Cognitive confusion: They may not connect physical discomfort to a need for medical help.
• Underreporting: Some individuals, even in early stages, may downplay symptoms or forget about them entirely.

This makes observation critical — especially for non-verbal patients or those with advanced dementia.

What to Look For

Signs that may indicate pain in someone with dementia include:

• Facial expressions (frowning, grimacing)
• Vocalizations (moaning, calling out)
• Changes in appetite or sleep
• Increased confusion or aggression
• Guarding certain body parts

Final Thoughts

Pain in dementia isn’t always obvious — but it’s very real. Proactively monitoring for signs of discomfort, using validated pain assessment tools, and responding with empathy can dramatically improve quality of life and overall health outcomes.

By listening closely — even when words are few — we can help ensure that no one suffers in silence.