The list is lengthy – the list of people who can’t tell you where the pain is, how bad it is, or even if they have it. We think of the elderly who have diseases like Alzheimer’s as one group, but there are also those who have had strokes and can no longer communicate, developmentally delayed people, young children, even people who can’t speak to you in a language that you can understand.
So, if you love or take care of someone who can’t communicate – how do you tell if he or she has pain?
You need to be observant and pick up on body and nonverbal cues; some are obvious, others may not be.
Changes in behavior or demeanor: Does the person seem more agitated or aggressive than usual? Or the opposite – is he quieter and trying to move less than usual? Is she moving repetitively, like rocking back and forth? Is he pacing when he usually doesn’t? Is she newly refusing to do things?
Guarding: Does she appear to be protecting a certain part of the body, as if in an effort to protect it? Is he constantly touching, rubbing or massaging a part of his body?
Appetite: Is she eating less than normal? Does his appetite seem to have waned?
Sleep: is she waking more often during the night than she used to? Is he tossing and turning more while in bed?
Mental status: Does she cry more or is her crying different from it used to be? Does he seem to be wandering more or did he wander but has stopped? Does she seem more irritable or defensive?
Posture: Does she seem to be more hunched over than usual? Is he holding his body more tensely than usual? Is she limping or having trouble maintaining balance?
It may seem like this is a long list, but it’s merely a guideline to help you understand what types of things may indicate pain or discomfort. Many times, a caregiver says after the fact, “if only I’d noticed….” Hopefully, this will help you understand what sorts of things to watch for.
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Tags: chronic pain blog, pain blog, elderly and pain, developmentally delayed and pain, determining pain, how to tell if there’s pain