How to Recognize Pain in Older Adults When They Don’t Say They’re Hurting

A woman with a strained expression illustrates the importance of being able to recognize pain in older adults and respond appropriately.


A sudden change in behavior doesn’t always have an emotional cause. When an older loved one becomes withdrawn, short-tempered, or less interested in everyday activities, it’s easy to assume they’re having a difficult day or that their dementia is progressing. Sometimes that’s true. Other times, the real problem is physical discomfort they can’t explain.

Pain in older adults can be challenging for family members to spot. This is especially common for someone living with dementia, but it can also happen when a person has simply learned to live with chronic aches and pains without talking about them. Instead of saying they’re hurting, they begin acting differently.

Knowing how to recognize those changes can help you respond sooner and make it easier for your loved one to get the care they need.

Notice Changes in Their Personality

You don’t need medical training to recognize when someone seems unlike themselves.

Maybe your loved one has become unusually impatient. Perhaps they’re less interested in conversation or no longer look forward to activities they once enjoyed. They may seem restless, eat less than usual, or prefer to spend more time alone.

One change by itself doesn’t necessarily point to pain, but when several changes appear together or continue for more than a few days, it’s worth considering whether discomfort may be the cause.

Observe How They Move

Pain often becomes most obvious during ordinary activities.

Watch your loved one as they stand from a chair, climb into bed, reach for something on a shelf, or walk through the house. A slower pace, hesitation before moving, or relying on furniture for support may all suggest they’re trying to avoid pain.

These subtle changes in movement often provide clues that words cannot.

Keep a Short Record

Trying to remember weeks of observations during a doctor’s appointment can be frustrating.

Instead, spend a few days writing down what you’ve noticed. Record when a behavior occurred, what your loved one was doing beforehand, how long it lasted, and whether anything seemed to improve the situation.

Those simple notes can help healthcare providers identify patterns and determine whether pain or another medical issue may be contributing.

Respond with Patience

When someone refuses to participate in an activity or becomes upset unexpectedly, it’s natural to want to encourage them to keep going.

Before responding, consider whether they may be reacting to physical discomfort rather than the situation itself.

Acknowledging what you observe with a calm statement such as, “Let’s take a short break,” or, “You seem uncomfortable today,” can be much more reassuring than trying to persuade them to continue.

Why Consistency Matters

One of the benefits of regular home care visits is that caregivers become familiar with what’s typical for each client.

That familiarity makes it easier to recognize gradual changes that might otherwise be overlooked. A caregiver may notice that getting dressed suddenly takes longer, a favorite daily walk has become shorter, or someone who usually enjoys conversation has become noticeably quieter.

Those observations provide valuable information that can help families address concerns before they become more serious.

Another Partner in Your Loved One’s Care

You don’t have to notice every change by yourself. At Covenant Caregivers , our caregivers get to know the people they serve well enough to recognize subtle differences in their routines, mobility, and behavior. By sharing those observations with you, we help provide another layer of support that can make a meaningful difference.

If you’d like to learn more about our in-home care services, call Covenant Caregivers at (601) 856-5660. We serve seniors in Jackson, Clinton, Brandon, and throughout southern and central Mississippi, and we’d be happy to answer your questions and schedule a free in-home consultation.