Read story D02: Where it hurts (image and text)
Where it hurts
Grace has advanced dementia and finds it hard to explain pain. Her son notices that she keeps holding her cheek. A dental assessment finds an abscess.
Pain may appear as refusing food, pulling away, calling out or a change in movement. Tell staff what you see and what is different from usual. A new change needs assessment for pain, delirium and other illness. In this example, dental treatment helps; the story does not establish that Grace has delirium.
Story text
Panel 1. Grace has advanced dementia. She says only a few words now.
Panel 2. Over two days she stops eating and pushes the carers away.
Panel 3.
- Nurse: Something has changed. Let's check for delirium, pain and infection.
Panel 4. The nurse watches Grace's face, sounds and movements for signs of pain.
Panel 5.
- Emeka: She keeps holding her cheek. Could it be her teeth?
Panel 6. A dentist visits and finds an abscess under a broken tooth.
Panel 7. The tooth is treated and her pain is controlled.
Panel 8. A few days later.
- Grace: Mm. Nice.
Bottom band. In dementia, pain may show as changed behaviour. Check for pain and delirium.