Relatives of dementia sufferers are urged strongly to consider their pain. Pain often goes undetected in people with dementia because they can no longer express themselves clearly. Their loved-ones or those looking after them should therefore consider signs that the person could be suffering from pain.
"When someone's character suddenly changes, for example, they become aggressive, scream or begin making defensive motions with their hands, this often is an indication of pain," said professor Rolf Dieter Hirsch, chairman of the German Academy for Gerontological Psychiatry and Gerontological Psychotherapy in Bonn.
In many cases people suffering dementia have toothache, said Hirsch. One indication of a painful dental condition is when a patient refuses food by clamping the jaws together.
Loved-ones should not rely on the patient to express his or her pain through facial expressions. Some dementia patients show no emotion, Hirsch said. In addition not every affliction is expressed through pain, he said, adding that their perception of pain is "completely distorted".
Hirsch and Hans Juergen Freter, spokesman for a German Alzheimer's assistance centre in Berlin, both recommend that relatives contact a doctor or dentist, if a patient behaves oddly. Even when a doctor visits a patient regularly, Freter said signs of pain might not be detectable. The doctor's visit lasts perhaps one-quarter of an hour, Freter said. Relatives and caregivers typically spend far more time with the patients.