by Roxanne Smedsrud


I have been working in hospice care for more than 20 years, and when I hear the word pain, I canít help but think no one should have to hurt at the end of life. This is especially true when I think of people living with dementia. Dementia is disease type that causes impairments in language, memory, personality, behavior and judgment. It is a chronic disease that causes continuous decline in the ability to see, hear, move, taste, remember, reason and understand. Because of their disease, most dementia patients can no longer report pain because they do not recognize it. Who will advocate for their comfort?


Pain in individuals with dementia is often under assessed and under treated. Studies indicate that although dementia patients experience severe or chronic pain, they regularly receive fewer pain medications than healthy senior adults. The results of one study also showed Alzheimerís disease, which is a category of dementia, did not alter the sensation of pain in individuals with Alzheimerís; it only altered their ability to report pain.


Because a person with dementia may not be able to tell anyone of the pain he or she experiences, itís so important to educate the caregiver. Whether the caregiver is a significant other, a family member, a CNA or a nurse, they all need to recognize the verbal and nonverbal signs of pain to ensure comfort for the individual with dementia. One situation in particular I have witnessed throughout my years as a hospice nurse is the misconception that the patient is comfortable as long as he or she is not moved around. A patient should be able to be repositioned without the fear of pain.


Signs or behaviorsónonverbal and verbalóindicating pain can include:



Anxiety or restlessness
Constant pacing, moving or unwillingness to sit down
Moaning, crying, sighing and even heavy breathing
Frowning, grimacing or a furrowed brow
Sleeping all day or not being able to sleep
Very rigid, striking out or resistive

It can be challenging to assess the comfort of someone with dementia. Pain is ever-changing and needs to be continually assessed, especially in the individual who is no longer able to even recognize pain. It is amazing what a little bit of pain medication, an hour before cares, can do for a personís comfort, and how much easier it will be for that caregiver to provide cares.


I hope this information will help caregivers continue to provide best care possible.


Roxanne Smedsrud is a clinical education specialist at Hospice of the Red River Valley.


Upcoming Events

We have several upcoming community events for†Hospice of the Red River Valley. We hope to see you there!


Living with Dementia

Tuesday, August 11, 2015

7-8:30 p.m.

Hjemkomst Center, 202 1st Ave. N., Moorhead, Minn.


This event, co-sponsored by HRRV and the Alzheimer’s Association, features Carol Bradley Bursack and Dr. Tricia Langlois. Attendees will learn practical advice, resources and stories to offer hope and guide those living with dementia at any stage and their caregivers. Bring your questions! This event is free and open to the community. For more information, click here.


Ole’s Ride

Saturday, August 29, 2015

Starts at Billy’s Corner Bar, Vergas, Minn.


Ole’s Ride is a motorcycle ride held in memory of Ole Barten, who lost his battle to cancer in February 2011. The ride kicks off from Billy’s Corner Bar in Vergas at noon. The cost is $25 per bike, $15 for additional rider, and includes a T-shirt, meal and chances at door prizes at each stop. A meal and live music by the FATCATS follow the ride. For more information, visit the Ole’s Ride Facebook page.


About Hospice of the Red River Valley

Hospice of the Red River Valley is an independent, not-for-profit hospice serving all, or portions of, 29 counties in North Dakota and Minnesota. Hospice care is intensive comfort care that alleviates pain and suffering, enhancing the quality of life for patients with life-limiting illnesses and their loved ones by addressing their medical, emotional, spiritual and grief needs. For more information, call toll free 800-237-4629, email questions@hrrv.org or visit www.hrrv.org.

by Roxanne Smedsrud

I have been working in hospice care for more than 20 years, and when I hear the word pain, I canít help but think no one should have to hurt at the end of life. This is especially true when I think of people living with dementia. Dementia is disease type that causes impairments in language, memory, personality, behavior and judgment. It is a chronic disease that causes continuous decline in the ability to see, hear, move, taste, remember, reason and understand. Because of their disease, most dementia patients can no longer report pain because they do not recognize it. Who will advocate for their comfort?

Pain in individuals with dementia is often under assessed and under treated. Studies indicate that although dementia patients experience severe or chronic pain, they regularly receive fewer pain medications than healthy senior adults. The results of one study also showed Alzheimerís disease, which is a category of dementia, did not alter the sensation of pain in individuals with Alzheimerís; it only altered their ability to report pain.

Because a person with dementia may not be able to tell anyone of the pain he or she experiences, itís so important to educate the caregiver. Whether the caregiver is a significant other, a family member, a CNA or a nurse, they all need to recognize the verbal and nonverbal signs of pain to ensure comfort for the individual with dementia. One situation in particular I have witnessed throughout my years as a hospice nurse is the misconception that the patient is comfortable as long as he or she is not moved around. A patient should be able to be repositioned without the fear of pain.

Signs or behaviorsónonverbal and verbalóindicating pain can include:

Anxiety or restlessness Constant pacing, moving or unwillingness to sit down Moaning, crying, sighing and even heavy breathing Frowning, grimacing or a furrowed brow Sleeping all day or not being able to sleep Very rigid, striking out or resistive

It can be challenging to assess the comfort of someone with dementia. Pain is ever-changing and needs to be continually assessed, especially in the individual who is no longer able to even recognize pain. It is amazing what a little bit of pain medication, an hour before cares, can do for a personís comfort, and how much easier it will be for that caregiver to provide cares.

I hope this information will help caregivers continue to provide best care possible.

Roxanne Smedsrud is a clinical education specialist at Hospice of the Red River Valley.

Upcoming Events

We have several upcoming community events for†Hospice of the Red River Valley. We hope to see you there!

Living with Dementia
Tuesday, August 11, 2015
7-8:30 p.m.
Hjemkomst Center, 202 1st Ave. N., Moorhead, Minn.

This event, co-sponsored by HRRV and the Alzheimer’s Association, features Carol Bradley Bursack and Dr. Tricia Langlois. Attendees will learn practical advice, resources and stories to offer hope and guide those living with dementia at any stage and their caregivers. Bring your questions! This event is free and open to the community. For more information, click here.

Ole’s Ride
Saturday, August 29, 2015
Starts at Billy’s Corner Bar, Vergas, Minn.

Ole’s Ride is a motorcycle ride held in memory of Ole Barten, who lost his battle to cancer in February 2011. The ride kicks off from Billy’s Corner Bar in Vergas at noon. The cost is $25 per bike, $15 for additional rider, and includes a T-shirt, meal and chances at door prizes at each stop. A meal and live music by the FATCATS follow the ride. For more information, visit the Ole’s Ride Facebook page.

About Hospice of the Red River Valley
Hospice of the Red River Valley is an independent, not-for-profit hospice serving all, or portions of, 29 counties in North Dakota and Minnesota. Hospice care is intensive comfort care that alleviates pain and suffering, enhancing the quality of life for patients with life-limiting illnesses and their loved ones by addressing their medical, emotional, spiritual and grief needs. For more information, call toll free 800-237-4629, email questions@hrrv.org or visit www.hrrv.org.