Beyond Words

Sometimes, for a variety of reasons, clients either cannot or will not verbally communicate that they are in pain or distress. If the distress is primarily psychological or emotional, they may not understand what is happening or may be overwhelmed by their feelings. While nothing can teach you to be a mind reader, there are some indicators to watch for to help you connect with your clients and to pick up on their distress.

Both chronic and acute pain can take a toll on the mind. We will be covering this more specifically in the future on this blog and, of course, in depth in the specialized classes offered by LifePulse. At the most basic level, caregivers must always remember that pain is highly individual and difficult to assess.

Each person’s subjective experience of pain is unique. Always try to avoid judging someone who seems to have a low pain tolerance, and be aware that others may experience a high level of pain before they will ask for help. Our culture’s preconceptions of both mental illness and pain can impact how much your clients may be willing to express themselves.

The following are general types of non-verbal and non-specific indications that your client may be in pain that cannot be expressed clearly:

• Facial Grimaces and Winces – Facial expressions say a lot. If your client is clenching teeth, has a furrowed brow, is tightening the face, or making other expressions of distress outside of the ordinary, you should take this as a sure sign of pain or distress.

• Bracing – People often try to minimize pain by holding onto something, gripping, or holding a body part.

• Restlessness – Sometimes people in pain shift and move in order to find a position that is less painful.

• Rubbing – If you notice a client massaging or rubbing an area, ask about it or make a note of it (depending on the client’s level of communication).

• Verbal/Vocal Complaints – Sometimes people cannot explain their pain or do not wish to say that they are in pain, but they will still make voluntary or involuntary noises. These may include grunts, moans, cries, outbursts, cursing, and objections. For some patients, this is as clearly as they can express themselves, so it is up to you to listen.

• Avoidance – Certain activities may be so painful that clients will try to avoid doing them just to avoid the pain. What clients are willing to give up to avoid pain is a good indicator of how much they are suffering.

Above all, remember that your client is a human being. When you offer assistance or a PRN, always remember to be respectful and to show empathy. You never know when a person may be struggling with the impact of acute pain or feeling an endless drain from chronic pain. Pain and disability impact a person’s sense of self-worth. You, as a caregiver, might do as much good with kindness and empathy as you do by administering medication to manage pain.

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