Client complains of pain — what you can and can't do

New, worse, or unexplained pain is a reportable change — observe, ask where and how much, and tell the nurse or your supervisor today. You may not give pain medication on your own; medication assistance rules still apply.

1. 1Ask and observe: where, when it started, what it feels like (sharp/dull), how bad (0–10 or their own words), what makes it better or worse.
2. 2Watch nonverbal signs too — grimacing, guarding a body part, refusing to move, changes in appetite or sleep. Important for clients with dementia who may not say 'pain'.
3. 3Call 911 first for danger signs: chest pain, pain with trouble breathing, sudden severe headache, severe abdominal pain with a rigid belly.
4. 4Comfort within scope: positioning, pillows, the bathroom, quiet — per the care plan.
5. 5Pain medication follows the assistance rules: the client self-directs and takes it themselves; you never decide dose or timing.
6. 6Report the same day and document: the client's exact words, what you observed, what you did, who you told.

Pain is whatever the client says it is — never dismiss or 'wait and see' on new pain in an older adult. Untreated pain also shows up as agitation, confusion, or refusing care.