The combination of chronic pain and dementia is difficult to manage. While advancing dementia can render an elder heartbreakingly vulnerable, chronic pain that can’t be expressed in words by the person with dementia multiplies the difficulty of compassionate care. Since dementia can leave people unable to verbally express the fact that they are in pain, they may scream, kick or hit. They may act out aggressively because they don’t understand why they are in pain. They just want it gone. If caregivers misinterpret the reason for this “acting out,” there is a chance that the elder will not receive proper pain management for his or her chronic or acute pain.