Identifying pain early plays a surprisingly important role in preventing infections. This is particularly the case in people who are unable to reliably verbalise their pain, such as those living with dementia, learning disabilities, severe illness, or delirium. Here is how:
Pain can be an early sign of infection
Many infections start with localised pain before obvious symptoms appear. Some common examples include:
- Urinary tract infections (UTIs): Pain or discomfort during urination, abdominal pain, or agitation in someone who can’t describe the pain.
- Skin infections: Pain at a wound site before redness or swelling develops.
- Chest infections: Pain when breathing or coughing.
- Influenza infections: Pain may include body aches, a sore throat, and stomach pain
If a person is unable to verbalise these symptoms, the infection may go unnoticed until it becomes more advanced, potentially leading to further complications.
Untreated pain weakens the immune system
Pain that goes untreated causes physical stress on the body, as it can trigger raised cortisol (the stress hormone), an increased heart rate and breathing, poor sleep, and reduced appetite.
These stress responses suppress the immune system, making an individual more vulnerable to infection and slowing their recovery if they do become unwell.
Pain can prevent movement, leading to secondary infections
Individuals who cannot verbalise their pain may stop moving, resist physical activity, or remain in one position for too long, increasing their risk of conditions such as:
- Pressure ulcers, which can easily become infected
- Chest infections, due to shallow breathing and reduced lung expansion
- Urinary infections, when pain leads to reluctance to drink or toilet regularly
Identifying the pain allows early intervention and measures such as re-positioning and mobility support, helping to prevent these issues.
Pain may indicate a problem with medical interventions
Residents who cannot verbalise their pain may show distress due to pain or discomfort from medical devices such as catheters, feeding tubes, and dressings. If this pain goes unnoticed and untreated, it can cause localised infections and skin damage, and potentially even bloodstream infections.
It is therefore critically important that the behavioural and physiological signs of pain are recognised, so carers can correct the treatment as soon as possible.
Pain behaviours often appear before visible signs
In people with communication difficulties, pain often shows as:
- Restlessness
- Facial expressions
- Withdrawal and introversion
- Aggression or agitation
- Guarding a part of the body
- Reduced appetite or drinking
Spotting these signs allows clinicians to investigate and treat underlying problems before they escalate into infection.
How PainChek® helps spot infections earlier
Infection prevention starts long before a thermometer beeps or a wound becomes red. For many people living with dementia, cognitive impairment, learning disabilities, or advanced frailty, pain is the earliest and often the only sign that an infection is developing. But when someone can’t verbalise their pain, this vital signal is frequently missed, leading to late diagnosis, rapid deterioration, and avoidable hospital admissions.
PainChek, a clinically proven medical device for rapid pain assessment, is changing this.
Using facial analysis, behavioural indicators, and a structured assessment process, PainChek uncovers pain that would otherwise go unnoticed. And by detecting pain earlier, carers can identify potential infections sooner, intervene faster, and significantly reduce the need for emergency hospital care.
Here’s how PainChek makes that possible.
PainChek detects pain earlier – even when it’s not visible
PainChek analyses subtle facial micro‑expressions and uses a structured checklist to identify pain in under two minutes, even in people who cannot explain what they’re feeling. This matters because pain often appears before the more recognisable symptoms of infection.
Indeed, in non‑verbal individuals, the earliest signs of a UTI, chest infection, or wound infection may be:
- Subtle facial expressions
- Restlessness
- Reduced movement
- Withdrawal or agitation
Traditional, paper-based observation methods can easily miss these clues, but PainChek®’s facial analysis capabilities detect them consistently and objectively. This enables teams to investigate sooner, checking vitals, hydration, wounds, urine, or breathing, and ultimately uncovering infections at a much earlier stage.
Prevents infection‑related complications
Research shows that when pain goes unidentified, it increases the risk of complications such as infections, falls, malnutrition, and unnecessary ambulance callouts, which are all major drivers of hospital admissions in care homes.
As described above, this is because untreated pain triggers a cascade of issues. Care staff may even focus on managing behaviours rather than investigating the underlying medical cause of an individual’s agitation, confusion, refusal to eat, or disrupted sleep.
By revealing the presence of pain early, PainChek shifts the response from reactive to proactive, allowing carers to initiate clinical checks before the situation becomes more critical.
Reduces avoidable hospital admissions
The link between early pain detection with use of PainChek and reduced hospital admissions is now well‑evidenced across UK care settings.
Key examples include:
Elsyng House Care Home (Oakland Care Homes): A 72% reduction in hospital admissions following daily PainChek® use, driven by earlier recognition of pain‑related issues including infections and falls.
Ryeview Manor (B&M Care): Early pain detection using PainChek led to fewer hospital transfers and improved wellbeing, with over 2,300 assessments resulting in measurable decreases in incidents that typically lead to hospital admissions.
Regular, rapid assessments help identify infection patterns sooner
Unlike traditional paper‑based tools, which can take up to 30 minutes if completed properly, PainChek assessments take just minutes and can be completed frequently without burdening staff workloads. Care homes report that this routine use allows them to:
- Build a clear pattern of a resident’s baseline
- Notice sudden changes in pain scores
- Trigger early checks for infection sources
- Act before issues escalate into emergencies
In effect, PainChek acts as an early‑warning system, catching the subtle clinical changes that often precede infection.
Care UK has used PainChek across its homes for a number of years and has assisted carers with infection identification and prevention. Suzanne Mumford, Head of Nursing & Dementia at Care UK, explains:
“What we have seen across all the homes that are using PainChek is fewer hospital admissions and early identification of infections and things that might cause a person to go into hospital. If someone is brewing an infection, they tend to behave slightly differently, and they may well have pain. Infections such as UTIs are uncomfortable and can be excruciatingly painful. If we can nip that in the bud early by identifying that the person is starting to get uncomfortable and may need treatment, then we can give that evidence to the GP and get treatment for them earlier.
“With respiratory infections, treating pain caused by things like coughing will help that person to settle and fight the infection better. This a benefit of PainChek we hadn’t anticipated – that we’d be able to identify the symptoms of infection much earlier, treat those infections, and improve the quality of people’s lives.”
At Azalea Court care home in the London borough of Enfield, residents have experienced significant benefits from use of PainChek in identifying infections early. The team shared three examples that demonstrate its impact:
- Early identification of a chest infection – one resident showed increased PainChek scores indicating pain and discomfort, particularly in the chest area, before any significant changes were noted in vital signs. Observations subsequently detected a rising NEWS2 score, confirming physiological deterioration. Early intervention with antibiotics and supportive care prevented hospital admission and led to a full recovery.
- Detecting a UTI – PainChek identified an increase in pain behaviours in a resident who was unable to communicate their symptoms. Clinical monitoring showed subtle changes in their temperature and pulse rate, raising staffs’ suspicions of a potential infection. Prompt clinical assessment and treatment resulted in symptom resolution for the resident.
- Managing generalised pain and care adjustments – a resident living with chronic conditions exhibited fluctuating PainChek scores alongside changes in their vital signs. This data prompted a review of the resident’s pain management and care plan, leading to tailored interventions that enhanced their comfort and quality of life, including the treatment of pressure injuries.
Making the invisible, visible
For people who cannot explain that they are in pain, digital pain assessment is a lifeline. PainChek gives these individuals a voice, allowing carers to recognise infections sooner and intervene faster.
With PainChek, care homes can transform and equalise their care – giving residents unable to verbalise pain the same chance at an early diagnosis and timely treatment as everyone else.
To find out how UK care homes have been using PainChek to prevent infections, check out our free resource: Prevention vs Reaction: Why Care Providers Must Rethink Their Approach to Tech, which is available to download here.
To learn how PainChek® could support best-practice pain management in your organisation, book a session with our team.
