Which of the following is a sign of pain in nonverbal elderly individuals?

• A. Agitation
• B. Refusal to eat
• C. Pulling at the face
• D. All of the above

Answer: (D)

Nonverbal elderly individuals often communicate pain through behavior rather than words, so multiple cues can point to discomfort. Agitation can reflect distress from pain, especially if it changes with movement or care. Refusal to eat may occur when pain makes chewing or swallowing uncomfortable or due to mouth or throat pain, so a drop in intake can signal underlying pain. Pulling at the face is a direct facial cue that can indicate facial, dental, or head-related pain, particularly when observed alongside other signs. When these cues appear together or deviate from the person’s normal patterns, they strongly suggest pain is present and should prompt careful assessment and appropriate management.