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My father has an extreme fear that he will have pain and when he has pain it’s the worst he’s ever had.
Most of this happens at night.

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Tink, welcome to the forum!

In dementia, pain signals seem to get mixed up and anxiety does as well.

All the reassurance in thebworld didn't help my mom's anxiety; meds did.

My mom also lost her abikity to localize pain. When asked to point to what hurt once, she pointed to the inside of her mouth. There was nothing apparently sore or immflamed in her mouth or throat, but someone realized that what she was TRYING to tell us was that her neck was sore.

My best advice is to get your dad a consult with a geriatric psychiatrist to treat this.
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I think those suffering from Dementia are like children when they get a scratch and act like they are dying. Not that Dad does not have pain, but maybe not as bad as he thinks it is. And trying to get them to describe it is like pulling teeth.
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Tink
Treat it as if it’s real because you really don’t know.

My DH aunt is on hospice for dementia. She has fallen a couple of times and sprained her ankles. She denies any pain. But when she would stand it was obvious she did have pain. It affected her routine. So I discussed this with her hospice nurse. We decided to give her Tylenol for a couple of weeks and she seems to feel better. At 94 and on hospice we felt it was ok.
In your case and especially since your dad has cancer, I might ask his care team for something before bed to see if it helped him sleep better. He might still have the fear but at least you would know any pain he has was being addressed.
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Depending on your father’s age, explain this to his doctor and ask for a prescription for pain meds. Agree with ppl that says, treat it like the pain is real. After all, it may be. And if not, at their age, the most important thing is to keep them happy and comfortable. We don’t need to worry about addictions, or the state of their liver when they’re in their 80’s or 90’s.

If your father is scared, alleviate his fear by showing him the pain meds bottle. That will relieve a lot of anxiety. Then when he is in pain, medicate him. You can even just give it to him nightly before bed, so that he will sleep well, and not fear that he’ll wake up in agony.
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