This is the fourth article in a series of five on dementia. Pain experienced by people with dementia is often poorly managed. Chronic pain can lead to further cognitive impairment, accidents and behavioural problems which can be minimised if the pain is properly assessed and managed. Patients with dementia receive fewer analgesics than any other patient group, but the likelihood of pain in this group is as high as in other older people. This article discusses the role of nurses in identifying and treating pain in patients with dementia. Approaches to assessment for improved detection and treatment of pain are outlined.