Summary: According to the definition of pain, it is recognized that the inability to communicate verbally does not preclude a patient’s need for appropriate analgesic treatment. However, pain occurring in patients with cognitive impairment is a significant clinical problem. Difficult communication and lack of sufficient knowledge are the causes of inadequate diagnosis and the lack of pain management in this group of patients. Some empirical data suggest that patients with cognitive impairment receive significantly less analgesics compared to their peers without such disorders. Patients with dementia are particularly vulnerable to inadequate pain treatment because their ability to recognize, assess and verbalize pain is limited, and self-report methods for diagnosis are often insufficient. When caring for patients with severe cognitive impairment and dementia, a more comprehensive approach to pain assessment should be considered, in which self-assessment methods and pain observation scales are integrated.