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My mom is ninty nine had a stroke four years ago she has a dementia but not really bad. She knows who her family are and I can read the paper to her. My mom is in a care home and I go every night to see her but lately mom has been saying that her face is hurting her. She used to suffer with trygemanal nuralger but when I told the nurse, she said your mom never said anything about it in the day?

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Pasport you can do anything. You can write a note for the attention of the primary care doctor attending your mother's care home, copied to your sister too, and say:

"For the last x weeks, my mother has consistently complained of pain in her face when I visit her during the evenings. In [20xx] she was diagnosed with trigeminal neuralgia. Please investigate a possible recurrence of this problem."

Unfortunately, as I remember from when my poor FIL was suffering, this sort of pain is difficult to relieve. But you'll have done what you can.

You can also get heat pads that she might possibly find comforting? Try it. They're little cushion things, stuffed with bran and sometimes lavender, and you warm them in the microwave (I'm sure the nurses can let you use the microwave if you ask them really nicely) following the instructions carefully so that they don't overheat.
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My DIL and I often found mom in very different mental states if one of us saw her during the day and one in the late afternoon or evening. google "sundowning". Share with sis.

Having POA doesn't make her GOD. If mom wants pain relief, have her ask for it in the nurse's presence. Can mom do that?

And why would being on antibiotics have ANYTHING to do with pain relief?
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Thank you for your all for your comments unfortunately when I told my sister she just said moms not said any thing to me but when I go at night mom is allways in pain with her face but my sister won't let mom have any pain relief she has had a chest infection and is on antibiotics at the moment I can not do anything as she is has got power of attorney
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I was thinking the same as surprise. It took several days before my sister and I figured out Mom had a sinus infection. Mom just can't articulate that she's in pain, but she's watched carefully and she'd crinkle her forehead for no reason. Normally she doesn't ever crinkle her forehead. By happenstance my sister grabbed a soiled hanky of Mom's and studied it. A round of antibiotics and she no longer indicates pain in her face.
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I'm sitting here with my sinuses clogged up from the recent crud, and I'm thinking... sinus infection! She does not have to drip to have a sinus problem. I spoke to the visiting drs about putting mthr on Tylenol, not just prn, for her arthritis since she seems to be hurting and won't admit it to anyone else. The pharmacy put it in her med packs with everything else.
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Maybe she needs to go for a cat scan of the head ..to rule out any vascular problems ,,,wouldn’t hurt .. talk to the doc there and see if she can be sent for a ct scan
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My mother NEVER told the folks at the nursing home when she was in pain. She was always "fine". Except when one of us visited, she'd be " in agony".

I think the nursing home staff though we were crazy! My mom had pretty severe arthritis, compression fractures in her spine and sometimes headaches. The combination of aphasia and vascular dementia, both results of a stroke seemed to have robbed her of the ability to express when she was in pain, and where the pain was.

My solution to this was to have her on regular pain relief ( tramadol) on a regular basis and Tylenol as needed if she was grimacing in what looked like pain. It seemed to work.

It's fine to talk to her nurse on the spot, but an overarching problem like this is best addressed at a care meeting. Then, follow up and make sure that new pain med orders have been written.

Be aware that an order for a med "prn" is not a regularly scheduled dose. Patient must request or nurse must ask and receive a positive response to "are you in pain?". No one wants to be accused of overmedicating an elderly patient, so if your mom says "No, I'm fine" to the nurse, she is not able to give the med unless it is scheduled. It took me 6 months to figure that out!
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What is your question Pasport? It's not that uncommon for family to notice when someone is out of sorts before staff does, (after all we know them better) now that you have brought it to their attention they should be on the lookout. How was her pain treated before? Is it concerning enough that she needs to be prescribed pain meds, or is this something that could be helped with an OTC cream analgesic, perhaps applied when you visit?
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