Background It is increasingly recognized that analysis of 'ordinary' language use and social interaction can contribute to our understanding of how individuals express and experience pain, as well as reveal ways in which human suffering is managed. However, there are few studies with a communicative approach to pain which focus on elderly clients. The purpose of this study is to describe language use with regard to accounts of pain experience in a Swedish context of elderly care.Method Based on six hours of recorded, transcribed and translated data from care encounters, an activity analysis of institutional settings as well as categorization of interactional discourse was made. There was a twofold focus: how elderly people initiate painful accounts, and how the professionals orient to such accounts. Attention is drawn to how both parties oriented primarily to the task of information exchange, and how they accomplished credibility by attending to aspects of role-relations and face-work and by shifting between institutional, professional and life-world frames in subtle, but different, ways. Findings It was found that the pain-talk encounters were a communicative activity (type), governed by the phases of: Framing, Mapping troubles and symptoms, Viz. clients, Self presentations, Counseling, and Concluding. A thematic interactional map of critical moment related to pain as social death and hope, and presentation of self as past and self as present, was achieved. Interpretation It is suggested that the caring aspect of professional skills is to support hope and to change focus from social death to life and recovering. It is also suggests that experience of pain in old age can be characterized as not only pathological but also as social and relational. This knowledge contributes to better understanding of pain and pain-related phenomena in old age, which might be useful in nursing.