Pain Assessment for People Who Have Dementia

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Introduction[edit | edit source]

There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging due to their inability to communicate or to self-report. Hence, it is important to choose and use a suitable pain assessment tool in order to provide proper treatment for people with dementia[1]. In this page we will view 2 assessment tools, PAINAD which is based on observation, and ePAT that is an electronic application developed to assess pain for people with dementia.

Pain Assessment in Advanced Dementia (PAINAD) scale[edit | edit source]

PAINAD[2] is a commonly suggested tool to assess people with dementia or any cognitive impairment that prevents them from communicating their pain. roper use of the PAINAD scale as part of a comprehensive pain management plan can help reduce the likelihood of a patient experiencing unrecognized and untreated pain[3]. This is an easy to use, simple, reliable and valid tool to assess pain in non-communicative people[2]. Studies confirm that using a self-report tool such as Numeric Rating Scare (NRS) is insufficient and inaccurate when used to assess people with dementia. Hence, an observational tool like PAINAD is more reliable[4]. This tool that consists of 5 behaviors which need to be observed; breathing, negative vocalization, facial expression, body language and consolability. The total score ranges from 0-10 and it is interpreted as follows:

  • 1-3=mild pain
  • 4-6=moderate pain
  • 7-10=severe pain

Below is a simple video that demonstrates using of PAINAD scale:

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Sub Heading 3[edit | edit source]

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References[edit | edit source]

  1. ↑ Lichtner V, Dowding D, Esterhuizen P, Closs SJ, Long AF, Corbett A, Briggs M. Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools. BMC geriatrics. 2014 Dec;14(1):138.
  2. ↑ 2.0 2.1 Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) scale. Journal of the American Medical Directors Association. 2003 Jan 1;4(1):9-15.
  3. ↑ Paulson CM, Monroe T, Mion LC. Pain assessment in hospitalized older adults with dementia and delirium. Journal of gerontological nursing. 2014 May 2;40(6):10-5.
  4. ↑ Malara A, De Biase GA, Bettarini F, Ceravolo F, Di Cello S, Garo M, Praino F, Settembrini V, Sgro G, Spadea F, Rispoli V. Pain assessment in elderly with behavioral and psychological symptoms of dementia. Journal of Alzheimer's Disease. 2016 Jan 1;50(4):1217-25.
  5. ↑ Tara Dorenkamp. PAINAD Video. Available from: https://www.youtube.com/watch?v=wgHqvx1sj_M [last accessed 6/16/2019]
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