Pain Assessment in Advanced Dementia (PAINAD)

Description

Warden et al reported the Pain Assessment in Advanced Dementia (PAINAD) score. This can help to identify pain in a patient with dementia who is noncommunicative. The authors are frm the Edith Nourse Rogers Memorial Veterans Medical Center, Northeastern University and Boston University.

Patient selection: advanced dementia

Parameters:

(1) breathing

(2) negative vocalization

(3) facial expression

(4) body language

(5) consolability

Parameter	Finding	Points
breathing	normal	0
	occasional labored breathing; short period of hyperventilation	1
	noisy labored breathing; long period of hyperventilation; Cheyne-Stokes respirations	2
negative vocalization	none	0
	occasional moan or groan; low-level speech with a negative or disapproving quality	1
	repeated troubled calling out; loud moaning or groaning; crying	2
facial expression	smiling or inexpressive	0
	sad; frightened; frown	1
	grimacing	2
body language	relaxed	0
	tense; fidgeting; distressed pacing.	1
	rigid; clenched fists; knees pulled up. Striking out. Pulling or pushing away.	2
consolability	no need	0
	distracted or reassured by voice or touch	1
	unable to console, distract or reassure	2

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 10

• The higher the score the greater the apparent pain.

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Pain Assessment in Advanced Dementia (PAINAD)

Description

Specialty