Pain Assessment in Advanced Dementia

Pain Assessment in Advanced Dementia (PAINAD) is a pain scale developed by Victoria Warden, Ann C. Hurley, and Ladislav Volicer to provide a universal method of analysing the pain experienced by people in late stage dementia.Development and Psychometric Evaluation of the Pain Assessment in Advanced Dementia (PAINAD) Scale

Behavior 0 1 2 ScoreBreathing independent of vocalization NormalOccasional laboured breathing, short period of hyperventilationNoisy, laboured breathing, long period of hyperventilation, Cheyne-Stokes respirationsNegative vocalization None Occasional moans or groans, low-level speech with a negative or disapproving qualityRepeated troubled calling out, loud moaning or groaning, cryingFacial expressionSmiling or inexpressiveSad, frightened, frownFacial grimacingBody language RelaxedTense, distressed pacing, fidgeting Rigid, fists clenched, knees pulled up, pulling or pushing away, striking outConsolabilityNo need to consoleDistracted or reassured by voice or touchUnable to console, distract, or reassure

"The total score ranges from 0-10 points. A possible interpretation of the scores is: 1-3=mild pain; 4-6=moderate pain; 7-10=severe pain."

See also FLACC scale - a pain scale for children

References