Neurology Book


Pain Assessment in Advanced Dementia Scale

Aka: Pain Assessment in Advanced Dementia Scale, PAINAD Scale
  1. Also See
    1. Dementia
    2. End-Of-Life Pain
  2. Criteria
    1. Breathing independent of vocalization
      1. Score 0: Normal
      2. Score 1: Occasional labored breathing with short periods of Hyperventilation
      3. Score 2: Noisy, labored breathing with longer periods of Hyperventilation (e.g. Cheyne-Stokes)
    2. Negative vocalization
      1. Score 0: None
      2. Score 1: Low level speech with negative or disapproving quality with occasional moan or groan
      3. Score 2: Repeated troubled calling out with loud moaning, groaning, and crying
    3. Facial expression
      1. Score 0: Smiling or inexpressive
      2. Score 1: Sad, frightened or frowning
      3. Score 2: Facial grimacing
    4. Body language
      1. Score 0: Relaxed
      2. Score 1: Tense, fidgeting, or distressed pacing
      3. Score 2: Rigid with fists clenched or knees pulled up. Pushing, pulling away or striking out
    5. Consolability
      1. Score 0: No need for consolability
      2. Score 1: Distracted or reassured by voice or touch
      3. Score 2: Unable to console, distract or reassure
  3. Interpretation
    1. Sum the score from the 5 criteria
    2. Interpret as a Pain Scale
      1. Total score 0: No pain
      2. Total score 10: Severe pain
  4. References
    1. Warden (2003) J Am Med Dir Assoc 4(1): 9-15 [PubMed]

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