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.[1][2]

Behavior 0 1 2 Score
Breathing independent of vocalization Normal Occasional laboured breathing, short period of hyperventilation Noisy laboured breathing, long period of hyperventilation, Cheyne-Stokes respirations
Negative vocalization None Occasional moans or groans, low-level speech with a negative or disapproving quality Repeated troubled calling out, loud moaning or groaning, crying
Facial expression Smiling or inexpressive Sad, frightened, frown Facial grimacing
Body language Relaxed Tense, distresses pacing, fidgeting Rigid, fists clenched, knees pulled up, pulling or pushing away, striking out
Consolability No need to console Distracted or reassured by voice or touch Unable to console, distract, or reassure
Pain Assessment in Advanced Dementia (PAINAD)
Purposeassess pain experienced by those with dementia

"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."

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References

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