A Comparative Investigation of Observational Pain Assessment Tools for Older Adults With Dementia

Abstract

Our results provide much needed psychometric information regarding newly developed pain assessments measures for seniors with dementia. The measures differed with respect to ability to differentiate pain-related from non-pain-related states. Moreover, our findings support the utility of comprehensive coverage of the AGS-recommended pain assessment domains.

Ethnic Differences in Nonverbal Pain Behaviors Observed in Older Adults with Dementia

“…For the entire sample (168 completed assessments), three nonverbal pain behavior categories were frequently identified by CNAs as being expressed by residents with dementia: pain words, pain faces, and pain noises. Lints-Martindale et al (2012) evaluated the psychometric properties of 6 nonverbal pain assessment tools and also found that pain faces and pain words/vocalizations were important pain behaviors when detecting pain and can be easier to identify than other nonverbal pain behaviors. Other research in cognitively intact older adults has found that facial expressions are often used to indicate pain (Closs et al, 2005; Mentes, Teer, & Cadogan, 2004).…”

“…Sheu et al (2011) reported good distinction between moderate and severe states of pain, but also noted some issues distinguishing between mild and moderate intensities. The NOPPAIN is also good for distinguishing pain during movement and at rest (Lints-Martindale, Hadjistavropoulos, Lix, & Thorpe, 2012). The tool is one of the few that has been tested with racially diverse staff as raters (Snow et al, 2004) and the NOPPAIN also rates the intensity of pain behaviors (Horgas et al, 2007; Snow et al, 2004).…”

Exploring healthcare assistants’ role and experience in pain assessment and management for people with advanced dementia towards the end of life: a qualitative study

“…Pain recognition and assessment in this patient population is widely recognised to be challenging as extensive cognitive deterioration in advanced stages often significantly impairs or removes the possibility of patient self-report, exposing patients to the risks of under-assessment and under-treatment of pain [1, 5–8]. Where patient testimony is unavailable or extensively impaired, health professionals are advised to observe for behavioural and nonverbal cues (such as grimacing, guarding, frowning, moaning, agitation, and aggression) which may indicate pain in nonverbal, cognitively impaired adults [9].…”

Can We Quickly and Thoroughly Assess Pain with the PACSLAC-II? A Convergent Validity Study in Long-Term Care Residents Suffering from Dementia

“…The item scores are then added with higher scores being indicative of higher levels of pain. The clinical usefulness and psychometric properties of the PASCLAC are well established (Aubin et al, 2008;Cheung & Choi, 2008;Herr, Decker, & Bjoro, 2004;Lints-Martindale, Hadjistavropoulos, Lix, & Thrope, 2012;Zwakhalen, Hamers, & Berger, 2006b). Considering the time spent by the evaluators with the LTC residents and the task observed (transfer/mobilization), items related to eating or sleeping were not evaluated.…”