Pain assessment in nonverbal older adults with advanced dementia.
OBJECTIVE
Pain assessment is a particular challenge among individuals with advanced dementia who lack the ability to formulate and express their experience of discomfort.


OBJECTIVE
Awareness of pain scales and methods specifically designed for use with nonverbal individuals with dementia is critical to expanded use and testing in clinical settings.


METHODS
Computerized literature searches using four databases revealed the five observational scales and two caregiver reports methods reviewed.


CONCLUSIONS
A small number of valid, reliable, and sensitive scales are available for use by nurses and allied health personnel. Each has strengths and limitations and all would benefit from additional testing.
Smith
Marianne
M
College of Nursing, University of Iowa, Iowa City, IA, USA. msmith1@netins.net
D000203:Activities of Daily Living; D000368:Aged; D003147:Communication Disorders / Q000150:complications / Q000451:nursing*; D003704:Dementia / Q000150:complications*; D005149:Facial Expression; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007697:Kinesics; D009633:Nonverbal Communication; D009730:Nursing Assessment / Q000379:methods; D015588:Observer Variation; D010146:Pain / Q000150:complications / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing / Q000592:standards; D019727:Proxy; D011594:Psychometrics; D015203:Reproducibility of Results; D012119:Respiration; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014705:Verbal Behavior