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]

See also: Pain § Assessment in non-verbal people

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)
Purpose	assess 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."

See also

• FLACC scale - a pain scale for children