Common Pain Behaviours in Cognitively-Impaired Elderly Persons
As care providers, we must ensure that our assessment skills are top notch, especially for those adults unable to speak their pain. For persons suffering with dementia, aphasia, or other conditions preventing an oral report, pain expression sometimes takes on less obvious forms, such as confusion, social withdrawal, aggression or subtle changes in behaviors ….which are not always typical manifestations of pain.
|Facial Expressions||Verbalizations Vocalization||Body Movements||Changes in Interpersonal Interactions||Changes in Interpersonal Activity Patterns or Routines||Mental Status Changes|
Closed or tightened eyes
Any distorted expression
Asking for help
Tense body posture
Gait or mobility changes
Decreased social interactions
Socially inappropriate behaviours
Increase in rest periods
Changes in sleep & rest patterns
Sudden cessation of common routines
|Crying or tears
Irritability or distress
Consider utilizing a tool to assist with assessment!
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Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc. 2003;4:9-15.
Herr, K., Coyne, P., McCaffrey, M., Manwarren, R. & Merkel, S. (2011). Pain Assessment in the Patient Unable to Self-Report. American Society for Pain Management Nursing