Assessment of pain in adults with cognitive impairment: A review of the tools

The aim of this paper was to discuss the results of a review into the literature related to chronic pain and the older adult. Several themes within the review have been identified and reported elsewhere and in the final report published by the University of Sheffield in the form of an annotated bibliography. This paper will focus upon the findings of the review in relation to the assessment of pain in the adult with cognitive impairment. Issues surrounding assessment in the non-cognitively impaired older adult have been reported elsewhere. For the present paper, nine studies will be discussed, which report the development and testing of pain assessment scales, the focus of which is upon behavioral indicators of pain. Several scales have been omitted from the review, and the rationale for this decision will be presented. Each of the selected scales will be discussed, and the authors will make recommendations for both clinical practice and for future research based upon the validity, reliability, and user friendliness of the scales. From the review, the authors can conclude that the Abbey, the DOLOPLUS-2, and the PACSLAC appear to be the most reliable and valid and practical in terms of "user friendliness". Thus, it would be appropriate to explore these scales further in a multi-center evaluation of these scales. In terms of practice, either scale could be applied easily as a behavioral measure within every day clinical settings. Copyright © Freund Publishing House Limited.