Pain-Behavioral Assessment Tools in the Nursing Home

Keela Herr, PhD, RN, FAAN, AGSF

Professor and Chair
Adult and Gerontological Area
The University of Iowa College of Nursing
Iowa City, IA

The gold standard for assessing pain is patient self-report. The high prevalence and undertreatment of pain among nursing home residents, however, demand that clinicians are also familiar with techniques to evaluate pain in nonverbal older adults. To help healthcare providers identify clinically useful pain-behavioral assessment tools for use in the nursing home, the MayDay Fund provided support for an expert panel to evaluate the currently available tools. Fourteen tools were rated using newly developed criteria, which included reliability, validity, and utility in the nursing home setting. As a result, the Pain Assessment in Advanced Dementia scale and the Pain Assessment Checklist for Seniors with Limited Ability to Communicate were selected as the most clinically relevant and applicable tools for everyday practice. The expert panel also made a series of recommendations for administering pain-behavioral assessment tools in the nursing home setting.

References

Herr K, Bursch H, Ersek M, Miller LL, Swafford K. Use of pain-behavioral assessment tools in the nursing home: expert consensus recommendations for practice. J Gerontol Nurs. 2010;36(3):18-29.
Fuchs-Lacelle S, Hadjistavropoulos T. Development and preliminary validation of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Pain Manag Nurs. 2004;5(1):37-49.
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(1):9-15.

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