{"id":1060,"date":"2022-09-19T09:09:18","date_gmt":"2022-09-19T13:09:18","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/pain-scales-clients-with-cognitive-impairment\/"},"modified":"2025-07-24T13:15:09","modified_gmt":"2025-07-24T17:15:09","slug":"pain-scales-clients-with-cognitive-impairment","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/pain-scales-clients-with-cognitive-impairment\/","title":{"raw":"Pain Scales: Clients with Cognitive Impairment","rendered":"Pain Scales: Clients with Cognitive Impairment"},"content":{"raw":"Assessment of pain in clients who are cognitively impaired<\/strong> requires a different approach because they may not be able to optimally communicate their pain via self-report. Instead, you may need to use observational tools<\/strong> that incorporate and sometimes rely on dimensions of pain such as behavioural and physiological cues (Lichtner et al., 2014). For example, clients with late-stage dementia often have limited cognitive capacity and are unable to understand and answer questions.<\/span>\r\n\r\nSystematic use of pain assessment tools enables better evaluation and management of pain in individuals who are cognitively impaired (Ludvigsson et al., 2020). However, to date no one tool has been widely adopted and internationally recognized for assessing pain in clients who are cognitively impaired (Kunz et al., 2020).<\/span>\r\n\r\nOver the last 30 years, many clinicians and researchers have developed and evaluated various tools for this population. One commonly used tool is the Abbey Pain Scale, and another more recent tool is the Pain Assessment in Impaired Cognition (PAIC15). All tools should be used with caution considering the complexity of psychometric testing of the validation and clinical utility of pain assessment tools with clients who have cognitive impairments like dementia (Lichtner et al., 2014).<\/span>\r\n

Abbey Pain Scale\u00a0<\/strong><\/span><\/h2>\r\nDevelopment of the Abbey Pain Scale began in the 1990s, with the goal of assessing pain in people with late-stage dementia whose communication is severely impaired<\/strong> (Abbey, 2004). The scale is appropriate for clinical practice because it is simple and efficient to use and can be used by various healthcare providers; it is not time consuming and is effective with a reasonable degree of validity.<\/span>\r\n\r\nAs shown in Figure 7<\/strong>, the scale is based on behavioural observations<\/strong> including:<\/span>\r\n