MDCalc

Pain Assessment in Advanced Dementia Scale (PAINAD)

Assesses pain in patients with dementia.

Choose the description that best fits the patient's behavior.

Breathing (independent of vocalization)
Negative vocalization
Facial expression
Body language
Consolability

Result:

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Advice

  • As with pain management in general, pain should be assessed serially and medications titrated accordingly.

  • The PAINAD scale requires close and attentive observation of the patient.

Critical Actions

Analgesic medications should be used judiciously in dementia, in a fashion guided by the patient’s (or proxy/surrogate’s) goals of care. Always keep the “double effect” of opioids in mind.