neurology geriatrics palliative
Pain Assessment in Advanced Dementia Scale (PAINAD)
Observational pain scale for non-verbal patients with advanced dementia. Assesses 5 behavioural indicators of pain: breathing, negative vocalisations, facial expression, body language, and consolability. Score 0-10; higher score indicates more pain. Validated by Warden et al. 2003. NICE CG103 and BSG recommend structured pain assessment tools in patients who cannot self-report.
References
- 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.
- NICE CG103. Delirium: prevention, diagnosis and management. NICE. 2010 (updated 2023). Pain assessment section.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Numeric Rating Scale (NRS) for Pain · Pain Assessment
- Critical-Care Pain Observation Tool (CPOT) · Pain Assessment
- Behavioral Pain Scale (BPS) for Ventilated Patients · Pain Assessment
- Abbey Pain Scale for Dementia · Pain Assessment
- DN4 Questionnaire for Neuropathic Pain · Pain Assessment
- CHEOPS — Children's Hospital of Eastern Ontario Pain Scale · Pain Assessment
Drugs
- Quetiapine (Elderly — Dementia Caution) · Atypical Antipsychotic
- Fentanyl Transdermal Patch (Elderly Chronic Pain) · Opioid Analgesic — Transdermal Patch
- Morphine Slow-Release (Elderly Chronic Pain) · Opioid Analgesic — Modified-Release Oral
- Methoxyflurane · Inhaled Analgesic — Acute Pain
- Donepezil · Acetylcholinesterase inhibitor (AChEI) — dementia
- Memantine · NMDA receptor antagonist — dementia
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against MDCalc, NICE, or your local guideline before clinical use.