Observational pain assessment scales for people with dementia: a review.

Dementia may alter the experience of pain and the ability to communicate it; this will, in turn, result in poor pain detection and inadequate treatment. The aim of this literature review is to identify the observational pain scales that have clinical utility and feasibility for use with people living with dementia in the community by district nurses in their daily practice. It was found that a consensus could not be reached on which tool to use in clinical practice. A further evaluation of the Non-communicative Patients Pain Assessment Instrument has improved its feasibility for use in the community environment, as it can be administered by family carers. This literature review concludes that observational pain scales need to be validated for use in the community and that there is a need to consider the involvement of the informal carer in the assessment of pain.