Pain Assessment in the Cognitively Impaired

Introduction: Many illnesses are accompanied by pain, and the pain can be mild, moderate, or severe.  In fact, pain is an indication that the entire body or some part of the body is not functioning as well as it should in its normal state.  Therefore, it is critical for a patient to communicate to the attending physician or the nurse regarding all aspects of the pain and its source.  However, not all patients are capable of verbalizing or expressing their physiological or psychological sufferings in a written format. These patients may be handicapped by age (infants and toddlers), impaired mental status (dementia, Alzheimer’s Disease, delirium, and head injuries), administration of tranquilizers that render them helpless, or loss of consciousness (state of coma).  As a result, caregivers and nurses must figure out how best they can evaluate the pain and offer adequate treatment for this condition.