Which tool assesses pain in older adults who cannot communicate verbally?

• A. PAINAD (Pain Assessment in Advanced Dementia)
• B. PACSLAC
• C. MMSE
• D. TUG

Answer: (A)

When a person cannot communicate their pain, you rely on watching for how they express discomfort. PAINAD, the Pain Assessment in Advanced Dementia, is built for this exact situation. It looks at five observable indicators—breathing, vocalization, facial expression, body language, and consolability—and assigns a score to each, giving a total that helps guide pain management even when self-report isn’t possible. This focus on observable behavior makes it the best choice for nonverbal older adults with dementia.

PACSLAC also uses behavioral cues to assess pain, but it’s more comprehensive and typically takes longer to administer, which can be less practical in quick, bedside assessments. MMSE is a cognitive screen, not a pain measure, and TUG tests mobility, not pain.