Pain assessment in the nonverbal or cognitively impaired

Hierarchy of pain assessment techniques

  1. Obtain self-report if possible
  2. search for potential causes of pain or other pathologies that could cause pain
  3. observe patient behaviors that are indicative of pain
  4. obtain surrogate reporting from family/parents/caregivers of pain and behavioral activity and changes
  5. Attempt an analgesic trial to assess a reduction in possible pain behaviors

Ferrel, B. R., & Coyle, N. (Eds.). (2010). Oxford textbook of palliative nursing (3rd ed.). New York: Oxford University Press.

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