Purpose: The PDF iconPACSLAC Checklist is used to screen for pain in older adults who have dementia or other cognitive impairment with a limited ability to communicate. The tool should be used by a professional nurse.

When to use: It should be used at the following time points:

  • At initial intake/admission to services
  • For an older adult with behavioral symptoms suggestive of pain, assess at least every 8 hours
  • Any time a change in pain status is reported
  • One hour following a pain intervention to assess effectiveness
  • For older adults residing in long term health care settings, assessments should be completed at each quarterly review

How to use:

Complete the PDF iconPACSLAC Checklist based on observations of the older adult during activity or movement (such as transferring out of bed or walking) after a day-long shift of observation. Determine presence or absence of each behavior on the checklist.

Determine the total score at each use.

Compare the total score after each use to the previous score received.

An increased score suggests that an increase in pain is likely. On the other hand, a lower score suggests that pain has decreased.

Documentation: Document/record all scores in a location that is readily accessible by other health care providers.

Note: The PACSLAC is a screening tool and not a definitive indicator of pain. Behavior observation scores should be considered alongside knowledge of existing painful conditions and reports from someone who knows the older adult (like a family member or nursing assistant) and their pain behaviors. Remember some older adults may not demonstrate obvious pain behaviors or cues.

Reference: Fuchs-Lacelle, S. & Hadjistavropoulos, T. (2004).  Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC). Pain Management Nursing, 5(1), 37-49.

PDF iconPACSLAC Instructions - PDF Version