Pain Assessment in Cognitively Intact Older Adults

The following research-based tools are useful to screen for pain and measure pain intensity in older adults who can indicate the presence and/or severity of pain verbally, in writing, or by other means such as finger span, pointing, head movement, or blinking eyes to answer yes or no questions.

Recommendations for Assessing Pain in Cognitively Intact Older Adults - List of recommendations to screen for pain in cognitively intact older adults

Pain Assessment Tools

FACES Pain Scale Revised (FPS-R)

Pain intensity rating scale useful for all older adults, including those with mild to moderate cognitive impairment. Some older adults will find this tool easy to use, and may prefer it over the Numerical Rating Scale. This scale requires either verbal ability or the ability to point to the image on the scale that most closely represents their pain.

• FACES Pain Scale Revised (FPS-R) Instructions PDF - Instructions on the use of the FACES Pain Scale Revised (FPS-R)
• FACES Pain Scale Revised (FPS-R) PDF

Numeric Rating Scale (NRS)

Pain intensity rating scale for use with individuals who can point to or state the number that reflects their current pain level.

• Numeric Rating Scale (NRS) Instructions PDF - Instructions detailing the use of the numeric rating scale (NRS) to assess pain intensity for persons able to self report.
• Numeric Rating Scale (NRS) Tool PDF - Pain intensity rating scale for use with individuals who can point to or state the number that reflects their current pain level.

Iowa Pain Thermometer- Revised

Pain intensity rating scale good for use with any individuals, including those with moderate to severe cognitive impairment.

• Iowa Pain Thermometer-Revised Instructions PDF - Instructions detailing the use of the Iowa Pain Thermometer-Revised to assess pain intensity for persons able to self report and is the best choice for most older adults.
• Iowa Pain Thermometer-Revised PDF - (VDS) or Iowa Pain Thermometer-Revised Tool

Pain Assessment Support Resources

Comprehensive Pain Assessment Form 

Form to assess pain in cognitively intact older adults.

• Comprehensive Pain Assessment Form - PDF Version

Pain Diary

A daily or weekly pain diary is potentially useful for older adults and the health care team. Pain diaries can enhance a sense of control during a time when many older adults experience a loss of control and can be appropriate in many settings. Pain diaries can be added to the care plan for the appropriate older adult with two-fold purpose: 1) for helping the care team gather information about pain care effectiveness and 2) to help the older adult better understand their pain experience. Care providers may find the information gained is useful to improve overall pain care.

• Pain Diary

ID Pain: a Neuropathic Pain Screen 

Pain Screening Tool to evaluate the presence of neuropathic pain.

• Neuropathic Pain Screen

One-Minute Pain Assessment

• “One Minute Pain Assessment” describes a quick and easy assessment that identifies older adults who may be experiencing pain regardless of cognitive status or verbal abilities.

Webpage Last Revised 07.31.2023