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Int J Palliat Nurs. 2012 Dec;18(12):581-90.

Improving pain assessment for patients with cognitive impairment: development of a pain assessment toolkit.

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St Gemma's Hospice and University of Bradford, 329 Harrogate Road, Moortown, Leeds, LS17 6QD, England.


A significant number of people experience pain and cognitive impairment toward the end of life. Assessment of their pain becomes more complex as their cognitive abilities diminish and they lose their ability to express themselves and understand their experience of pain. The rate and pattern of cognitive decline differs between individuals, which makes it difficult to take a standardised approach to pain assessment. Based on a review of the literature, this article describes the development of a pain assessment toolkit consisting of guidelines and a selection of self-report and behavioural assessment tools to support health professionals in tailoring their assessment to meet the needs of an individual with cognitive impairment.

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