Purpose       

The ** Editable WORD .doc - PACSLAC 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:

1) At admission to the Nursing Home to establish an initial baseline level of behaviors that may be related to pain

2) At each quarterly nursing review

3) Weekly for older adults with a trigger for pain or problem with pain

4) Any time a change in behavior is reported that might be related to pain

5) Reassess as appropriate to determine if treatment goals are met   
 

How to Use

Complete the *PACSLAC 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.