APS v.1
The Abbey pain scale for dementia patients (APS) is a tool to help grade the severity of pain in patients with advanced dementia.
The APS helps to provide a standardized method to ascertain the severity of pain among dementia patients, an at-risk group for whom non-verbal approaches to assess pain are important.
The tool analyses 5 variables of pain on a 0 to 3 scale range of Absent, Mild, Moderate and Severe. The total score is the sum of all 5 varables and ranges from 0 to 15. The 5 variables/aspects are: Vocalization - Whimpering, crying Facial-expression - Tense, frowning, grimacing, frightened Body language - Fidgeting, rocking, guarding, withdrawn Physiological changes - Temp, pulse or BP elevations, diaphoresis, flushing/pallor Physical changes - Skin tears, pressure sores, arthritis, contractures, previous injuries Score interpretation: Score ≤2 = no pain. Score 3-7 = mild pain. Score 8-13 = moderate pain. Score ≥14 = severe pain. All scores can be categorised by the type of pain: acute, chronic and acute on chronic.
Do not use without also performing a thorough examination to explore any physical injuries, the patient's state of vital signs and any sources of potential pain that may need to be treated.
Ref. 1: Abbey J, et al. The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia. Int J Palliat Nurs. 2004 Jan;10(1):6-1 Ref. 2: Liu JY, et al. The psychometric qualities of four observational pain tools (OPTs) for the assessment of pain in elderly people with osteoarthritic pain. J Pain Symptom Manage. 2010 Oct;40(4):582-98.
OBSERVATION.abbey_pain_scale_for_dementia_patients.v1, EVALUATION.abbey_pain_scale_assessment.v1
