مريض بخرف متقدم لا يستطيع الكلام، وصار يتأوه ويعبس ويحمي بطنه عند لمسه. كيف يُقيّم ألمه؟

A client with advanced dementia cannot speak and now moans, grimaces and guards his abdomen when touched. How is his pain assessed?

1. A behavioural scale such as PAINAD
2. Asking him where it hurts and how much
3. Pain cannot be assessed in him at all
4. A 0–10 numeric rating scale

Answer: A) A behavioural scale such as PAINAD. For non-verbal clients, behavioural scales assess breathing, vocalisation, facial expression, body language and consolability, such as PAINAD. Dementia does not mean absence of pain.