Pain

Pain.  It’s not something that a person often registers into their brain until ones’ self is in pain.  It is often not our first thought when we see someone frowning, walking slowly, or furrowing their brow.  We may think the person is unhappy or “in a bad mood.”  Thinking in terms of the people we support, there is often a communication barrier.  A person may not be able to tell us when he or she is in pain.  Further, they may not want to admit that they are having pain due to fear of the doctor.  Worse yet, a person may be so experienced in dealing with pain and never getting relief that even if they are able to tell someone, they still say nothing. 

HCQU Nurse, Jenifer Baker, RN, came across a helpful tool to discern pain in people with Intellectual Disabilities.  Although the pain scale is for use with “nonverbal adults,” it is important to recognize that most people exhibit these behavioral signs of pain, long before they address the pain.  It may be helpful to think about yourself.  Has anyone ever asked you “What’s wrong?” At that point you answer “I have a headache.”  Perhaps immediately after, you reach for an aspirin.  Did the person see your headache?  No, they saw your behavioral expression of your headache.  Pursed lips, slight grimace, limited talking, etc.  

The Chronic Pain Scale for Nonverbal Adults with Intellectual Disabilities (CPS-NAID) helps us to navigate the behavioral signs for pain.  Help support the people you work with by downloading or printing the tool below. 

Click to view, download, or print the Chronic Pain Scale: http://pediatric-pain.ca/wp-content/uploads/2013/04/CPSNAID.pdf