neurologic disorders
Evaluation of Pain
Patients with dementia or aphasia
Assessing pain in patients with disorders affecting cognition, speech, or language (eg, dementia, aphasia) can be difficult. Pain is suggested by facial grimacing, frowning, or repetitive eye blinking. Sometimes caregivers can describe behaviors that suggest pain (eg, sudden social withdrawal, irritability, grimacing). Pain should be considered in patients who have difficulty communicating and who inexplicably change their behavior. Many patients who have difficulty communicating can communicate meaningfully when an appropriate pain scale is used. For example, the Functional Pain Scale has been validated and can be used in nursing home patients who have Mental Status Examination scores of 