Assessment Tool: PACSLAC

Observe the patient over a defined period and check each behaviour that is present. The PACSLAC is most useful for serial assessments — compare current scores to the patient's own baseline. Integrate findings with clinical judgment and knowledge of the individual patient.

Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC)

A 60-item observational pain assessment tool for use with seniors with dementia or limited verbal ability. Developed by Fuchs-Lacelle and Hadjistavropoulos (2004). Items are observed over a defined period. Check each behaviour that is observed. Total score 0–60; higher scores suggest greater pain intensity.

General interpretation guidance

0–7

Mild / no significant pain

8–14

Moderate pain

≥ 15

Severe pain

Note: No universally validated cut-off scores exist for PACSLAC. Interpretation should consider the individual patient's baseline and clinical context. Serial assessments are more informative than single observations.

Subscale 1 – Facial Expressions

Grimacing Sad look Tighter face Dirty look Change in eyes (squinting, dull, bright, increased eye movement) Frowning Pain expression Pale face Facial flushing Teeth clenching Mouth open Creasing forehead Nose wrinkling

Subscale 2 – Activity / Body Movements

Fidgeting Pulling away Flinching Restlessness Pacing Wandering Guarding sore area Touching / holding sore area Limping Clenching fist Going into fetal position Stiff / rigid Striking out Pointing to area that hurts Grabbing Thrashing Decreased activity Refusing to move Moving in a guarded way Arching / stiff body posture

Subscale 3 – Social / Personality / Mood

Physical aggression (hitting, pushing, scratching, biting) Not wanting to be touched Not allowing people near Angry / mad Throwing objects Increased confusion Anxious Upset Agitated Cranky / irritable Frustrated Sad / tearful

Subscale 4 – Physiological Indicators / Eating & Sleeping Changes / Vocal Behaviors

Cold and clammy Changes in skin colour (pale, flushed) Diaphoresis / sweating Shaking / trembling Teary eyed Crying Whimpering Moaning / groaning Yelling / screaming Calling out for help Using foul language Noisy breathing Asking for help Decreased appetite Refusing food

Result

PACSLAC Score: 0/60

Pain level:

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