Validated bedside pain assessment for patients who cannot self-report. Developed in Australia for aged care and dementia settings.
📋 Source: Abbey J et al. “The Abbey pain scale: a 1-minute numerical indicator for people with end-stage dementia.” Int J Palliat Nurs 2004;10(1):6–13. For observational use by trained carers and clinicians. Not a substitute for clinical assessment. Information is general in nature. Always consult a qualified healthcare professional for advice specific to your situation.
👤Completed by the observer — nurse, carer, or clinician — not by the patient. Observe the patient directly and score each item based on what you see right now.
Patient details (optional — for printed record)
Total score
No pain
0 / 18
0 of 6 items scored0%
Item 1 of 6 — Vocalisation
What sounds is the patient making?
Whimpering, groaning, crying, screaming — or none.
0 — Absent
1 — Mild
2 — Moderate
3 — Severe
Item 2 of 6 — Facial expression
What is the patient's facial expression?
Looking tense, frowning, grimacing, looking frightened — or relaxed.
0 — Absent
1 — Mild
2 — Moderate
3 — Severe
Item 3 of 6 — Change in body language
Has the patient's body language changed?
Fidgeting, rocking, guarding a body part, withdrawn — or usual posture and movement.
0 — Absent
1 — Mild
2 — Moderate
3 — Severe
Item 4 of 6 — Behavioural change
Is the patient's behaviour different from usual?
Increased confusion, refusing food, altered usual patterns — or no change from baseline.
0 — Absent
1 — Mild
2 — Moderate
3 — Severe
Item 5 of 6 — Physiological change
Are there physiological signs of distress?
Temperature, pulse, or blood pressure outside normal limits; diaphoresis; flushing or pallor.
0 — Absent
1 — Mild
2 — Moderate
3 — Severe
Item 6 of 6 — Physical changes
Are there relevant physical findings?
Skin tears, pressure areas, arthritis, contractures, or other conditions that may be causing pain.
0 — Absent
1 — Mild
2 — Moderate
3 — Severe
Type of pain (clinical judgement)
Chronic
Acute
Acute on chronic
Item
Score
Total
Save to patient record
Print or save as PDF to file in the patient record. Includes score, breakdown, and pain type.
Clinical tool — not a substitute for clinical judgement. The Abbey Pain Scale is an observational aid. A high score indicates pain is likely and should prompt clinical review and appropriate management. It does not identify the source of pain, nor does it replace comprehensive pain assessment. Pain management decisions — including analgesia — must be made by a qualified clinician based on the full clinical picture.
This tool is intended for use in non-verbal adults (e.g. advanced dementia, acquired brain injury, post-operative patients who cannot self-report). For verbal patients, direct self-report scales are preferred.
Source & Validation
Abbey J, Piller N, De Bellis A, et al. The Abbey Pain Scale: a 1-minute numerical indicator for people with end-stage dementia. International Journal of Palliative Nursing. 2004;10(1):6–13. doi:10.12968/ijpn.2004.10.1.12013
Aged Care Quality and Safety Commission. Pain management in residential aged care. agedcarequality.gov.au
Australian Commission on Safety and Quality in Health Care (ACSQHC). Comprehensive care standard — pain assessment. safetyandquality.gov.au
The Abbey Pain Scale was developed by Dr Jennifer Abbey and colleagues in Queensland, Australia. It is freely available for clinical use. Reproduced here for non-commercial clinical and educational purposes.
My Aged Care: 1800 200 422 · Carer Gateway: 1800 422 737 · Dementia Australia: 1800 100 500 For a full directory of aged care and carer support services, visit AskMyGP helplines directory.
Was this tool helpful?
🏥
My Aged Care information
For patient and carer resources on aged care services and support — myagedcare.info →