The diagnostics of pain in older people with cognitive impairments should always consist of a subjective self-report of pain and a structured observation of pain behavior. It is important to note that the subjective self-report of pain becomes less valid with increasing cognitive decline (starting with a moderate degree of dementia). The external observation of pain behavior should include at least the three behavioral domains facial expressions, body movements and vocalization and should be performed during resting situations and during activities of daily living. Moreover, the patient should be observed for at least 3 min. Online forms of training have recently been developed and are freely available for training in external observation.

中文翻译：

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痴呆症患者的疼痛记录

对有认知障碍的老年人的疼痛诊断应始终包括对疼痛的主观自我报告和对疼痛行为的结构化观察。重要的是要注意，随着认知能力下降（从中等程度的痴呆症开始），疼痛的主观自我报告变得不那么有效。疼痛行为的外部观察应至少包括面部表情、身体动作和发声三个行为域，并应在休息情况和日常生活活动期间进行。此外，应观察患者至少 3 分钟。最近开发了在线培训形式，可免费用于外部观察培训。