Research Description:

Facial Expressions of Pain

Physical pain is a significant problem for many elderly adults. Effective pain management is a complex clinical process that requires thorough assessment, appropriate intervention and systematic reassessment. Dementia complicates this process because the ability to recall, recognize and verbally report pain is compromised in persons with dementia. Evidence suggests that persons with dementia are less likely to report and be treated for pain than cognitively intact elders. There is no empirical evidence, however, to indicate that persons with dementia experience less pain. Thus, strategies must be developed to assess pain in this vulnerable population.

Dr. Ann L. Horgas is addressing this problem by developing strategies to measure behavioral indicators of pain. This work, funded by the NIH/National Institutes for Nursing Research, focuses on examining the effect of dementia on (a) self-reports of pain and (b) behavioral indicators of pain. Behavioral indicators include body movements, vocalizations and facial grimacing. Data has been collected from 155 adults over the age of 65, drawn from nursing homes, assisted living facilities and senior housing in North Central Florida.

My project focuses on the analysis of facial expressions of pain. I will learn the sophisticated facial coding methods of The Facial Action Coding system developed by Ekman and Friesen (1978) and apply them to the assessment of pain in elderly adults. Facial expressions will be coded using The Observer, a program created by Noldus. The results of this study will yield important information about how elderly adults express pain non-verbally, and whether dementia influences the expression of pain.