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DOLOPLUS-2 SCALE

BEHAVIOURAL PAIN ASSESSMENT IN THE ELDERLY

NAME : Christian name : DATES

Unit :

Behavioural records
SOMATIC REACTIONS
1• Somatic • no complaint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0
complaints • complaints expressed upon inquiry only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
• occasional involuntary complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• continuous involuntary complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

2• Protective • no protective body posture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0


body postures • the patient occasionally avoids certain postures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
adopted at rest • protective postures continuously and effectively sought . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• protective postures continuously sought, without success . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

3• Protection • no protective action taken . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0


of sore areas • protective actions attempted without interfering against any investigation or nursing . . . . . . . . . . . 1 1 1 1
• protective actions against any investigations and nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• protective actions taken at rest, even when not approached . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

4• Expression • usual expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0


• expression showing pain when approached . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
• expression showing pain even without being approached . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• permanent and unusually blank look (voiceless, staring, looking blank) . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

5• Sleep pattern • normal sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0


• difficult to go to sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
• frequent waking (restlessness) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• insomnia affecting waking times . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

PSYCHOMOTOR REACTIONS
6• Activities • usual abilities unaffected . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0
of daily living • usual abilities slightly affected (careful but thorough) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
(washing • usual abilities highly impaired, washing &/or dressing is laborious and incomplete . . . . . . . . . . . . 2 2 2 2
&/or dressing)
• washing &/or dressing rendered impossible as the patient resists any attempt . . . . . . . . . . . . . . . . 3 3 3 3

7• Mobility • usual abilities & activities remain unaffected . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0


• usual activities are reduced (the patient avoids certain movements and reduces his/her walking distance) 1 1 1 1
• usual activities and abilities reduced (even with help, the patient cuts down on his/her movements) . 2 2 2 2
• any movement is impossible, the patient resists all persuasion . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

PSYCHOSOCIAL REACTIONS
8• Communication • unchanged . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0
• heightened (the patient demands attention in an unusual manner) . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
• lessened (the patient cuts him/herself off) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• absence or refusal of any form of communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

9• Social life • participates normally in every activity (meals, entertainment, therapy workshops) . . . . . . . . . . . . . 0 0 0 0
• participates in activities when asked to do so only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
• sometimes refuses to participate in any activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• refuses to participate in anything . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

10• Problems • normal behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 0 0 0


of behaviour • problems of repetitive reactive behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 1
• problems of permanent reactive behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 2 2
• permanent behaviour problems (without any external stimulus) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 3 3

SCORE
COPYRIGHT

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