What Do the PainChek Descriptors Mean? – PainChek Support

A PainChek Assessment looks at 42 descriptors (attributes) across these 6 domains:

The Face
The Voice
The Movement
The Behaviour
The Activity
The Body

You may be wondering what those descriptors mean and so the table below provides an explanation of each of them.

Also noted for each descriptor is the time frame to consider when assessing a person. That is, do you consider what is happening right now, or do you consider what's been occurring over a period of time (e.g. last week).

The Face

Descriptor	Explanation	Time frame to consider upon recording items
Brow lowering	Anatomical changes in upper face (lower central forehead) · Lowering down of both eyebrows · Movement of eyebrows towards each other · Appearance of vertical or oblique wrinkles between eyebrows in the lower central part of the forehead	At the time of assessment
Cheek raising	Anatomical changes in central face (infraorbital region) · Pulling of skin towards the eye · Pulling the cheeks upward by lifting of the infraorbital triangle · Narrowing the eye aperture and wrinkling the skin below the eye · Appearance of Crow’s feet lines or wrinkles · Deepening of the lower eyelid furrow	At the time of assessment
Tightening of eyelids	Anatomical changes in upper face · Tightening of the eyelids · Narrowing of the eye aperture · Raising of lower lid	At the time of assessment
Wrinkling of nose	Anatomical changes in central face · Pulling of skin upward along the side of the nose towards the root of the nose · Appearance of wrinkles along the side and root of nose · Wrinkling of infraorbital furrow · Lowering the medial portion of the eyebrows · Pulling the centre of the upper lip upwards	At the time of assessment
Raising of upper lip	Anatomical changes in central-lower face · Prominent deepening or wrinkling of infraorbital furrow · Deepening of nasolabial furrow · Pouching at upper lip and nasal passages · Widening and raising of the nostril wings	At the time of assessment
Pulling at corner lip	Anatomical changes in lower face · Drooping or oblique movement of lateral corners of the lips	At the time of assessment
Horizontal mouth stretch	Anatomical changes in lower face · Bilateral stretch of lips.	At the time of assessment
Parting lips	Anatomical changes in lower face · Relaxed opening of the mouth i.e. jaw drop.	At the time of assessment
Closing eyes	Shutting both eyes for at least half a second	At the time of assessment

The Voice

Descriptor	Explanation	Time frame to consider upon recording items
Noisy pain sounds	Sounds or utters related to pain e.g. ouch, ah, mm	At the time of assessment
Requesting help repeatedly	Include one or more of the followings: · Expressing numerous verbal requests of help within short periods of time e.g. “help me, help me” · Constant talking · Repetitive use of words or phrases (i.e. echophrasia) · Verbal nonsense · Vocalizations with/without discernible meaning Exclude verbal requests for ADL purposes	At the time of assessment
Groaning	Using a deep, creaking or incoherent sound	At the time of assessment
Moaning	Producing a long, low pitched and inarticulate sound	At the time of assessment
Crying	Weeping, sobbing or whimpering	At the time of assessment
Screaming	Using excessively loud voice when communicating (as in shouting or yelling)	At the time of assessment
Loudtalk	Making louder than normal pitched voice	At the time of assessment
Howling	Producing a long wailing cry sound	At the time of assessment
Sighing	Breathing in followed by long audible sound upon breathing out	At the time of assessment

The Movement

Descriptor	Explanation	Time frame to consider upon recording items
Altered or random leg/arm movement	Changed or random movement of any of the limbs	At the time of assessment
Restlessness	Unable to relax i.e. fidgeting	At the time of assessment
Freezing	Sudden stiffening, avoiding movement, holding breath	At the time of assessment
Guarding/touching body part	An abnormally stiff, rigid or interrupted movement while changing position. Protecting affected area by holding body part	At the time of assessment
Moving away	Avoiding being touched or staying away from the interaction	At the time of assessment
Abnormal sitting/standing/walking	Distorted, asymmetrical or changed sitting, standing (e.g. posture), and/or imbalanced gait (e.g. Limping)	At the time of assessment
Pacing/wandering	Roaming restlessly back and forth	At the time of assessment

The Behaviour

Descriptor	Explanation	Time frame to consider upon recording items
Introvert	Being unsocial or socially isolated i.e. reluctant to be involved in social activities	Over the last 7 days
Verbally offensive	Verbally abusive or aggressive, cursing, swearing or using foul/insulting language	At the time of assessment
Aggressive	Involved in combative or violent behaviour	At the time of assessment
Fear or extreme dislike of touch, people	Phobias of being touched or interaction with people including family members, other residents, and/or aged care staff	At the time of assessment
Inappropriate behaviour	Aberrant or socially unacceptable behaviour e.g. fiddling	Over the last 7 days
Confused	Unclear in thinking or understanding e.g. unable to follow instructions or repetitive questioning	At the time of assessment
Distressed	Anxious, worried and agitated	At the time of assessment

The Activity

Descriptor	Explanation	Time frame to consider upon recording items
Resisting care	Unable to cooperate or become compliant, or refuse to receive care e.g. food, medicine	Over the last 7 days
Prolonged resting	Long resting periods	Over the last 7 days
Altered sleep cycle	Changed sleep-wake cycle e.g. long sleeps during the day	Over the last 7 days
Altered routines	Changed the order or timing of activities from the norm	Over the last 7 days

The Body

Descriptor	Explanation	Time frame to consider upon recording items
Profuse sweating	Excessive sweating in various parts of the body excluding circumstances due to environmental factors such as no air conditioning or lack of proper ventilation	At the time of assessment
Pale/flushed (red-faced)	Colour faded or red-colored face	At the time of assessment
Feverish/cold	Changes in body temperature either too hot or too cold	At the time of assessment
Rapid breathing	Fast rate of breathing	At the time of assessment
Painful injuries	Injuries are known to induce pain e.g. falls, bed sores, active wounds	Over the last 7-14 days
Painful medical conditions	Conditions known to cause pain including currently presented e.g. dental infections, urinary tract infections, or previously documented chronic conditions in medical history e.g. arthritis	Consult medical history

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