Pain is so universal that its recognition should be an essential skill of all those working with older people. It places a blight on daily life, limiting functional ability and imparing the quality of life. The symptom manifests itself in many ways, not only as a sensory experience but also by causing psychological distress.

It may be difficult for some older people to articulate their pain, for example those with dementia, some forms of stroke or Parkinson's disease. The non-verbal manifestations of pain must be recognised and interpreted so that the distress caused to these most vunerable members of society can be alleviated, and this guidance provides tools to assess pain in these groups.

The British Pain Society has worked with the British Geriarics Society and the Royal College of Physicians to review the current evidence in the literature and to produce sound guidance to help all practitioners in assessing for the presence of pain. The guidance will be of use to all healthcare professionals working with older people including those in hospital, in the community and in care homes.

The concise guideline has been developed to provide:

* Recommendations in simple and clear terms for assessing pain in all older people
* Several types of scales that can be photocopied & used to assist in assessments, to monitor progress & evaluate the effect of treatment
* An algorithm for simple implementation of the guidance.

The guideline, with its accompanying laminated algorithm, comprises an accessible tool for assessing pain in older people. Its use in hospitals, in the community and in care homes should improve the detection of pain, thus increasing the likelihood of high-quality care for older people and reducing morbidity associated with pain.

'I fully commend this guidance, and hope that health and social practitioners will take heed and utilise it in their everyday practice.'

(From the Foreword by Professor Ian Philp, National Director for Older People)