Detecting pain in people with an intellectual disability.

The assessment of pain in a person with an intellectual disability (ID) is often a difficult undertaking complicated by idiosyncratic reactions or vague descriptions. The person with an ID may also be unable to verbally communicate their discomfort. For the carer who knows the individual with an ID, knowing how they respond to painful stimuli assists the carer to detect new instances of pain. The emergency nurse is unlikely to have met the person with an ID and therefore detecting pain by observing behaviour or using self-report measures is unlikely to succeed. There have been some attempts to categorize behavioural responses to pain by people with an ID, however, they have not been developed into a useful assessment tool. Emergency nurses must therefore rely on the person who knows the person with an ID.