Try: Use this sheet to document activites that are causing the Care recipient (cr) pain the level of pain and pain management strategies over time keeping a pain journal will help you document the cr cr’s progress in managing pain date ____ time when pain occurred ____ a m p m ask the cr to rate the pain on a scale of 0 no pain to 10 severe pain ____ where is the pain ____ what was the cr doing when the pain started _ what did you or the cr do to control the pain ___ did this work yes ____no ____ information references adapted from www palliativecare org au "pain management diary sample" by agency for healthcare research and quality no date

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Categories: Medical Physical, Mobility, Needs Some Assistance, Needs Much Assistance, Immobile, Independence, No Supervision, Some Supervision, Maximum Supervision

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Keywords: Pain painful pain journal pain diary palliative

*This information is listed as a Fact Sheet and is not explicitly medically licensed