Our results provide much needed psychometric information regarding newly developed pain assessments measures for seniors with dementia. The measures differed with respect to ability to differentiate pain-related from non-pain-related states. Moreover, our findings support the utility of comprehensive coverage of the AGS-recommended pain assessment domains.

This is the first study to discriminate among FACS measures collected during innocuous and graded levels of precisely measured painful stimuli in seniors with (mild) dementia and in healthy control group participants. We conclude that, as hypothesized, FACS can be used for the assessment of evoked pain, regardless of the presence of AD.

Findings indicate that the empirical and theoretically driven revisions to the PACSLAC led to improved ability to differentiate between pain and nonpain states, while retaining its clinical utility.

The findings do not support the idea that the availability of systematic pain assessment information leads to change in clinician's medication practices. As such, educational interventions and public policy initiatives are needed to ensure that treatment providers do not only gather but also use pain assessment information.

Recent publications (i.e., Chodos, 2017;Peachy, Hicks, & Adams, 2013) have made many recommendations for improving access to psychological services for all Canadians but lack a focus on rural and northern (R&N) populations. Limited access to psychologists' expertise is demonstrable in R&N regions, where resources are particularly strained. This article examines the recommendations through the lens of the R&N psychologist, including those that aim to change existing service delivery models and increase funding. The authors highlight the unique challenges (e.g., recruitment and retention of professionals) and opportunities (e.g., a history of maximizing limited resources) inherent to R&N psychological practice in Canada. We also suggest strategic maximization of current resources (e.g., use of technology to reach remote locations, increased use of stepped care models) alongside a much needed increase of overall support for psychological service provision in R&N areas, particularly among Indigenous communities; we strongly encourage cultural sensitivity and local consultation prior to implementation of psychological services within Indigenous communities.