People with cognitive impairment are often unable to inform others of their pain. Nurses need to be able to assess pain in cognitively impaired adults so that appropriate pain management strategies can be implemented. Evidence suggests that certain verbal, facial and behavioural signs may be indicative of pain. This article describes the process undertaken in developing a specific tool to facilitate pain assessment. The tool was developed after extensive analysis of pain research literature, input from experienced nurses and critical review by a panel of experts in dementia care. The research study will be published in next week's Nursing Standard.