Best Practices in Nursing: Fulmer SPICES - Assessing Health Issues in Older Adults

In this assessment we will discuss about practices in nursing and below are the summaries point:- Fulmer SPICES is an effective assessment tool for identifying common health issues in older adults. The acronym SPICES stands for Sleep Disorders, Problems with Eating or Feeding, Incontinence, Confusion, Evidence of Falls, and Skin Breakdown. It helps nurses prevent unnecessary health complications and implement appropriate interventions for older adults.

From The Hartford Institute for Geriatric Nursing, New York University Rory Meyers College
Best Practices in Nursing
Care to Older Adults
general assessment series
Issue Number 1, Revised 2019 Editor-in-Chief: Sherry A. Greenberg, PhD, RN, G
Managing Editor: Robin Coyne, MSN, RN, AGA
New York University Rory Meyers College of N
Fulmer SPICES: An Overall Assessment Tool for Old
By: Terry Fulmer, PhD, RN, FAAN
The John A. Harford Foundation
WHY: Normal aging brings about inevitable and irreversible changes. These normal aging chang
responsible for the increased risk of developing health-related conditions within the older adult
issues experienced by older adults include: sleep disorders, problems with eating or feeding, inco
evidence of falls, and skin breakdown. Familiarity with these commonly-occurring issues helps t
unnecessary iatrogenesis and promote optimal function of the aging individual. Flagging conditi
allows the nurse to implement preventative and therapeutic interventions (Fulmer, 1991; Fulmer
BEST TOOL: Fulmer SPICES is an efficient and effective instrument for obtaining the informatio
health alterations in the older adult patient (Fulmer, 1991; Fulmer, 1991; Fulmer, 2001). SPICE
common syndromes of the elderly requiring nursing intervention:
S is for Sleep Disorders
P is for Problems with Eating or Feeding
I is for Incontinence
C is for Confusion
E is for Evidence of Falls
S is for Skin Breakdown
TARGET POPULATION: The problems assessed through SPICES occur commonly among the en
population. Therefore, the instrument may be used for both healthy and frail older adults.
VALIDITY AND RELIABILITY: The instrument has been used extensively to assess older adults
setting, to prevent and detect the most common complications.Full psychometric testing has not been done, how
validation has been conducted (Aronow, Borenstein, Haus, Braunstein, & Bolton, 2014; Fulmer, 2
in the acute care setting within 24 hours of admission, SPICES has been shown to be valid and p
events, as well as significantly correlated with age and other validated assessments for vulnerabi
depression (Aronow et al., 2014).
STRENGTHS AND LIMITATIONS: The SPICES acronym is easily remembered and may be use
common problems of the elderly population in all clinical settings. It provides a simple system fo
of further assessment and provides a basis for standardizing quality of care around certain para
system and refers to only the most frequently-occurring health issues of older adults. Through th
complete assessments are triggered.It should not be used as a replacement for a complete nursing assess
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Best Practices in Nursing
Care to Older Adults
A series provided by The Hartford Institute for Geriatric Nursing,
NYU Rory Meyers College of Nursing
EMAIL: [e-mail]ITE: www.hign.org
CLINICALNURSINGWEBSITE: www.ConsultGeri.org
general assessment series
MORE ON THE TOPIC:
Best practice information on care of older adults: https://consultgeri.org.
Aronow, H. U., Borenstein, J., Haus, F., Braunstein, G. D., & Bolton, L. B. (2014). Validati
screening tool for frailty risks among hospitalized older adults. Nursing Research and
10.1155/2014/846759
Fulmer, T. (1991). Grow Your Own Experts in Hospital Elder Care. Geriatric Nursing, Ma
Fulmer, T. (2001). The geriatric resource nurse: A model of caring for older patients. Am
Nursing, 102, 62.
Fulmer, T. (2007). How to try this: Fulmer SPICES. AJN, 107(10), 40-48; quiz 48-49.
Mitty, E. (2010). Iatrogenesis, frailty, and geriatric syndromes. Geriatric Nursing, 31(5),
Fulmer SPICES: An Overall Assessment Tool for Older Adul
Patient Name: Date:
SPICES EVIDENCE
Yes No
Sleep Disorders
Problems with Eating or Feeding
Incontinence
Confusion
Evidence of Falls
Skin Breakdown
Adapted from Fulmer, T. (1991). The Geriatric Nurse Specialist Role: A New Model. Nursing Management, 22(3), 9
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The Hartford Institute for Geriatric Nursing recognizes Meredith Wallace Kazer, PhD, APRN, A/GNP-BC as one of
this issue.