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Fulmer SPICES Tool in Patient Health Assessment


It is worth noting that holistic health assessment is a comprehensive approach towards evaluating the patient’s condition. In particular, individual health is viewed as a complex system, which includes not only the physical component but also the psychological and mental state of a person and the interaction of these components. In general, the holistic approach towards health assessment suggests that any intervention should be aimed at supporting the patient’s well-being to ensure his or her positive spiritual condition. The purpose of this paper is to review the Fulmer SPICES tool and analyze its usability.

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Screening Tool

The Fulmer SPICES includes six major areas to be considered. They are “sleep disorders, problems with eating or feeding, incontinence, confusion, evidence of falls, and skin breakdown” (Fulmer & Wallace, n.d., para. 1). Importantly, the positive answer to any of these categories should serve as a sign for the healthcare specialist to initiate interventions and pay particular attention to this patient. For instance, sleep disorders might negatively affect the health of the older adult resulting in constant fatigue, poorer recuperation, and other consequences. Eating disorders and malnutrition cause the deficit of the essential nutrients in the organism of the individual; therefore, it is significant to instruct patients on the importance of proper nutrition. Such health problems as incontinence and confusion can become the additional stress factors for any patient apart from the fact that they are the indicators of certain chronic illnesses.

Further on, if the nurse traces the evidence of falls, it is crucial to provide the necessary education and interventions to ensure further falls and related injuries are prevented (Fulmer & Wallace, n.d.). Moreover, if the patient has a caregiver, it is the role of the specialist to make sure the individual is not subjected to adult abuse or neglect. Apart from that, skin breakdown can easily deteriorate, and it is important to ensure the patient receives the essential assistance in terms of skin disease prevention. Overall, each of these areas is equally crucial and, improper care might result in the emergence of these issues. Because older adults have weaker recuperation processes and might require additional care and support, it is important to monitor their condition constantly and eliminate the possibility of developing any of these complications.

Possible Outcomes

If the problems covered by the screening tool were not addressed and the interventions were not provided, it is rather likely that patients might develop chronic conditions such as chronic urinary incontinence, pressure ulcers, mental disorders, depression, and other illnesses. Also, falls in the elderly patients are rather likely to cause fall-related injuries and fractures, which might lead to increased mortality rates. In general, screening tests can assist in appraising the change of condition greatly (Fulmer & Wallace, n.d.). Such tools help in detecting the deterioration at an early stage. By the screening results, the specialist can propose certain interventions to prevent further health weakening. Moreover, they can assist in determining the possible causes of these health conditions. Therefore, such tools as Fulmer SPICES are the source of valuable information for healthcare providers.

Tools for Children and Adolescents

There are certain helpful screening tools to evaluate the areas of concern with minors and adolescents such as CHQ-CF, KIDSCREEN-52, Kid-KINDL, and so on (Petersson, Simeonsson, Enskar, & Huus, 2013). They are aimed at the detection of disease-specific implications and the overall assessment of an individual’s condition. In general, they provide the nursing staff with a comprehensive health overview. Nevertheless, it is crucial to emphasize that such instruments cannot replace the essential checks and observations but rather serve as an additional source of information.

Screening Results

SPICES screening tool has been utilized to evaluate the condition of Mrs. G. P. She is a 52-year-old woman with type II diabetes. She is married and has two adult children. At present, she receives medication according to her condition and has regular checkups with her therapist. However, the tool displayed that the woman has sleep and eating disorders. To be more precise, the woman rather often feels tired but cannot fall asleep by herself. She considers taking medication to help her go to sleep but plans to consult her doctor first. In terms of nutrition, the woman tries to keep the diet as required by her condition but she consumes fatty and salty food, which has caused a significant weight gain (Sharma & Pk, 2014). Therefore, patient education is highly advisable. Mrs. G. P. should be advised on a healthier lifestyle including proper nutrition and physical exercises.


Thus, it is essential to instruct the person to consume more green vegetables and fruit (permissive in her condition), to drink more water, and exercise regularly (Asif, 2014). The woman should be strongly advised to reduce the consumption of unhealthy foods to maintain proper glycemic control. Also, it will be helpful to take daily walks with her husband in the fresh air, especially in the evenings, which will also help the woman fall asleep at night.

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SPICES: Overall Assessment Tool for Older Adults

Sleep Disorders


The patient responded “yes” to having difficulty falling asleep.
She often feels tired and wants to sleep more to recuperate and feel energized; however, she cannot fall asleep by herself.


  • Regular physical exercises will help Mrs. G. P. feel more energized in the daytime.
  • Regular walks in the fresh air will help to receive more oxygen and release tiredness (Sharma & Pk, 2014).
  • Sufficient oxygen intake will help to fall asleep; therefore, regular evening walks will help resolve the sleep disorder.
  • Spending more time outdoors with her husband will help Mrs. G. P. feel more harmonious and release the stress related to constant nerve strain.
Problems with Eating or Feeding


The patient responded “yes” to having problems with eating.


  • Mrs. G. P. should reduce the consumption of unhealthy products (including fatty, salty, spicy, sweet foods).
  • She should eat more green vegetables and fruit to manage blood sugar (such as apple, pear, grapes, berries, and so on).
  • She should drink more pure water.


The patient responded “no” to having incontinence.
Mrs. G. P. should not hesitate to contact the health care provider if she starts experiencing incontinence since this problem can be easily resolved if addressed promptly.



The patient responded “no” to experiencing confusion.
Mrs. G. P. should not hesitate to contact the health care provider if she starts experiencing confusion since this problem can be managed effectively if addressed immediately.

Evidence of Falls


The patient denied falling or experiencing balancing problems.
According to the observation, the woman has no signs of falls or fall-related injuries.


  • Regular physical exercises and walks in the fresh air will help strengthen the muscular skeleton and prevent the emergence of balancing problems (Asif, 2014).
  • It is advisable to work out and take walks under the supervision of Mrs. G. P.’s husband to eliminate the possibility of falls.
Skin Breakdown


The patient responded “no” to having skin breakdown.
According to observation, no breakdowns were evident.


  • It is advisable to keep a well-balanced diet to avoid the emergence of skin problems.
  • Being physically active will also assist in keeping the skin in good condition and tone.


Asif, M. (2014). The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. Journal of Education and Health Promotion, 3(1), 1-19.

Fulmer, T., & Wallace, M. (n.d.). Fulmer SPICES: An overall assessment tool for older adults

Petersson, C., Simeonsson, R., Enskar, K., & Huus, K. (2013). Comparing children’s self-report instruments for health-related quality of life using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Health and Quality of Life Outcomes, 11(75), 1-10.

Sharma, R., & Pk, P. (2014). Diet and lifestyle guidelines for diabetes: Evidence based ayurvedic perspective. Romanian Journal of Diabetes Nutrition and Metabolic Diseases, 21(4), 335-346.

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