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Fulmer SPICES: Overall Assessment Older Adults Cheat Sheet by

Overall Assessment of Geriatric Person
assessment     healthcare     spices     geriatric     tool     fulmer


Normal aging brings about inevitable and irreve­rsible changes. These normal aging changes are partially respon­sible for the increased risk of developing health­-re­lated problems within the elderly popula­tion. Prevalent problems experi­enced by older adults include: sleep disorders, problems with eating or feeding, incont­inence, confusion, evidence of falls, and skin breakdown. Famili­arity with these common­ly-­occ­urring disorders helps the nurse prevent unnece­ssary iatrog­enesis and promote optimal function of the aging patient. Flagging conditions for further assessment allows the nurse to implement preven­tative and therap­eutic interv­entions (Fulmer, 1991; Fulmer, 1991)
Credit: The Hartford Institute for Geriatric Nursing, New York Univer­sity, College of Nursing is cited as the source.

SPICES Assessment

S - Sleep Disorders
P - Problems with Eating or Feeding
I - Incont­inence
C - Confusion
E - Evidence of Falls
S - Skin Breakdown
Fulmer SPICES is an efficient and effective instrument for obtaining the inform­ation necessary to prevent health altera­tions in the older adult patient (Fulmer, 1991; Fulmer, 1991; Fulmer, 2001). SPICES is an acronym for the common syndromes of the elderly requiring nursing interv­ention:



The problems assessed through SPICES occur commonly among the entire older adult popula­tion. Therefore, the instrument may be used for both healthy and frail older adults.


The instrument has been used extens­ively to assess older adults in the hospital setting, to prevent and detect the most common compli­cations (Fulmer, 2001; Lopez et al., 2002; Pfaff, 2002; Turner, J. et al., 2001; NICHE). Psycho­metric testing has not been done.


The SPICES acronym is easily remembered and may be used to recall the common
problems of the elderly population in all clinical settings. It provides a simple system for flagging areas in need of further assessment and provides a basis for standa­rdizing quality of care around certain parame­ters. SPICES is an alert system and refers to only the most freque­ntl­y-o­ccu­rring health problems of older adults. Through this initial screen, more complete assess­ments are triggered.
It should not be used as a replac­ement for a complete nursing assess­ment.

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