Fulmer SPICES: An Overall Assessment Tool for Older Adults

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 SPICES, developed by Terry Fulmer, PhD, APRN, FAAN at New York University College of Nursing, is an efficient and effective instrument for obtaining the information necessary to prevent health alterations in the older adult patient. SPICES is an acronym for the 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

The goal of this tool is to improve patient care for older adults by helping nurses to evaluate common conditions.

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. The instrument has been used extensively to assess older adults in the hospital setting, to prevent and detect the most common complications.