NU416M4 Holistic Health Assessment

NU416M4 Holistic Health Assessment

SPICES represents Sleeping disorder, Problems with eating and feeding, Incontinence, Confusion, Evidence of falls, and Skin breakdown. The aim of the tool is to reduce the incidence of patient harm allied to geriatric syndromes. When questioning SPICES questions, this may unmask other relevant information that can help in composing a more comprehensive care plan (Aronow et al, 2014). The responses to the SPICES questions give a score to guide the treatment plan for every patient. For example, when the patient has sleeping disturbances, reduced appetite, incontinence, confusion, and pressure ulcers; then such a patient can score highly based on the score guidelines. Such a patient is at a higher risk of patient harm. The information is then collected to develop a care plan to provide solutions or lower the risks through use of the SPICES screening tool (Aronow et al, 2014).  NU416M4 Holistic Health Assessment

Screening Tool

The patient who was screened using the SPICES screening tool was a 68-year-old female. The patient had multiple chronic issues that included hypertension, diabetes, and arthritis.

Sleeping Disorder

  1. How well do you normally sleep?

The patient described her sleep pattern as disruptive and attributed her lack of sleep to pain. In this case, it was evident that the patient’s sleep was fitful and that the medication. The patient was further screened for airway compromise to unravel if it might also be contributing to the sleep problems and therefore this tool is useful in aiding further assessment of the identified problem (Aronow et al, 2014).


Problems with Eating and Feeding

  1. How is your appetite and what might be contributing to any appetite problems?

The patient reported that her appetite had drastically reduced and that the pain was nauseating and this had reduced her appetite. In order to improve the patient’s appetite, better pain management is necessary and it is also important to keep assessing the patient’s desire to eat during her hospital stay (Guyonnet & Rolland, 2015). NU416M4 Holistic Health Assessment


The patient’s incontinence was first evaluated via observation.  The patient was further asked about any difficulties in reaching the toilet, which she denied. According to Seematter-Bagnoud & Bula (2018), urinary incontinence can be prevented using strategies such as voiding schedule.


Similarly, confusion in the patient was also initially assessed using observation. On further probing, the patient was not aware of time or location, indicating confusion. The cognitive status of the patient can be alleviated by involving the family members to assist in orientation. According to Aronow et al (2014) hospitalization for the older adults can disrupt their sleeping patterns and feeding patterns and this can disorient patients especially if they are within an unfamiliar environment.

Evidence of Falls

The patient was asked, “have you ever sustained a fall?” The patient denied having sustained fall and thus her SPICES assessment was negative for evidence of falls.

Skin Breakdown

The patient has various risk factors for skin breakdown. For example, physical examination identified redness on the patient’s coccyx and this resulted in measures to prevent worsening of the skin breakdown being implemented. This was ensured by turning the patient every two hours and putting the patient on a voiding schedule rather than using absorbent pads (Seematter-Bagnoud & Bula, 2018).

Teaching Tool

The SPICES assessment tool can be used to provide the necessary information to develop care plans and reduce harm among older patients. In addition, using the tool, the risk factors can be identified and the patients are then education on risk reduction and how to address the identified problems. For example, through the SPICES assessment, sleeping problems were identified for the patient. As a result, the patient was educated about sleep hygiene where she was advised to reduce conversations in the hallways during sleeping time and to ensure that the room was well lit during sleep (Seematter-Bagnoud & Bula, 2018). Another example is where the SPICES assessment tool can also be used to teach the patient how to avoid confusion by conducting patient orientation after admission. As Aronow et al (2014) explain, the SPICES assessment tool can be used to assess older adults for confusion and implement interventions that alleviate fears that lead to confusion.


The SPICES assessment tool is used to assess for the common problems that older adults experience such as sleep problems, incontinence, skin breakdown, problems with eating or feeding, evidence of falls, and confusion. Identification of these common disorders can help in preventing pointless iatrogenesis and promoting optimal function of the aging adults.  In this patient, the common problems that were identified included sleep disturbances, confusion, and problems with eating and feeding. Identification of these conditions can allow for further assessment and implementation of preventative and treatment interventions. In addition, SPICES assessment tool can provide information that can be used in performing patient education. Every aspect of the assessment tool is vital in the assessment to ensure that all problems are addressed and the appropriate interventions are developed to ensure the provision of quality patient care NU416M4 Holistic Health Assessment


Aronow H, Jeff B, Haus F, Glenn B & Bolton L. (2014). Validating SPICES as a Screening Tool for Frailty Risks among Hospitalized Older Adults. Nurs Res Pract. 2014(2014), 846759.

Guyonnet S & Rolland Y. (2015). Screening for malnutrition in older people. Clin Geriatr Med. 31(3),429–437.

Seematter-Bagnoud L & Bula C. (2018). Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach. Public Health Rev. 39(8). NU416M4 Holistic Health Assessment

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