Question

Is anyone familiar with the Holistic Assessment SPICES An Overall Assessment Tool for Older Adults ● S = Sleep Disorders ● P = Problems with Eating or Feeding ●

I = Incontinence ● C = Confusion ● E = Evidence of Falls ● S = Skin Breakdown •

What questions should be asked to help identify problems in each area?

Teaching

• Identify evidence-based interventions for each area of the SPICES tool. - Cite your sources.

• Include self-care strategies to address the health promotion and/or safety problems you identified.

any examples would be most helpful

Answer 1

Elderly patients are vulnerable and at a high risk for numerous risk factors like falls, decubitus ulcer and other injury related fracture.

Skin Breakdown : It is essential for the nurses to document the presence of decubitus ulcer at the time of admission. Braden score assessment tool can be used to score the degree of pressure ulcer.

Problems with eating: Firstly it is mandatory to assess the ability of the individual to meet the activity of daily living. Assess the feeding habits whether patient can eat on his own or need help from family or health care professionals. Assess the presence of dysphagia at the time of admission and plan the care accordingly.

Incontinence: Assess the ability of the patient to move to toilet to defecate and urinate oh his own or he is partially or totally have bowel and bladder incontinence.

Sleep disturbance: Assess the total duration of sleep during day and night time. Check for any sleep apnea to rule pot the sleep disturbances.

Confusion: Use mental status questionnaire to assess the level of orientation. Assess recent and remote memory.

Evidence of falls: Assess the components like any previous history of falls within few months, means of mobility either assisted or self, orientation. Based on the risk score categorize the nursing care.