Promoting Excellence : Spiritual Assessment Tool (ALS)

Spiritual Assessment Tool

Referred to as FICA, this spiritual assessment tool aids in taking a spiritual history of the patient, with recommended questions and suggestions.

Clinical Care Tools - Spiritual

The Amyotrophic Lateral Sclerosis Workgroup of
Promoting Excellence in End-of-Life Care
Hiroshi Mitsumoto, MD, Chair

Hiroshi Mitsumoto, MD
Chair, ALS Workgroup
Eleanor & Lou Gehrig MDA/ALS Center
College of Physicians & Surgeons
Columbia University Neurologic Institute
New York, NY
[email protected]

Recommendation of the workgroup for use of this instrument:
Used by clinicians as an aid in assessing the spiritual needs of the patient. Specific questions and general recommendations are included.

care plan, clergy, spiritual assessment, spiritual care, spiritual well-being, emotional well-being

To use this tool:
You may print and copy this tool for your own use from the website. Please credit source.

Copyrighted 1999 Christina Puchalski, MD.

To view this tool:
ALS Appendix B, p 36 (pdf PDF 835 KB / 62 pages)

Posted March 10, 2005

Completing the Continuum of ALS Care: A Consensus Document

# ALS04, type:spiritual

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit for more resources.

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