Discovering the persons true spiritual wishes is important. According to one statistic, 83% of all patients would like to have a spiritual discussion at admission to hospital. Hence Dr. Christina Pulchalski developed the "FICA" model of taking a spiritual history, (F- Faith and Belief, I - Importance, C - Community and A - Address/Action in Care).

F Faith:"What do you believe in that gives meaning to your life?" A broad, open-ended question is usually asked. There is no single correct question,
although Dr. Pulchalski has found the above and the following to be useful. "Do you consider yourself to be a religious or spiritual person?"

Both religious and spiritual are used because individuals may relate to one and may even take offense at the other. Many individuals who will say they are not religious will admit to being spiritual, which should prompt a discussion of what this means to them. Conversely, an answer such as,
"Yes, I'm Catholic," tells you something but begs exploration of what this means.

I Importance and Influence:"How important is your faith (or religion or spirituality) to you?" Just hearing that the person is spiritual or a member of a particular religion tells you little. How important is this? How is it important? There is a big difference between a Catholic who has not been to Mass since childhood and one who goes to Mass daily.

C Community:"Are you a part of a religious or spiritual community?" Particularly for those who participate in an organized religion, community is often a central part of their spiritual and social experience. It is not uncommon that just when this community becomes most important, when death approaches, the individual is cut off from that community because of illness and caregiving needs.

A Address or Application:"How would you like me to address these issues in your health care?" "How might these things apply to your current situation?" "How can we assist you in your spiritual care?" Patients and families often feel better simply because they have been given permission to share their beliefs. That you have inquired is usually seen as a sign of respect. However, there may be very specific things you can do to be of assistance. In a talk on assessing suffering, Baines told the story of a man who reported 10 of 10 on a scale of suffering that related entirely to his spiritual care. He had regularly attended a certain service and was now unable to do so, which resulted in unbearable suffering. With permission the hospice team contacted the ministry, which sent a home ministry team to the patient's home. His suffering score drop to 0 of 10.57 As in this case, assistance for many will mean access. A simple phone call to the proper clergy member can significantly
relieve distress. Patients
Asking if patients have any special concerns or fears and then addressing them may be of great assistance.

See also http://www.mywhatever.com/cifwriter/library/70/4966.html for an excellent discussion