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FIM Functional Independence Measure. Functional Independence Measurement (FIM) Used as an outcome measurement tool to assess change in a patient FIM scores.

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Presentation on theme: "FIM Functional Independence Measure. Functional Independence Measurement (FIM) Used as an outcome measurement tool to assess change in a patient FIM scores."— Presentation transcript:

1 FIM Functional Independence Measure

2 Functional Independence Measurement (FIM) Used as an outcome measurement tool to assess change in a patient FIM scores are given to the pt at – Evaluation FIM Level – Predicted FIM level for D/C at evaluation – Actual FIM level at D/C FIM is copyrighted. The following slides are descriptions similar to FIM but may not be actual FIM descriptions or scoring.

3 The Burden of Care Task of BADL or mobility the pt can complete How much assistance is needed to perform the task Consider: – Time – Personnel – Assistive Devices – All personnel, all environments, 24 hrs a day

4 FIM FIM Scores include: – Defined by a specific task – Uses physical assistance Tasks – Eating – Feeding – Grooming – Dressing – Bathing – Bowel and Bladder – Transfers – Bed mobility and surface / Toilet Transfer – Locomotion – Stairs – Expression – Memory – Problem Solving – Social Interaction – Comprehension

5 FIM Physical Assistance Levels Independence 7 Complete Independence (timely, safely, assumes responsibility) 6Modified Independence (device, safety, extra time, assumes responsibility) Modified Dependence 5 Supervision (cueing, setup prior to task or removal/disposal, coaxing) 4 Minimal Assistance (pt = 75% or more: contact guard, guiding assist) 3 Moderate Assistance (pt = 50% to 74%, provides a lift to trunk) Complete Dependence 2 Maxiamal Assistance (pt = 25-49%) 1 Total Assistance (pt < 25%, two person assist) No Helper Helper

6 Use of Code 0 Pt did not perform activity Pt unsafe Pt refuses Medical reason

7 Physical Assistance The amount of assistance a patient requires in order to perform a task Definitions may vary pending institution

8 Physical Assistance Dependant/Total Max Mod Min SBA-CG or Hand hold or Hands on Assist Mod I Independent

9 Physical Assistance Percentage of help Mod for 2 LE and min for 1 LE Mod boost at trunk – 75%, 50%, 25% (any time you lift from trunk they are mod- raise or lowering) Two person assist –even if 2 nd person is just there for safety. – Is total assistance – Equipment/SBA Dividing the task into parts – Grading two parts of the task = total task – Always default to the higher level of assistance. Verbal or tactile cueing (grab hand to prevent injury) – Usually not calculated into the assistance unless SBA, Mod I, or Indep. to assist with safety

10 Physical Assistance Documentation – Bed Mob: supine to sit min PA – Bed Mob: supine to sit min PA at the trunk – Bed Mob: supine to sit min PA L LE – Bed Mob: supine to sit log roll mod PA at trunk x 1, min PA L LE X1 = total assist

11 FIM – Bed mobility and Surface Transfer Pt must perform the entire supine to sit, sit to supine and surface to surface which may include sit to stand and stand to sit (Get in/out of bed, sit to stand, surface to surface mobility) Must use hospital bed to score Assess physical assistance for each task and take the lowest score

12 FIM – Transfers Slides Transfers: include bed mobility, sit to stand, surface to surface Able to perform on own Indep 7 Need for time, use of arms/equip Mod Indep 6 Needs to have some standing by SBA5 Needs min assist Min4 – Steadying, assist with 1 LE Needs mod assist Mod 3 – Assist to lift trunk, assist with 2 LE Needs max assist Max 2 Needs total assist or two people Total1 Activity did not occur UTA 0

13 Locomotion – Gait or W/C Slides Distance the patient walks – How much assistance was needed Distance the patient propels the w/c – How much assistance was needed – If independent with a w/c is still mod I because of the w/c according to FIM – Always score the lowest score

14 Locomotion – Gait or W/C Locomotion If able to walk or wheel 150 ft no assist Independent7 If able to walk or wheel 150 ft with device or increased time Modified Indep 6 If able to walk or wheel 150 ft with SBA SBA5 With min asst Min4 With mod Mod3 With max Max2 If able to walk or wheel ft or less any assist Max2 Walks or wheels less than 50 ft Total1 Needs total assist Total1 Activity did not occur 0

15 Locomotion – Stairs Slides Stairs – Full Flight is 14 steps If able to perform stairs, no use of device Indep 7 If able to perform stairs with assist or need of time Mod I 6 If able to perform stairs with need of SBA SBA 5 with min assist Min 4 with mod Mod 3 If able to perform 4-6 stairs any assist Max 2 Less than 4 steps Total 1 Activity Did Not Occur 0


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