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: Tasks 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)
Modified 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 2nd 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 59 - 66
Transfers: include bed mobility, sit to stand, surface to surface
Able to perform on own Indep
Need for time, use of arms/equip Mod Indep
Needs to have some standing by SBA 5
Needs min assist Min 4
Steadying, assist with 1 LE
Needs mod assist Mod
Assist to lift trunk, assist with 2 LE
Needs max assist Max
Needs total assist or two people Total 1
Activity did not occur UTA

13. Locomotion – Gait or W/C Slides 72 - 79
Distance the patient walks
How much assistance was needed
Distance the patient propels the w/c
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
If able to walk or wheel 150 ft no assist Independent 7
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 SBA With min asst Min With mod Mod 3
With max Max 2
If able to walk or wheel ft or less any assist Max 2
Walks or wheels less than 50 ft Total 1
Needs total assist
Total 1
Activity did not occur

15. Locomotion – Stairs Slides 80-82
Stairs – Full Flight is 14 steps
If able to perform stairs, no use of device Indep
If able to perform stairs with assist or need of time Mod I
If able to perform stairs with need of SBA SBA
with min assist Min
with mod Mod
If able to perform 4-6 stairs any assist Max
Less than 4 steps Total
Activity Did Not Occur