Alpha-FIM assessment on stroke patients Presented by Lise Zakutney BSc. OT. OT. Reg. (Ont) Champlain Regional Stroke Network Winter 2017

What does the Alpha-FIM measure? The Alpha-FIM is a standardized outcome measure for acute care settings. It measures the Burden of Care. The burden of care is estimated in terms of hours that are expected to be spent by another person to complete daily personal care tasks.

Alpha-FIM completion is mandatory in Ontario for all stroke patients since October 2014 Only completed in acute care hospitals in Ontario with stroke units. All stroke patients admitted with ischemic or hemorrhagic strokes must have an Alpha-FIM assessment completed. ****The Alpha-FIM needs to be completed within the first 3 days of admission. **** Day 1 is the day the patient is admitted to the hospital (even when the patient is in ER)

Patient who walks less than 45 meters or 150 feet Eating Grooming Bowel management Toilet transfers Expression Memory

Patient who walks more than 45 meters or 150 feet Transfers: Bed, Chair Walking Bowel management Toilet transfers Expression Memory

Central East Stroke Network June 2009 Compare this slide with page 10 of your instrument guide. Patients are rated on a scale from 1 to 7 To the right of the dotted line (rating of 6 or 7) means that the patient does not need a helper to complete the activity. To the left of the dotted line (rating 1 – 5) means that a helper must be present to complete the activity. Rating 5 is setup or supervision. That is, the helper is present but does not need to touch the patient. Rating 1 – 4 means that a helper is present and needs to hands on assist the patient to complete the activity. (next slide) Self Study for AlphaFIM® Assessors

Presently, triage using the Alpha-FIM within the Champlain Region Alpha FIM® score > 90= outpatient rehabilitation, community stroke rehab, community services. Alpha FIM® score 40-89= inpatient rehabilitation Alpha FIM® score <40= ongoing assessment, H2H with CCAC, RHAL etc NOTE: The AlphaFIM® Instrument rating is ONE of the components for consideration in discharge planning

Alpha-FIM form on OACIS

Which ADL items are assessed on the Alpha-FIM? GROOMING items consist of: Brushing his teeth Combing or brushing his hair Washing and drying his face Washing and drying his hands Shaving for a men (*Ask family to bring an electric razor), putting make up for a women Encourage the patient to do these activities independently if they can. If they can not do these tasks independently, can they do they if you set them up? If they need more help, can you only provided verbal cues that will allow him to perform the activities? If they need physical help to perform tasks, can you start by showing them how to do the task, maybe use hand over hand guidance to do the tasks?

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