FIM Test Flashcards
Total Assistance (patient < 25%)
1
Maximal Assistance (patient = 25% to 49%)
2
Moderate Assistance (patient = 50% to 74%)
3
Minimal Assistance (patient = 75% or more
4
Supervision (cueing, setup, coaxing)
5
Modified Independence (device, safety, extra time)
6
Complete Independence (timely, safely)
7
No helper • No setup • No device
Level 7, Complete Independence:
No helper • Patient requires a device • Patient requires more than a reasonable amount
of time (three times expected)
• There are safety considerations for which the patient accepts responsibility
Level 6, Modified Independence:
Patient requires verbal cueing, coaxing, encouragement, or instructions
• Setup includes assistance with preparation before the patient performs an activity, or removal and disposal of equipment or materials after an activity is performed
Level 5, Supervision:
A helper provides touching assistance, contact guard assistance, or guiding assistance, or the patient performs 75% or more of the effort
Level 4, Minimal Assistance:
A helper provides lifting assistance, or the patient performs 50% to 74% of the effort
Level 3, Moderate Assistance:
A helper provides lifting assistance, or the patient performs 25% to 49% of the effort
Level 2, Maximal Assistance:
The patient requires two helpers or performs less than 25% of the effort
Level 1, Total Assistance:
indicates that the patient did not perform the activity and that a helper did not perform the activity for the patient during the entire assessment time frame
code 0
No FIM® item can be coded ? on discharge
0
If the patient does not perform the activity at the time of discharge, rate the patient level
1, Total Assistance
Based on observations performed in the first ? days
3
if the patient uses a wheelchair and a helper is required to:
• Lock and unlock brakes
• Lift and lower (or remove and replace) footrests
• Remove or replace armrests • Positions a sliding board • Apply an orthosis • Supervise or provide cues
Record level 5, Supervision/Setup
The patient requires touching, steadying, or contact guard assistance, or the patient requires a helper to lift only one leg onto or off the bed
Level 4:
The patient requires lifting for part of the transfer (either to bring the patient to a standing position or to help lower the patient), a helper must lift both legs onto or off the bed, or both
Level 3:
The patient requires assistance both for lifting (to come to a standing position) and for lowering (to come to a sitting position)
Level 2:
A helper performs all tasks, the patient utilizes a mechanical lift, or more than one helper is required
Level 1:
If the patient requires two helpers because of functional limitations, rate the patient
level 1, Total Assistance
If two helpers are present because of an organizational (hospital) policy, but the patient requires assistance from only one of them, base the patient’s rating on
the amount of assistance the one helper provides
150 feet or greater
Level 3:
50 to 149 feet
Level 2: