What is the Functional Independence Measure (FIM)?

The Functional Independence Measure (FIM) is an assessment tool that aims to evaluate the functional status of patients throughout the rehabilitation process following a stroke, traumatic brain injury, spinal cord injury, cancer etc.

FIM is an 18-item, clinician reported scale that assesses an individuals functional capability in six areas including self-care, continence, mobility, transfers, communication and cognition. Each of the 18 items are graded on a scale of 1-7, based on the level of independence in that item.

Performed on admission to and departure from hospital, FIM is a consistent data collection tool for the comparison of rehabilitation outcomes across the healthcare continuum, allowing clinicians to track changes in the functional status of patients from onset of rehabilitation care to discharge and follow-up.

As such, FIM scores may be interpreted to indicate level of independence or level of care required. This scale is used to assess how well a person can carry out basic activities of daily living and how dependent they will be on help from others.

  • Level 1: Total Assistance
  • Level 2: Maximal Assistance
  • Level 3: Moderate Assistance
  • Level 4: Minimal Assistance
  • Level 5: Supervision
  • Level 6: Modified Independence

What is the Functional Independence Measure (FIM)?

The Functional Independence Measure (FIM) is an assessment tool that aims to evaluate the functional status of patients throughout the rehabilitation process following a stroke, traumatic brain injury, spinal cord injury, cancer etc.

FIM is an 18-item, clinician reported scale that assesses an individuals functional capability in six areas including self-care, continence, mobility, transfers, communication and cognition. Each of the 18 items are graded on a scale of 1-7, based on the level of independence in that item.

Performed on admission to and departure from hospital, FIM is a consistent data collection tool for the comparison of rehabilitation outcomes across the healthcare continuum, allowing clinicians to track changes in the functional status of patients from onset of rehabilitation care to discharge and follow-up.

As such, FIM scores may be interpreted to indicate level of independence or level of care required. This scale is used to assess how well a person can carry out basic activities of daily living and how dependent they will be on help from others.

  • Level 1: Total Assistance
  • Level 2: Maximal Assistance
  • Level 3: Moderate Assistance
  • Level 4: Minimal Assistance
  • Level 5: Supervision
  • Level 6: Modified Independence

Dependence levels

Level 1: Total Assistance

The user can contribute up to 25% of the effort required or requires total assistance to complete the task.

Clients with a FIM of 1 may require Moving and Handling equipment such as a free standing gantry e.g. Castor Gantry or as a permanent solution, the MilkyWay overhead tracking, ceiling lift, slings or the WendyLett low friction, in bed management system.

Skin integrity should also be considered using the aSSKINg framework, and a thorough skin assessment completed using an appropriate risk assessment tool such as Purpose-T. Users who required Total Assistance may benefit from a high quality dynamic mattress to off-load pressure over bony prominences such as the Quattro range, or a specialist anti-deformation mattress such as the Carital Optima – a Dementia Design Accredited Product.

Level 2: Maximal Assistance

The user can provide between 25 and 49% of the effort required to complete the task.

Modified dependence levels

Clients with any of the following modified dependence levels (3, 4, 5 or 6) may require access to enablement equipment to assist with their daily living for example, the easy-to-use ReTurn7500i and ReTurnBelt.

Level 3: Moderate Assistance

The user can perform between 50 and 75% of the task.

Level 4: Minimal Assistance

Able to perform over 75% of the task, the user will only require incidental hands on assistance.

Level 5: Supervision

The user may need verbal prompting and requires standby assistance only.

Independence levels

Level 6: Modified Independence

The user needs assistance of an aid but requires no help to operate it.

Level 7: Complete Independence