Levels of Assist
FIM 0
Activity does not occur
FIM
Basic indicator of patient disability Used to track changes in the patients ability 18 items - 2 subscales - motor and cognition
FIM 7
Complete independence
FIM Mod I
Especially for FIM, if theres any AE being used its mod I. Glasses or hearing aids or dentures can be considered at modified independent. Ex: dressing: client can retrieve clothes from dresser, return to bed, put clothes on independently, you're not needed for anything Modified independent can be written as mod i. Means person can do activity without OT intervening but person can do it with extra time or AE
FIM 2
Maximal assistance Pt can perform 25-49% of tasks You're doing 51-75%
FIM 4
Minimal contact assistance Pt can perform 75% or more of the task You're doing 25% or less
FIM 3
Moderate assistance Pt can perform 50% to 74% of task You're doing 26-50%
FIM 6
Modified independence Pt requires use of a device but no physical assistance
Minimal Assist
Patient requires 25% physical or verbal assistance of one person to complete a task safely. Client performs 75% or more of the task If you can break down the taks into 10 steps but of the pt. is doing 75% of the tasks alone but you have to step in for the last 25% then its min assist. Ex: changing socks: pt has to retrieve new socks, sit down, remove old socks, put new socks on feet, remove bunchies, place old socks in hamper. If pt can do 4 of those tasks then they would be min assist
Moderate Assist
Patient requires 50% physical or verbal assistance of one person to complete a task safely Patient performs 50%-74% of task
Stand by assist/ contact guard assist
Patient requires caregiver or someone to provide hands-on guarding to perform task safely Contact guard=CG Stand by assist=SBA Ex: transfer and you have to tap cue them to get them all the way up Ex: walking with walker and you have to tap them to remind them not to put all their weight on the bad leg
Maximal Assist
Patient requires physical or verbal assistance for 51%-75% of an activity by one person
FIM 5
Supervision or setup
Dependent
The Patient requires more than 75% physical or verbal assistance by one or more persons to perform all activities You are tired at the end of a session where your pt is dependent FIM: If it takes 2 people/therapists to work with a clients to get through a task, the client is dependent regardless of if the pt tried to help. 2 people=dependent
FIM 1
Total assistance Pt can perform less than 24% of the task or requires more than one person to assist You're doing 76%+
Supervision
low probablity of the patient having a problem performing the activity, but helper should be within arm's reach No hands on assistance May provide verbal cues
Independent
patient is consistently able to perform the activity safely No requirements of cueing, supervision, or assistance, with or without adapted devices, at normal or near normal speeds ***If your client uses an adapted device or requires extra time, MODIFIED INDEPENDENT can be used.