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Functional Independence Measure

FIM (Functional Independence Measure) is a widely used tool, particularly within the field of rehabilitation and involves the classification of a person's mobility according to 7 levels of function, from independence to total assistance.

It is important to understand how FIM scoring works.

By looking at the broad categories ‘dependent’ (FIM scores 3, 4 and 5) and ‘complete dependence’ (FIM scores 1 and 2), the FIM can assist in equipment needs identification (remembering that this tool is not designed for person-specific risk assessment).

Independent

Another person is not required for the activity. (NO HELPER)

7. Complete Independence

All of the tasks described as making up the activity are typically performed safely, without modification, assistive devices or aids and within a reasonable time.

6. Modified Independence

Activity requires one or more than one of the following: an assistive device, more than reasonable time, or safety (risk) considerations.

Dependent

Another person is required for either supervision or physical assistance in order for the activity to be performed (REQUIRES HELPER).

5. Supervision or set-up

Person requires no more help than standby, cueing or coaxing without physical contact, or helper sets up needed items or applies orthoses.

4. Minimal Assistance

With physical contact, the person requires no more help than touching and person expends 75% or more of the effort.

3. Moderate Assistance

Person requires more help than touching alone or expends half (50%) or more (up to 75%) of the effort.

Complete Dependence

The person expends less than half (50%) of the effort. Maximal or total assistance is required, or the activity is not performed.

2. Maximal Assistance

Subject expends less than 50% of the effort, but at least 25%.

1. Total Assistance

Subject expends less than 25% of the effort.

Important Information Before Using the Tool

The range of equipment appropriate to a particular ward, care facility or private home should be identified as part of an adequate generic manual handling risk assessment carried out in compliance with the Manual Handling Operations Regulations 1992 (as amended) and any local manual handling policy. The table below indicates the type of equipment that may be appropriate in respect of each broad functional independence category of patient/person in order to ensure that safer handling practice can be facilitated. A person-specific risk assessment must be carried out in respect of those who require any assistance with movement/mobility.

Functional Independence Measure (FIM)

(see page 4 for description of levels of function)

Passive Hoist

(mobile or overhead)

Independent

7. Complete independence

6. Modified independence

Unlikely to be required except in retrieval after a fall/collapse

Unlikely to be required

Dependent

5. Supervision or setup

4. Minimal contact assistance

3. Moderate assistance

May be required

Must be available

Complete Dependence

2. Maximal assistance

1. Total assistance

Must be available

Unlikely to be required


Resources

Granger CV, Hamilton BB, Linacare JM, Heinemann AW, Wright BD, Performance profiles of the functional independence measure. Am J Phys Med Rehabill 1993; 72:84-9

Helpful Links

Australian Institute of Health and Welfare

Category: Journal

Functional Independence Measure