The Functional Independence Measure (FIM) score is an essential tool used in rehabilitation and occupational therapy to assess and monitor patients' functional independence. The FIM score measures the patient's level of independence in performing everyday activities and provides a standardised method for evaluating functional outcomes across various settings and diagnoses.
In Australia, the FIM score is widely used in occupational therapy practice, particularly in rehabilitation settings, such as hospitals and nursing homes. The FIM score is also used in research to evaluate occupational therapy interventions' effectiveness and compare outcomes across different patient populations.
FIM Score Subscales and Categories
The FIM score comprises two subscales: motor and cognitive. The motor subscale assesses the patient's physical abilities, including self-care, mobility, and sphincter control. The cognitive subscale evaluates the patient's cognitive skills, including communication, social interaction, and problem-solving.
Each subscale consists of six categories, and each category is scored on a scale from 1 to 7, with 1 indicating complete dependence and 7 indicating complete independence. The categories are as follows:
Motor Subscale:
- Self-care (eating, grooming, bathing, dressing, toileting)
- Sphincter control (bladder and bowel)
- Mobility (bed, chair, wheelchair, stairs)
- Locomotion (walking or using a wheelchair)
- Communication (expression and comprehension)
- Social cognition (interpersonal interactions, problem-solving, memory)
Cognitive Subscale
- Cognitive comprehension (understanding of commands and questions)
- Cognitive expression (ability to communicate needs and ideas)
- Social interaction (ability to interact with others in a socially appropriate manner)
- Problem-solving (ability to solve problems and make decisions)
- Memory (short and long-term memory)
- Orientation (awareness of time, place, and person)
FIM Score Calculation and Levels
The FIM score is calculated by adding the motor and cognitive subscales scores, resulting in a total score between 18 and 126. A higher score indicates greater functional independence.
The FIM score has seven levels, each indicating a patient's level of independence in performing activities of daily living (ADLs). These levels are:
Level 1:Total assistance - The patient requires complete assistance from another person to perform the task.
Level 2: Maximal assistance - The patient requires assistance from another person to perform the task but can contribute to the activity.
Level 3: Moderate assistance - The patient requires assistance from another person to perform the task but can perform some aspects of the activity independently.
Level 4: Minimal assistance - The patient requires occasional assistance from another person to perform the task but can perform most aspects of the activity independently.
Level 5: Supervision or setup - The patient requires no physical assistance but needs someone to supervise or set up the activity.
Level 6: Modified independence - The patient requires no assistance but may use assistive devices or require more time to complete the task.
Level 7: Complete independence - The patient can perform the task independently without assistance or the need for assistive devices.
It is important to note that the FIM score does not measure a patient's ability to perform all tasks or activities. It is specific to ADLs and does not consider a patient's ability to perform other tasks, such as instrumental activities of daily living (IADLs) or work-related tasks.
The FIM score is a valuable tool for Occupational Therapists in Australia, as it objectively measures a patient's level of independence in performing ADLs. This information can then be used to set realistic goals, track progress over time, and determine the necessary level of care for the patient.
Understanding the different levels of the FIM score can help Occupational Therapists in Australia provide better care to their patients and achieve better outcomes.
The FIM score is a valuable tool used in occupational therapy to assess and monitor patients' functional independence. It provides a standardised method for evaluating functional outcomes across various settings and diagnoses and has several practical applications in treatment planning and evaluation. Using the FIM score, occupational therapists in Australia can improve the quality of care they provide and better communicate functional outcomes to other healthcare professionals and insurance providers.
Enable Lifecare is an assistive technology wholesaler in Australia, selling disability equipment to dealerships and providing support for Occupational Therapists. We strive to produce and source high-quality and innovative products to help Australians improve their quality of life.
