Fim Scale PDF Details

The Functional Independence MeasureTM and Functional Assessment Measure Brain Injury Scale, essential tools in the rehabilitation of individuals with disabilities, especially those recovering from brain injuries, facilitates the evaluation of a patient's progress through detailed assessments. This form uses a seven-point scale ranging from complete independence to total assistance, allowing professionals to meticulously track the improvement or regression in various areas of functionality. These areas cover a wide spectrum of daily activities and skills, including self-care tasks like feeding, grooming, and toileting, mobility specifics such as transferring between bed, chair, and wheelchair, and more complex locomotion abilities including walking or wheelchair use. Moreover, it delves into communication skills, both comprehension and expression, accurately reflecting the patient's ability to understand and interact with their environment. The form also provides insight into the patient's psychosocial adjustment, assessing social interaction, emotional status, and the critical aspect of cognitive functions like problem-solving and memory. This comprehensive approach ensures a holistic view of the patient's capabilities, guiding therapeutic interventions and measuring outcomes effectively.

QuestionAnswer
Form NameFim Scale
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesfim scale pdf, fim score chart, functional independence measure pdf, fim handouts

Form Preview Example

FUNCTIONAL INDEPENDENCE MEASURETM AND FUNCTIONAL ASSESSMENT MEASURE

BRAIN INJURY

Scale:

 

7 Complete Independence (timely, safely)

(Patient Stamp)

6Modified Independence (extra time, devices)

5Supervision (cuing, coaxing, prompting)

4Minimal Assist (performs 75% or more of task)

3Moderate Assist (performs 50%-74% of task)

2Maximal Assist (performs 25% to 49% of task)

1Total Assist (performs less than 25% of task)

 

SELF CA RE IT EM S

 

A d m

Go a l

D/C

F/U

1 .

Fe e d i n g

 

 

 

 

 

 

2 .

G r o o m i n g

 

 

 

 

 

 

3 .

Ba t h i n g

 

 

 

 

 

 

4 .

D r e ssin g U p p e r Bo d y

 

 

 

 

 

5 .

D r e ssi n g Lo w e r Bo d y

 

 

 

 

 

6 .

T o i l e ti n g

 

 

 

 

 

 

7 .

Sw a l l o w i n g *

 

 

 

 

 

 

 

SPHIN CTER CON TROL

 

 

 

 

 

8 .

Bl a d d e r M a n a g e m e n t

 

 

 

 

 

9 .

Bo w e l M a n a g e m e n t

 

 

 

 

 

 

M O BILIT Y IT EM S ( T y p e o f T r a n sf e r )

10.

Bed , Ch air , W h eelch air _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

 

 

 

11.

Toilet _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

 

 

 

12.

Tub or Shower

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

 

 

 

13.

Car Tr ansfer *

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

 

 

 

 

LOCOMOTION

 

 

 

 

 

 

14.

W a l k i n g / W h e e l c h a i r

( c i r c l e )

15.Sta i r s

16.Co m m u n i ty A cce ss*

 

COM M U N ICA TION ITEM S

17.

Co m p r e h e n si o n - A u d i o / V i su a l ( ci r cl e )

18.

Ex p r e s s i o n - V e r b a l , N o n - V e r b a l ( ci r cl e )

19.Re a d i n g *

20.W r i t i n g *

21.Sp e e c h I n t e l l i g i b i l i t y *

PSYCHOSOCIA L A D JU STM EN T

22.So ci a l In te r a cti o n

23.Em o tio n a l Sta tu s*

24.A d j u stm e n t to Lim ita tio n s*

25.Em p l o y a b i l i ty *

COGN ITIV E FU N CTION

26.Pr o b l e m So l v i n g

27.M e m o r y

28.O r i e n ta ti o n *

29.A tte n ti o n *

30.Sa f e ty Ju d g e m e n t*

*FAM items

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admt

Date

 

D/C

 

Date

 

Admt

Date

 

D/C

 

Date

RN

 

 

 

 

 

 

 

ST

 

 

 

 

 

 

 

 

PT

 

 

 

 

 

 

 

PSY

 

 

 

 

 

 

 

 

OT

 

 

 

 

 

 

 

REC

 

 

 

 

 

 

 

 

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