Functional Independence Measure (FIM) Guide
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ScribdTranslationsFunctional Independence Measure (FIM) Guide
Translated by
ScribdTranslationsFUNCTIONAL INDEPENDENCE MEASURE (FIM)
WITH DESCRIPTION OF THE ACTIVITIES
LAST NAME AND FIRST NAME OF THE BENEFICIARY N°S.S. OSFATLYF
DIAGNOSIS
SCORE TABLE OF LEVELS OF FUNCTIONAL INDEPENDENCE
Each item will be scored from 1 to 7 as follows:
Degree of dependency Puntaje / Nivel de funcionalidad
7 - Total independence
Without help
6 - Independence with adaptations
5 - Supervision without patient assistance
Modified dependency 4 - Minimum assistance, the patient contributes 75% or more
3 - Moderate assistance, the patient contributes 50% or more
2 - Maximum assistance, the patient contributes 25% or more
Complete dependency
1 - Total assistance, the patient contributes 25% or less
CATEGORY SCORE DOMINION
SELF-CARE
[Link]ÓN:Implica uso de utensilios, masticar y tragar la comida. Especifique grado
of supervision or assistance needed for the patient's feeding and what measures have been taken
taken to overcome the situation.
[Link] GROOMING: Involves washing one's face and hands, combing hair, shaving or
putting on makeup and brushing teeth. Indicate the characteristics of this assistance. Is it
Is the supervision and/or preparation of hygiene elements necessary?
[Link]: Involves washing from the neck down, in a bathtub, shower, or sponge bath.
bed. Indicate whether the body wash requires supervision or assistance, and the degree of
patient participation.
4. DRESS HALF BODY UPPER: It involves dressing from the waist up, thus
como colocar órtesis y prótesis. Características de la dependencia.
[Link] BODY DRESS: It involves dressing from the waist down,
includes putting on shoes, fastening, and placing orthotics and prosthetics. Characteristics of the
dependency.
[Link] HYGIENE: Involves maintaining perineal hygiene and adjusting clothing before and
after using the bathroom or bedpan.
Motor
SPHINCTER CONTROL
91 points
7. BLADDER CONTROL: It involves the complete and intentional control of urination.
and the use of necessary equipment or agents for evacuation, such as probes or devices
absorbents, frequency.
8. INTESTINE CONTROL: It involves the complete and intentional control of evacuation.
intestinal, and the use of equipment or agents necessary for evacuation. Example catheters or
ostomy devices. Frequency.
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MOBILITY
9. TRANSFER FROM BED TO CHAIR OR WHEELCHAIR: It involves moving to a
bed, chair, wheelchair, and return to the initial position. If walking, it must be done standing.
Degree of patient participation.
[Link] IN BATHROOM: Involves sitting down and getting off the toilet. Level of participation of
patient.
11. TRANSFER IN BATHTUB OR SHOWER: Involves getting in and out of the bathtub or shower.
Ambulation
12. WALKING / MOVING IN A WHEELCHAIR: Involves walking on a
flat surface once you are standing or propel your wheelchair if you cannot walk.
13. CLIMBING AND DESCENDING STAIRS: Involves going up and down steps.
COMMUNICATION
14. UNDERSTANDING: It involves the comprehension of auditory or visual communication.
Writing, gestures, signs, etc.
[Link]: It involves the clear expression of verbal and non-verbal language.
SOCIAL KNOWLEDGE
16. SOCIAL INTERACTION: It involves skills related to being understood;
participate with others in social situations, and respect boundaries. Detail the characteristics Cognitive
behavioral aspects of the patient determining if there is any degree of participation in the 35 points
different social and therapeutic situations, describing the level of behavioral reaction
in the face of instances involving maladjustment, as well as the degree of impact on oneself
same and the environment.
17. PROBLEM SOLVING: Involves solving everyday problems.
18. MEMORY: It involves the ability to recognize and memorize activities.
simple and/or familiar faces.
TOTAL /126
JUSTIFICATION OF THE DEPENDENCY
______ / ______ / ______ _____________________________
Date Signature and Seal of the Treating Physician
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