FIM

Question 1

50-74% of independence

Answer 1

3: Mod A

Question 2

0% assistance. AE or AT, extended time, decreased safety.

Answer 2

6: Mod I

Question 3

0% assistance. Feel comfortable leaving pt alone

Answer 3

7: Independent

Question 4

25-49% of independence

Answer 4

2: Max A

Question 5

0% physical assistance to perform task, but requires cognitive assistance or set-up

Answer 5

5: Supervision or Set-up

Question 6

75% independence

Answer 6

4: Min A

Question 7

24% or less of independence

Answer 7

1: Dependent