CHAPTER 12: FUNCTIONAL INDEPENDENCE MEASURE (FIM)

Description

The Functional Independence Measure (FIM) scale, introduced by Granger et al. (1984), is an interactive observational tool that the clinician can use to grade an individual’s level of performance while engaging in activities of daily living (ADLs). It is a quantitative hierarchical measure that includes 7 levels that differentiate major gradations in activity performance from independence (7) to dependence (1) and is considered a classification system the clinician can use to judge a client’s ability to carry out an activity independently vs his or her need for assistance from another person or a device. If help is needed the scale quantifies that need where the need for assistance (burden of care) translates to the time/energy that another person must expend to serve the dependent needs of the impaired individual to achieve and maintain a certain quality of life. Higher scores on the FIM thus denote persons that have a higher level of independence and require a smaller amount of assistance. The FIM scale contains a total of 18 items and the sum of all 18 items gives the client’s total score, which can range from 18 to 126. Developed by the Uniform Data System for Medical Rehabilitation (UDSMR), its unique software database provides the clinician as well as therapy teams with a way of collecting rehabilitation data in a consistent manner where participating units can report FIM scores, along with client demographics which can then be included within comparative reports generated by the National Rehabilitation Reporting System (Fioravanti, Bordignon, Pettit, Woodhouse, & Ansley, 2012). Facilities can then use these reports to compare programs and client populations with other similar facilities as well as for internal program evaluation.

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