FIM FIM Levels of Assistance 3

Question 1

On the FIM, which principle dictates that you must score the patient's actual performance during the assessment period—not their potential ability or best effort?

Accepted Answer

Performance principle

Answer

The FIM is scored based on what the patient actually does, not what clinicians believe they could do; this is known as the performance principle.

Question 2

A patient can transfer from bed to wheelchair with only light touch at the shoulder for balance. The helper contributes less than 25% of the effort. Which FIM level is correct?

Accepted Answer

Minimal Assist (4)

Answer

Minimal Assist (Level 4) is used when physical contact is made but the helper's contribution is less than 25% of the total effort; the patient performs 75% or more.

Question 3

What is the critical distinction between FIM Level 5 (Supervision) and Level 4 (Minimal Assist)?

Accepted Answer

Whether the helper makes physical contact with the patient

Answer

Level 5 (Supervision) involves no physical contact—the helper only cues or guards—while Level 4 (Minimal Assist) involves actual physical contact where the helper provides less than 25% of the effort.

Question 4

What is the maximum possible total FIM score across all 18 items?

Accepted Answer

126

Answer

With 18 items each scored up to 7, the maximum total FIM score is 18 × 7 = 126, representing complete independence across all functions.

Question 5

A patient requires setup assistance (laying out clothing) before dressing but then independently completes the entire task. Which FIM level applies?

Accepted Answer

Supervision (5)

Answer

Level 5 (Supervision/Setup) applies when a helper sets up items or provides preparatory assistance, even if no physical contact or cueing is needed during the actual task performance.

FIM - Functional Independence Measure Practice Test

FIM - Functional Independence Measure Practice Test

FIM FIM Levels of Assistance 3