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notes

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Term
Definition
bed mobility   term used to describe pre-transfer activities & position changes done in bed  
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min assist   pt gives 75%  
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mod assist   pt gives 50%  
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max assist   pt gives 25%  
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independent   don't have to help pt at all  
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SBA   stand by assist- stand close/don't touch/some places have stopped doing this  
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total assist   pt not doing anything  
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contact guarding (cg)   feel like you need a hand on them but you're not really helping them  
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supervised (S)   observing  
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modified independence (mod I)   might need reminder or they have assistive device  
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indicators of mastery   1) guidance & cuing by PTA must be withdrawn in order for mastery 2) the pt will primarily rely on the "feel" of the movement  
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factors that affect learning   individual learning styles, pre-existing skills/abilities (literate?), cultural/social implications  
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FIM score 7 (Complete Independence)(I)   all of the tasks described as making up the activity are typically performed safely, without modification, assist/adaptive devices, or aids, AND w/in reasonable amt of time. trsf-WC, no std: can lock brakes, lift ft rests, std/lat  
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FIM score 6 (Modified Independence) (Mod I)   1 or more of following may be true: activity requires assist/adaptive device; activity takes 3x longer than normal; or there are safety consid. trsf-use of sliding board, grab bars, special seat, AD, orthoses, prostheses  
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FIM score 5 (Supervision or set up) (S)   subject requires no more help than standby, cuing or coaxing, w/out physical contact OR helper sets up needed items or applies orthoses or assistive/adaptive devices  
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FIM score 4 (Minimal Contact Assistance) (+1 min A)(CGA)   subject requires no more help than touching, steadying, guiding, AND expends 75% or more of the effort-trsf-assist to lift one LE  
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FIM score 3 (Moderate Assistance) (+1 mod A)   subject requires more help than touching or expends 50-74% of the effort-trsf-assist to lift 2 LE  
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FIM score 2 (Maximal Assistance) (max A)   subject expends 25-49% effort  
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FIM score 1 (Total Assistance) (total A)   subject expends less than 25% of the effort-trsf-+2 or mechanical lift  
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purpose of FIM score   measure level of disability  
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when to use FIM score   at time of admission (within 3 days of admit) at discharge (last 3 days)  
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who uses FIM score   someone familiar with the patient's daily performance  
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how to use FIM score   direct observation or actual performance of identified activities  
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scale for FIM score   7-0 w/some modifiers for some activities, never leave any blanks, never use N/A, if performance varies over 24 hr period, document lower score  
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self care   usually OT-grooming, eating, bathing, upperbody dressing, lower body dressing, toileting  
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sphincter control   usually nursing-bladder management, bowel management  
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mobility   usually PT-transfer bed-chair, transfer toilet, transfer bath or shower, locomotion, stairs  
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communication   usually Speech Therapy-comprehension, expression  
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social cognition   usually Speech Therapy-social interaction, problem solving, memory  
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