Ot 3rd Quarter FIM Competency
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Mrs. M is a 70 y. O, married white female who lives with her husband. She has PVD, Hypertension, DM and is obese. She had bilateral knee replacement on 8/14/13 due to degenerative joint disease and is transferred to SCC on 8/20/13 for acute rehab.
- 1.Eating - Mrs. M requires dentures to chew a regular diet without problems; she can feed herself independently. What is the FIM score?
- A.
6 or Mod I
- B.
5 or Supervision
- C.
2 or Max Assist
- D.
7 or Independent
- E.
4 or Min Assist
- 2.Grooming - Mrs. M keeps her grooming supplies in a basket at the sink. She needs to sit at the sink for safety concerns. Once she is seated at the sink, she is able to wash, rinse and dry her face and hands, clean her dentures and comb her hair without assistance. Mrs. M does not wear make-up. What is the FIM score?
- A.
6 or Mod I
- B.
4 or Min Assist
- C.
7 or Independent
- D.
5 or Supervision
- E.
1 or Total Assist
- 3.Bathing - Mrs. M is able to wash, rinse and dry her chest, abdomen and both arms. A helper has to wash rinse and dry both upper and lower legs/feet, perineal area and buttocks. What is the FIM score?
- A.
1 or Total Assist
- B.
5 or Supervision
- C.
3 or Mod Assist
- D.
2 or Max Assist
- E.
7 or Independent
- 4.Dressing: Upper Body - Mrs. M is not able to gather her clothes from their customary place. After the helper places them on her nightstand, she is able to apply and remove her bra and shirt on her own. What is the FIM score?
- A.
4 or Min assist
- B.
5 or Set up
- C.
7 or Independent
- D.
1 or Total Assist
- E.
3 or Mod Assist
- 5.Lower Body: Dressing - Due to having had bilateral knee replacement, Mrs. M requires 2 helpers for undressing her lower body. She requires mod assist for removing her underwear and total assist to remove her pants, shoes and socks. What is the FIM score?
- A.
Activity did not occur because she was undressing, not dressing
- B.
6 or Mod I
- C.
2 or Max Assist
- D.
1 or Total Assist
- E.
4 or Min Assist
- 6.Toileting - During the first FIM Day, Mrs. M uses a bedpan when she needs to void. She needs a helper to pull down her pants and underwear. She requires help to clean herself and to pull up her pants and underwear. What is the FIM score?
- A.
1 or Total Assist
- B.
3 or Mod Assist
- C.
5 or Supervision
- D.
7 or Independent
- E.
4 or Min Assist
- 7.Toileting - By her third day of admission, Mrs. M can use the commode. She is able to pull her own pants and underwear down, clean herself and pull her own pants and underwear up. However, she requires 1 helper to steady her during these 3 tasks. The helper does not assist with the tasks, but the helper is physically assisting for balance. What is the FIM score?
- A.
1 or Total Assist
- B.
3 or Mod Assist
- C.
4 or Min Assist
- D.
5 or Supervision
- E.
7 or Independent
- 8.Transfers: Toilet - Mrs. M uses a bedpan for toileting, with a helper emptying the bedpan after use.
- A.
1 or Total Assist
- B.
5 or Supervision
- C.
4 or Min Assist
- D.
Do not assess if patient is unable to use toilet or commode.
- E.
3 or Mod Assist
- 9.Comprehension - Mrs. M easily follows concrete commands during therapy sessions but needs occasional repetition. She is concerned about the batteries in her hearing aid, and asked her husband to bring in extras.
- A.
6 or Mod I
- B.
5 or Supervision
- C.
2 or Max Assist
- D.
1 or Total Assist
- E.
7 or Independent
- 10.Expression - Mrs. M has no difficulty expressing herself . She is able to state her needs adequately to staff, and is currently calling her husband to make sure he brings the batteries in for her hearing aides.
- A.
3 or Mod Assist
- B.
1 or Total Assist
- C.
6 or Mod I
- D.
7 or Independent
- E.
4 or Min Assist
- 11.Social Interaction - Mrs. M is in pain periodically, is tearful at times alone in her room, but does not require redirection or medications. Around other patients, she enjoys interacting with them, encouraging them to participate and get stronger in their therapies.
- A.
1 or Total Assist
- B.
5 or Supervision
- C.
2 or Max Assist
- D.
0 or Activity did not occur
- E.
7 or Independent
- 12.Problem Solving - Mrs. M tends to overestimate her functional abilities and doesn't ask for help during lower body dressing for example; when her feet get caught in her pants, she needs a cue to initiate use of a reacher. She needs verbal cuing occasionally, less than 10% of the time, for problem solving during ADLs.
- A.
7 or Independent
- B.
5 or Supervision
- C.
3 or Mod Assist
- D.
1 or Total Assist
- E.
4 or Min Assist
- 13.Memory - Mrs. M feels that her hospitalization has thrown her off kilter and she has come up with a daily planning system to remember the times and places of her therapy sessions, when visiting hours are, her room number, and the names of her rehab team.
- A.
3 or Mod Assist
- B.
4 or Min Assist
- C.
1 or Total Assist
- D.
7 or Independence
- E.
6 or Mod I
- 14.If you, the helper, is providing between 50% - 75% of the effort to complete the task and the patient is performing 25-49% of the effort, the FIM score is:
- A.
2 or Max Assist
- B.
3 or Mod Assist
- 15.Patient wants to make chicken soup but the OT cannot get the exact ingredients that the patient wants. She's familiar with using boullion cubes but the kitchen only has broth concentrate. This is unfamiliar to her. She has never used broth concentrate and needed prompting to read the instructions in the packaging. After she solved the problem,she was able to finish the chicken soup without further direction, and it was delicious! What is the FIM score for Problem Solving?
- A.
5 or Supervison; needs direction less than 10% of the time.
- B.
4 or Minimal;occasional direction (pt solves routine problems 75-90% of the time)
- 16.When a patient transfers out unexpectedly: Kudos to all of you for documenting DC FIMs on the same day the patient leaves acutely, and documenting the FIM scores taken from the day before. Thank you!! The following is an usual clinical situation; If a patient is admitted on a Monday (FIM Day 1), transfers out acute on Wednesday (FIM Day 3), you do not have to complete a DC FIM because your admission FIMs are used to calculate the DC FIMs.
- A.
True
- B.
False
- 17.The definition of an accident is the wetting of linens and/or clothing only. If a patient is incontinent and wears a brief but does NOT soil their clothing or linens, this is NOT an accident. True or False
- A.
True
- B.
False
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