Functional Independence Measure

ADL Grade Legend:

Self-care 7 = Complete Independence: The activity is typically
 Feeding 7/7 performed safely, without modification, assistive devices
 Grooming 7/7 or aids, and within reasonable time.
 Bathing 3/7 6 = Modified Independence: The activity requires an
 Upper Garment Dressing 3/7 assistive device and/or more than reasonable time and/or is
 Lower Garment Dressing 3/7 not performed safely.
Sphincter Control 5 = Supervision or Set-up: No physical assistance is
 Bladder Mx 7/7 needed, but cuing, coaxing, or set up is required.
 Bowel Mx 7/7 4 = Minimal Contact Assistance: Subject requires no more
Mobility than touching and expends 75% or more of the effort
 Bed mobility 7/7 required in the activity.
 Chair Mobility 7/7 3 = Moderate Assistance: Subject requires more than
 Toileting 2/7 touching and expends 50-75% of the effort required in the
 Transfer 2/7 activity.
Locomotion 2 = Maximal Assistance: Subject expends 25-50% of the
 Gait 4/7 effort required in the activity.
 Expression 5/7 1 = Total Assistance: Subject expends 0-25% of the effort
Communication required in the activity.
 Comprehension 7/7
 Expression 7/7
Social Cognition
 Social Interaction 7/7
 Memory 7/7
 Problem Solving 7/7
Total 100/126
Findings: All ADLs are independently performed by the patient except that patient needs supervision of
helper on locomotion expression with use of quad cane on gait +1 standby assist close guarding; on
bathing and dressing of upper and lower garments pt requires moderate assistance, while on toileting and
transfer pt requires maximal assistance.
Significance: Precautions on the level of assistance needed in performing ADLs by the pt should be
observed to prevent falls.