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Get Functional Independence Measure and Functional Assessment Measure

coaxing, prompting) 4 Minimal Assist (performs 75% or more of task) 3 Moderate Assist (performs 50%-74% of task) 2 Maximal Assist (performs 25% to 49% of task) 1 Total Assist (performs less than 25% of task) (Patient Stamp) 1. 2. 3. 4. 5. 6. 7. SELF CARE ITEMS Feeding Grooming Bathing Dressing Upper Body Dressing Lower Body Toileting Swallowing* 8. 9. SPHINCTER CONTROL Bladder Management Bowel Management 10. 11. 12. 13. MOBILITY ITEMS (Type of Transfer) Bed, Chair, Wheelchair ___________.

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