EATING

My dad used to have a saying my siblings and I still joke about. Whenever we went on family outings the most important thing to him was where and what we were going to eat. YA GOTTA EAT! He would exclaim!


In scoring FIMs in the EATING category O (activity did not occur) is an acceptable number. But, it's rare. Eating is an activity that happens to most of us on a daily basis. If a person is unable to eat he/she may have a PEG or are receiving TPN, IV feedings. If the nurse is helping to administer that feeding they are a 1 Total Assist. If the patient self-administers the feeding, without a helper. then they are Modified Independent or a 6.


It helps to remember that 6 and modified independence and device hang together like birds of a feather.

                                                 EATING

EATING: Eating includes the ability to use suitable utensils to bring food to the mouth, as well as the ability to chew and swallow the food once the meal is presented in the customary manner on a table or tray. The patient performs this activity safely.


NO HELPER
7 Complete Independence—The patient eats from a dish while managing a variety of food consistencies, and drinks from a cup or glass with the meal presented in the customary manner on a table or tray. The subject opens containers, butters bread, cuts meat, pours liquids, and uses a spoon or fork to bring food to the mouth, where it is chewed and swallowed. The patient performs this activity safely.


6 Modified Independence—Performance of the activity involves safety considerations, or the patient requires an adaptive or assistive device such as a long straw, spork, or rocking knife; requires more than a reasonable time to eat; or requires modified food consistency or blenderized food. If the patient relies on other means of alimentation, such as parenteral or gastrostomy feedings, then (s)he self-administers the feedings.

HELPER
5 Supervision or Setup—The patient requires supervision (e.g., standing by, cueing, or coaxing) or setup (application of orthoses or assistive/adaptive devices), or another person is required to open containers, butter bread, cut meat, or pour liquids.


4 Minimal Contact Assistance—The patient performs 75% or more of eating tasks.


3 Moderate Assistance—The patient performs 50% to 74% of eating tasks.


 2 Maximal Assistance—The patient performs 25% to 49% of eating tasks.


1 Total Assistance—The patient performs less than 25% of eating tasks, or the patient relies on parenteral or gastrostomy feedings (either wholly or partially) and does not self-administer the feedings.


0 Activity Does Not Occur—Enter code 0 only for the admission assessment. The patient does not eat and does not receive any parenteral/enteral nutrition during the entire assessment time frame. Use of this code should be rare.