Transfers

The order for restoring confidence in mobility based on increasing activity demands (easiest to hardest) is as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. I am not surprised by this hierarchy. I think the hierarchy is in this sequence because with each step, the complexity of the activities increase. For example, the steps involved with driving are going to be a lot more complex than transferring from the bed. It also would not make sense for these steps to be switched around; why learn driving if you cannot get out of bed? This hierarchy shows that mobility skills build upon each other. I witnessed many wheelchair and bed transfers with my time shadowing at assisted living facilities but would've enjoyed getting to see other types of transfers. So, I have really enjoyed learning about all the different transfer techniques and when they should be used. In conclusion, I do agree with this approach. We as occupational therapists should use this as a guide but also remember to adapt when some of our clients are progressing differently than the exact order of this hierarchy.