Transfers Hierarchy

The order, from simplest to hardest, for restoring confidence in mobility based on increasing activity demands is 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 sequencing. I would say for the most part in my clinical observation time, I have experienced this process. In addition, I agree with this process as it goes from simple to hard. It also gets more complex as you move to the next sequenced step. For example, driving has more complex contextual tasks than toilet and tub transfer. It also seems as if it will allow the client to see progress sooner than putting him/her on a goal that is not within an acceptable time frame. Overall, I think this is a good hierarchy, and I agree with it. I am able to come to this conclusion a little easier knowing what is involved in transfers. Lectures have taught me valuable material such as a log role is needed for someone who does not need to rotate or move the spine. In addition I have learned different types of assistive devices such as the sliding board, trapeze for the bed, etc. Considering I did roughly 400 hours of observation in a skilled nursing facility for geriatrics, this has been one of my favorite parts about biomechanics.