Transfers

The order of hierarchy of mobility skills 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 think that this hierarchy is in this specific order because you start out with simple task of transfer and then work your way up to more complex tasks. I agree with the order because I believe it is easier to complete the simple task before trying to master harder tasks. I have seen this work in my experience as a physical therapist technician. I have seen clients start out trying to get off the mat by themselves to being able to get into a wheelchair by themselves after surgery. I think every client is different though. Sometimes I would see clients be able to transfer from the wheelchair to the mat with no problem, then struggle to get from the mat to the chair. I believe that as occupational therapist, we can adapt to any different situations that may arise. Even though a client may not follow the exact steps in the hierarchy of mobility, we need to be flexible to each specific client. I have also had the experience of seeing someone fall down the hierarchy of mobility. My grandmother was diagnosed with Alzheimer's Disease about 13 years ago. I have seen here be functional enough to drive to know she cannot get out of the bed by herself anymore. Even though she went backwards down the hierarchy, she did progress through each level of mobility skill. Overall, I think this approach to the hierarchy is well because it allows you to start from an easy level or level that if comfortable to the individual and build up from that point.