Transfers


The hierarchy for restoring confidence in mobility based on activity demands (easiest to hardest) is as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADLs, toilet and tub transfer, car transfer, functional ambulation for community  mobility, and community mobility and driving.
Based on my previous observations from shadowing and interning, plus the knowledge I have gained during my time as an OT student, this order does not surprise me. As we go through the list, the activities become more demanding and require more complex movements. It makes sense to start at restoring the simplest level of function in bed mobility and transfers and eventually making your way to the most complex, which is driving. During my observations at an inpatient rehab hospital, I was able to see this hierarchy in effect and why it is important. The therapist must ensure the clients’ confidence and safety with easier activity demands before introducing more complicated activities. This also allows the therapist to see where the client is comfortable and what needs to be worked on next to allow the client to become more mobile and independent.

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