Restoring Confidence in Mobility

Hierarchy for restoring confidence in mobility from start to finish is: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, community mobility and driving.

This is pretty similar to what I expected, I think the sequence follows a good pattern and allows you to complete one important task which in return helps you complete the next task. I think this is the sequence because you need to be able to do one thing in order to do the next. It also follows a sequence of cognitive and physical ability, which is extremely important for completing a task, which is why OT's also do activity analysis'. For example, if you can transfer from a mat to a wheelchair, then you will be able to sit up and be stable for functional ambulation for ADL's. Being able to sit up for functional ambulation for ADLs in return will allow you to transfer to the toilet/tub for grooming (ADL) etc. etc.

I definitely agree with this approach and think it will be a good resource for me to remember when working with my own clients one day. I can't expect them to go straight from the bed to community mobility and driving, so knowing and practicing this sequence really shows importance. Having hands on experience with this in the SIM lab has really shown me the importance of bed mobility, transfers and functional ambulation. These patients will typically be in the acute care setting and their goals will more than likely be related to grooming, toileting, bathing and just being able to get to the bathroom to do these things, or even sitting up in bed. As a future practitioner, I will get to practice the importance of this hierarchy everyday.