Transfer Hierarchy
The hierarchy for for mobility skills is listed in the following order: 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 upon my previous experience of working as a tech in an outpatient neuro clinic, I did expect this order. I believe that the hierarchy is in this particular order because it starts from the most basic of the tasks and progresses to tasks that are more complex and require more skill. This order ensures that a client learns how to perform the skills that they need to perform each day first, like getting in and out of bed, before moving on to complex tasks such as driving.
I have observed this particular hierarchy throughout my observation experience. While working at the neuro clinic, I was able to see firsthand the sequence of events that a new client must take while learning mobility skills. While observing, though, I was also able to witness how each client climbed this hierarchy differently. The sequence of events is not an order that each person has to follow exactly, but instead follows based upon their own needs, disability, and capabilities. For example, two clients who had sustained a TBI were both admitted to the neuro clinic around the same time. One of the clients had a more serious and complex TBI and therefore had to start and spend more time working on proper bed mobility. The second client's TBI was not as serious and he was able to immediately start working on cognitive skills that pertained to community mobility and driving. Each of these clients had to go through the same sequence of events, just in a different manner.
Based upon what I have seen and learned throughout my observation experiences and through the Biomechanics lectures, I agree with this transfer hierarchy. I believe that it allows for a smooth progression of mobility skills and provides a client with the best method to regaining independence in activities that are important to them.
I have observed this particular hierarchy throughout my observation experience. While working at the neuro clinic, I was able to see firsthand the sequence of events that a new client must take while learning mobility skills. While observing, though, I was also able to witness how each client climbed this hierarchy differently. The sequence of events is not an order that each person has to follow exactly, but instead follows based upon their own needs, disability, and capabilities. For example, two clients who had sustained a TBI were both admitted to the neuro clinic around the same time. One of the clients had a more serious and complex TBI and therefore had to start and spend more time working on proper bed mobility. The second client's TBI was not as serious and he was able to immediately start working on cognitive skills that pertained to community mobility and driving. Each of these clients had to go through the same sequence of events, just in a different manner.
Based upon what I have seen and learned throughout my observation experiences and through the Biomechanics lectures, I agree with this transfer hierarchy. I believe that it allows for a smooth progression of mobility skills and provides a client with the best method to regaining independence in activities that are important to them.
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