Hierarchy of mobility skills

Mobility is defined as the ability to move freely. This is a luxury we often take for granted because it can be taken from us in the blink of an eye. As a future occupational therapist, it will be my responsibility to help individuals regain or maintain their mobility by using the hierarchy of mobility skills. This pyramid starts using a larger base of support and progresses to a smaller base of support. It begins with bed mobility, to mat transfer, to wheelchair transfer, to bed transfer, to functional ambulation for ADL, to toilet and tub transfer, to car transfer, to functional ambulation for community mobility, and lastly to community mobility and driving. 

At first glance, the hierarchy pyramid wasn't what I expected. After looking and thinking about it, it made more sense on why it is in the order it is in. The way it is set up allows for the client to gain confidence in their ability to be successful and to trust the therapist assisting them. This set up allows them to improve their strength, stability, and balance while working their way to becoming more independent. 

During my observation in a skilled nursing facility, I got to see this done with several patients. At the time, I had no idea there was a hierarchy to follow, but looking back it is cool to see the things you learn without even knowing it. I was able to see this done many times. Once with a stroke client, an MS client, amputee client, and COPD client. 

To me, the set up of the hierarchy of mobility skills is organized to enable individuals to gain their confidence and ability. With the use of a larger base of support, the clients can challenge and push themselves to reach the top of the ladder and reach the skills that require a smaller base of support with more balance and stability. The higher up the client gets, the more independent the client can be allowing for a better quality of life for the client.