Hierarchy of Transfers - How are you going to get there?

Transferring our bodies to different surfaces is important to carry out daily activities. These surfaces may include a bed, wheelchair, and a car seat. Being able to transfer to the surfaces enables our bodies to travel from place to place. The hierarchy of mobility skills in order of difficulty is: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADLs, toilette and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. This is expected since each skill level is a precursor to the next to maintain maximal independence. For instance, a person who uses a wheelchair and wishes to be independent should be able to mobilize in bed to transfer to their wheelchair then they can safely transfer to their vehicle to complete their daily tasks. I have observed this in the past and I agree with this hierarchy because it allows the therapist to assess the independence level of a client. My experience as a physical therapist technician has allowed me to see the difficulties that some people with injuries may experience by watching them transfer from wheelchairs and maneuver different mats and surfaces. It is also important to note, that some clients may need more help from caregivers and assistive devices as they progress through the levels of transfer.