Keeping Up With Kaylee

As  the activity demands of an individual increases, the need for greater confidence in mobility does too. The hierarchy of mobility skills, from the most stable to the least, is: bed mobility, mat transfer, wheelchair transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. This sequence is logical and decreases in support as the client progresses through the levels. The base of support varies for each skill. The largest base of support is with bed mobility, which is also the lowest level on the hierarchy. For the highest level, community mobility and driving, there is more maneuvering through environments other than the home. This means extra walking or transfers than the client would usually perform in the home. This is what I have observed in my past experiences. For a client who is very weak and in the hospital, ...

When deciding what assistive device is best for each client, there are many factors that need to be considered in order to have the best "fit." It is important to consider the physical condition of the client, including their disability, weight bearing status, strength, and balance. For example, if the client is not allowed to put any weight through one leg, you would not want to suggest they receive a cane.  Additionally, it is important to fit the assistive device to your client to ensure safety and proper body mechanics. If the client's crutches are too short and not adjusted to match their landmarks we use to fit, then they will likely have poor body mechanics.  If these factors are not considered, it can be detrimental to your client and cause an increase in risk for falls or further injury. To properly fit a cane or rolling walker to your client, the hand grip should be at the level of their greater trochanter to allow their elbow to be flexed 20-30 de...