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SKILLS 6 – ONE ARM ASSIST W OUTER GARMENT, STOOL, AND CANE ASSIST
SKILLS 7 – TWO ARM ASSIST
SKILLS 8 – STAND AND PIVOT
Skills Sheet – One Arm Assist w Outer Garment, Stool, and Cane Assist
Completes Successfully?
Step
Yes
No
1. Informs the patient of the procedure
2. Assists patient with good mobility with outer garment
3. Positions body appropriately with strong stance
4. Grasps patient’s forearm and back above elbow
5. Shifts weight to back leg as patient stands
7. Assists patient for 10 steps or more on side opposite the cane
8. Assists patient into van using step stool; stays nearby and
appropriately positions body downhill to prevent falls.
Instructor Signature: _________________________________________ Date: _____________
Skills Sheet – Two Arm Assist
Completes Successfully?
Step
Yes
No
1. Informs the patient of the procedure
2. Positions body appropriately with strong stance
3. Grasps own forearm and offers it to patient
4. Shifts weight to back leg as patient stands
Instructor Signature: _________________________________________ Date: _____________
Skills Sheet – Stand and Pivot
Completes Successfully?
Step
Yes
No
1. Informs the patient of the procedure
2. Positions body in front of patient with strong stance
3. Slides arms under patient’s arms and locks hands
4. Shifts weight to back leg as the patient stands
5. Turns patient in front of chair; sits patient down in chair
Instructor Signature: _________________________________________ Date: _____________