Rancho Level of Cognitive Functioning.csv

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Author:
Camille
ID:
251292
Filename:
Rancho Level of Cognitive Functioning.csv
Updated:
2013-12-06 14:54:01
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Rancho Level Cognitive Functioning
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Description:
Rancho Level of Cognitive Functioning
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  1. Level I-No Response: Total Assistance
    Complete absence of observable change in behavior when presented visual; auditory; tactile; proprioceptive; vestibular or painful stimuli
  2. Level II-Generalized Response: Total Assistance
    • "Demonstrates generalized reflex response to painful stimuli;
    • Responds to repeated auditory stimuli w increased or decreased activity;
    • Responds to external stimuli with physiological changes generalized; gross body movement & or not purposeful vocalization;
    • Responses noted above may be same regardless of type & location of stimulation
    • Respones may be significantly delayed"
  3. Level III-Localized Response: Total Assistance
    • "Demonstrates withdrawal or vocalization to painful stimuli;
    • Turns toward or away from auditory stimuli;
    • Blinks when strong light crosses visual field;
    • Follows moving object passed within visual field;
    • Responds to discomfort by pulling tubes or restraints;
    • Responds inconsistently to simple commands;
    • Responses directly related to type of stiumulus;
    • May respond to some persons but not others"
  4. Level IV-Confused Agitated: Maximal Assistance
    • "Alert & in heightened state of activty;
    • Purposeful attempts to remove restraints or tubes or crawl out of bed;
    • May perform motor activities such as sitting; reaching & walking but w out any apparant purpse or upon another's request;
    • Very brief & usually non-purposeful moments of sustained alternatives & divided attention;
    • Absent short-term memory;
    • May cry out or scream out of proporation to stimulus even after its removal;
    • May exhibit aggressive or flight behavior;
    • Mood may swing from euphoric to hostile w no apparent relationships to environmental events;
    • Unable to cooperate with treatment efforts;
    • Verbalizations are frequently incoherent & or inappropriate to activity or environment."
  5. Level V-Confused; Inappropriate Non-Agitated: Maximal Assistance
    • "Alert; not agitated buy may wander randomly or with a vague intention of going home;
    • May becoe agitated in response to external stimulation; & or lack of environmental structure;
    • Not oriented to person; place or time;
    • Frequent brief periods; non-purposeful sustained attention;
    • Severly impaired recent memory; w confusion of past & present in reaction to ongoing activity;
    • Absent goal directed; problem solving; self-monitoring behavior;
    • Often demonstrates inappropriate use of objects w out external direction;
    • May be able to perform previously learned tasks when structured & cues provided;
    • Unable to learn new information;
    • Able tor espond appropriately to simple commands failry consistently w external structures & cues;
    • Responses to simple commands w out external structure are random & non-purposeful in relation to command;
    • Able to converse on a social; automatic level for brief periods of time when provided external structure & cues;
    • Able to converse on a social; automatic level for brief periods of time when provided external structure & cues;
    • Verbalizations about present events become inappropriate & confabulatory when external structure & cues are not provided."
  6. Level VI-Confused; Appropriate: Moderate Assistance
    • "Inconsistently oriented to person; time & place;
    • Able to attend to highly familiar tasks in non-distracting environment for 30 minutes w moderate redirection;
    • Remote memory has more depth & detail than recent memory;
    • Vague recognition of some staff;
    • Able to use assistive memory aide w maximum assistance;
    • Emerging awareness of appropriate response to self; family & basic needs;
    • Moderat assist to problem solve barriers to task completion;
    • Supervised for old learning (e.g. self care);
    • Shows carry over for relearned familiar tasks (e.g. self care);
    • Maximum assistance for new learning w little or nor carry over;
    • Unaware of impairments; disabilities & safety risks;
    • Consistently follows simple directions;
    • Verbal expressions are appropriate in highly familiar & structured situations."
  7. Level VII-Automatic; Appropriate: Minimal Assistance fof ADLs
    • "Consistently oriented to person and place; within highly familiar environments. Mod Assist for orientation to time
    • Able to attend to highly familiar tasks in a non-distraction environment for at least 30 min w min assist to complete tasks
    • Minimal supervision for new learning
    • Demonstrates carry over of new learning
    • Initiates and carries out steps to complete familiar personal and household routine but has shallow recall of what he has been doing
    • Able to monitor accuracy and completeness of each step in routine personal and household ADLs and modify plan w min assist
    • Superficial awareness of his condition but aware of specific impairments and disabilities and the limits they place on his ability to safely; accurately; and completely carry out his household; community; work and leisrue ADLs
    • Minimal supervision for safety in routine home and community ax
    • Unrealistic planning for the future
    • Unable to think about consequences of a decision or action
    • Overestimates abilities
    • Unaware of others' needs and feelings
    • Oppositional uncooperative
    • Unable to recognize inappropriate social interaction behavior"
  8. Level VIII-Purposeful; Appropriate: Stand-By Assist
    • "Consistently oriented to person; place; and time
    • Independently attends to and completes familiar tasks for 1 hr in distracting environments
    • Able to recall and integrate past and recent events
    • Uses assistive memory devices to recall daily schedule; to do lists; and record critical information for later use w stand by assist
    • Initiates and carries out steps to complete familiar personal; household; community; work and leisure routines w stand by assist and can modify the plan when needed w min assist
    • Requires no assist once new tasks ax are learned
    • Aware of and acknowledges impairements and disabilities when the interfere w task completion but requires stand by assist to take appropriate and corrective action
    • Thinks about consequences of a decision or action w min assist
    • Overestimates or underestimates abilities
    • Acknowledges others'needs and feelings and responds appropriately w min assist
    • Depressed
    • irritable
    • Low frustration tolerance easily angered
    • Argumentative
    • Self-centered
    • Uncharacteristically dependent or independent
    • Able to recognize nad acknowledge inappropriate social interaction behavior while it is occurring and takes corrective action w min assist"
  9. Level IX-Purposeful; Appropriate: Stand by assist on request
    • "Independently shifts back and forth between tasks and completes them accurately for at least 2 consecutive hrs
    • Uses assistive memory devices to recall daily schedule; to do lists and record critical information for later use w assist when requested
    • Initiates and carries out steps to complete familiar personal; household; work and liesure tasks independently and unfamiliar personal; household; work and leisure tasks w assist when requested
    • Aware of and acknowledges impairments and disabilties when the interfere w task completion and takes appropriate corrective action but requires stand by assist to anticipate a problem before it occurs and take action to avoid it
    • Able to think about consequences of decisions or actions with assistance when requested
    • Accurately estimates abilities but requires stand by assist to adjust to task demands
    • Acknowledges others' needs and feelings and responds appropriately w stand by assist
    • Depression may continues
    • May be easily irritated
    • May have low frustration tolerance
    • Able to self monitor appropriateness of social interaction w stand by assist"
  10. Level X-Purposeful; Apppropriate: Mod Independent
    • "Able to handle multiple tasks simultaneously in all environments but may require periodic breaks
    • Able to independently procure; create and maintain own assistive memory devices
    • Independently initiates and carries out steps to complete familiar and unfamiliar personal; household; community; work; and leisure tasks but may require more than usual amount of time and or compensatory strategies to complete them
    • Anticipates impact of imapirments and disabilities on ability to complete daily living tasks and takes action to avoid problems before they occur but may require more than usual amount of time and or compensatory strategies
    • Able to independently think about consequences of decisions or actions but may require more than usual amount of time and or compensatory strategies to select appropriate decision or action
    • Accurately estimates abilities and independently adjusts to task demands
    • Able to recognize the needs and feelings of others and autommatically repond in appropriate manner
    • Periodic periods of depression may occur
    • Irritability and low frustration tolerance when sick; fatigued and or under emotional stress
    • Social interaction behavior is consistently appropriate"

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