Correct
C. Rancho Los Amigos level 10.
Level X – Purposeful, Appropriate: Modified 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 impairments 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 the appropriate decision or action.
• Accurately estimates abilities and independently adjusts to task demands.
• Able to recognize the needs and feelings of others and automatically respond 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.
Rancho levels of cognitive functioning:
1. No response = total assistance – not even response to pain
2. Generalized response = total assistance – general response to pain, gross body movements, vocalizations, response may be delayed
3. Localized response = total assistance – withdrawal from painful stimuli, turns towards sound, blinks at light, eyes follow objects, responds to family members – moving to music
4. Confused/agitated = maximal assistance – alert, tries to remove restraints, can sit, stand, walk; aggressive, mood swings, uncooperative, incoherent
5. Confused, inappropriate, non-agitated – maximal assistance – wanders around, non-oriented to person, time, place; brief periods of attention, poor memory/learning, can respond to simple commands, able to converse for brief periods – making a sandwich
6. Confused appropriate – moderate assistance – sometimes oriented to person, time, place; able to do tasks for 30 min in structured environment, slight remote memory, carryover of easy tasks, unaware of impairments, appropriate verbal responses – repetitive self-care
7. Automatic appropriate – minimal assistance for ADLs – oriented to person, time, place; 30+ min on task in familiar environment, carryover of new learning, awareness of the condition, can’t estimate consequences of their actions
8. Purposeful appropriate – standby assistance – has memory of past events, can do household and community work, leisure; depressed, irritable, argumentative, recognizes inappropriate social behavior
9. Purposeful appropriate: standby assistance on request – 2+ hours on task, can do work and leisure, aware of impairments, able to think about consequences, depression, irritable, self-monitors appropriately
10. Purposeful appropriate – modified independence – able to multitask, independently maintains memory, anticipates consequences, brief depression periods, socially appropriate, low frustration tolerance
Incorrect
C. Rancho Los Amigos level 10.
Level X – Purposeful, Appropriate: Modified 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 impairments 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 the appropriate decision or action.
• Accurately estimates abilities and independently adjusts to task demands.
• Able to recognize the needs and feelings of others and automatically respond 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.
Rancho levels of cognitive functioning:
1. No response = total assistance – not even response to pain
2. Generalized response = total assistance – general response to pain, gross body movements, vocalizations, response may be delayed
3. Localized response = total assistance – withdrawal from painful stimuli, turns towards sound, blinks at light, eyes follow objects, responds to family members – moving to music
4. Confused/agitated = maximal assistance – alert, tries to remove restraints, can sit, stand, walk; aggressive, mood swings, uncooperative, incoherent
5. Confused, inappropriate, non-agitated – maximal assistance – wanders around, non-oriented to person, time, place; brief periods of attention, poor memory/learning, can respond to simple commands, able to converse for brief periods – making a sandwich
6. Confused appropriate – moderate assistance – sometimes oriented to person, time, place; able to do tasks for 30 min in structured environment, slight remote memory, carryover of easy tasks, unaware of impairments, appropriate verbal responses – repetitive self-care
7. Automatic appropriate – minimal assistance for ADLs – oriented to person, time, place; 30+ min on task in familiar environment, carryover of new learning, awareness of the condition, can’t estimate consequences of their actions
8. Purposeful appropriate – standby assistance – has memory of past events, can do household and community work, leisure; depressed, irritable, argumentative, recognizes inappropriate social behavior
9. Purposeful appropriate: standby assistance on request – 2+ hours on task, can do work and leisure, aware of impairments, able to think about consequences, depression, irritable, self-monitors appropriately
10. Purposeful appropriate – modified independence – able to multitask, independently maintains memory, anticipates consequences, brief depression periods, socially appropriate, low frustration tolerance