Rancho 4 and up Flashcards
briefly describe RLAS IV
Confused/Agitated: Max Assist
- aggressive or flight behavior
- mood swings
- inappropriate words or social pragmatics
T/F: Ranco IV can cooperate with treatments if you try hard enough
FALSE
unable to cooperate with treatment efforts
do the best you can and you may occasionally get something out of them
how do you distinguish between a Rancho IV and V?
when the pt is not longer agitated, they have moved out of Rancho IV
briefly describe RLAS V
Confused/Inapproriate Non-agitated: Max Assist
- still severely disoriented
- not agitated but may have infrequent outbursts
- complete inability to learn new tasks
- communication is difficult due to cog breakdown
how would you structure a treatment session with a Rancho V?
- perform all treatment in a closed environment with no distractions if possible
- pt may recognize familiar task but are easily distracted and need max assist
- keep things simple and functional based
how do you distinguish between a Rancho V and VI?
when the pt can orient some, they have moved from a V to a VI
briefly describe RLAS VI
Confused, Appropriate: Mod Assist
- orientation improves slighty
- small improvements in endurance
- a lot less tangential and word substituations in speaking
- can have a simple conversation now
- consistently follows simple directions
how would you structure a treatment session with a Rancho VI?
- stay in closed environment
- keep tasks simple and familiar, push duration some
- introduce memory assistive device but they will need max assist
- they are unaware of impairments so careful guarding
- push learning skills
- supervise w/old learning
- utilize memory aids for carry over
- max assist for learning new tasks
how do you distinguish between a Rancho VI and VII?
when the pt can consistently orient, they have transitioned out of Rancho VI and to VII
briefly describe RLAS VII
Automatic, Appropriate: Min Assist
- consistent orientation (mod assist for time)
- more endurance with familiar tasks and less help needed
- problem solving emerges for familiar tasks
- very robotic
- demos carryover of new learning
- superficial awareness of their condition
how would you structure a treatment session for a RLAS VII?
- can introduce more fun/variety in activities
- may attempt a very low-level group therapy with time for short time
- their social skills are rough
- they cannot demo empathy yet
- be aware that they cannot consider consequences of a decision or action
how do you distinguish between a RLAS VII and VIII?
complete orientation to person, place and time indicates a change from VII to VIII
briefly describe RLAS VIII
Purposeful, Appropriate: SBA
- Consistent orientation x3
- more of personality comes back
- memory, recall, and carryover improves
- able to recall and integrate past and recent events
- growing awareness of impairments may result in depression
- overestimation/underestimation of abilities
how would you structure a treatment session with a RLAS VIII?
- can perform familiar tasks in open environment independently for 1 hour
- take first and last 5 minutes of every session to challenge memory by talking through previous session
- they need SBA using an assistive memory device to complete
- no longer need assistance once new task/activity is learned
- need SBA to correct task when impairments interfere
T/F: a RLAS IX no longer needs SBA or any support
FALSE
still need a lot of social support (SBA upon request) and supervision meaning they will need a familiy member or a caregiver 24/7 to give cues
