Rancho Los Amigos Levels Of Cognitive Functioning

Question 1

Level I

Answer 1

• No response
• The individual appears to be in a deep sleep and is completely unresponsive to any stimuli presented

Question 2

Level II

Answer 2

• Generalized response
• The individual reacts inconsistently and no purposefully to stimuli in a nonspecific manner
• Responses may be physiologic changes, gross body movements, or vocalization
• Responses are limited in nature and are often the same, regardless of stimuli presented

Question 3

Level III

Answer 3

• Localized response
• The individual reacts specifically but inconsistently to stimuli
• Responses are directly related to the type of stimulus (e.g., turning head toward sound)
• May follow commands in an inconsistent, delayed manner (such as closing eyes or extending an extremity)
• May also show vague awareness of self and body by responding to discomfort by pulling at tubes/catheters

Question 4

Level IV

Answer 4

• Confused, agitated response
• Unable to perform self-care without MAX ASSISTANCE
• Interventions: simple reaching activities or objects identification
• The individual is in a heightened state of activity with a severely decreased ability to process information
• Behavior is often bizarre and nonpurposeful
• Gross attention is very short
• No short-term recall (may be reacting to past events)
• May perform motor actions (sitting, reaching, ambulating) but NOT purposeful or on request

Question 5

Level V

Answer 5

• Confused, inappropriate, nonagitated
• Still MAX ASSIST overall
• Interventions: Simple cognitive activities (e.g., orientation to self & place) and ADLs with step-by-step curs
• The individual appears alert and is able to respond to SIMPLE commands fairly consistently
• ## Requires structure

Question 6

Level VI

Answer 6

• Confused, appropriate
• MOD ASSIST to problem solve during tasks
• Able to attend to familiar tasks for up to 30 mins
• Max assist for new learning
• Interventions: SIMPLE IADLs (e.g., cold food prep, housekeeping)
• Long term memory stronger than short term

Question 7

Level VII

Answer 7

• Automatic, appropriate
• MIN ASSIST for ADLs & some household tasks
• Ego-centric & overestimates own abilities
• Interventions: May include prevocational training

Question 8

Level VIII

Answer 8

• Purposeful, appropriate
• STAND BY ASSIST
• Driving & vocational rehab possible
• Interventions: memory aids (calendar, planning), higher level problem solving