Ranchos Los Amigos Levels of Cognitive Function Flashcards
I. No Response
pt appears in a deep sleep, completely unresponsive to any stimuli
II. Generalized Response
pt reacts inconsistently/ non-purposefully to simuli in non-specific manner
responses are limited & often the same, regardless of stim, may be physiologic changes/ gross body movements/ vocalization
III. Localized Response
pt reacts specifically but inconsistently to stim
Responses are directly related to type of stim
May follow simple commands (close eyes, squeeze hand) in inconsistent, delayed manner
IV. Confused-Agitated
pt in heightened state of activity- behavior is bizarre/non-purposeful relative to environment
pt doesn’t discriminate b/w people & objects- unable to cooperate directly w/ Tx efforts
Verbalizations= incoherent/inappropriate to environment, confabulation may be present (production of fabricated, distorted/ misinterpreted memories about oneself/the world, without conscious intention to deceive)
Gross attention to environment is brief, selective attention = non-existant, no short or long term recall
V. Confused-Inappropriate
Pt can respond to simple commands consistently- increased complexity/lack of structure elicits non-purposeful, random/ fragmented responses
Demonstrates gross attention to environment but highly distractible, lacks ability to focus on specific task
W/ structure, may converse on social automatic level for short periods- verbalization = inappropriate/ confabulatory
Memory severely impaired- shows inappropriate use of objects, may perform previously learned tasks but cannot learn new info
VI. Confused-Appropriate
Pt shows goal-directed behavior but is dependent on external input/ direction
Follows simple instructions consistently, shows carry-over of relearned tasks (self-care)
Responses may be incorrect due to memory problems but are appropriate to situation
Past memories show more depth and detail than recent memory
VII. Automatic-Appropriate
Pt appears appropriate and oriented w/in hospital/home settings
Goes through daily routine automatically, but robot-like
Minimal-no confusion, has shallow recall of activities, shows carry-over for new learning @ decreased rate
W/structure, able to initiate social/recreational activities, judgement remains impaired
VIII. Purposeful-Appropriate
Pt recalls/integrates past & recent events, is aware of/responsive to environment
Shows carry-over of new learning, no supervision needed once activities are learned
May show decreased ability due to premorbid abilities/abstract reasoning/ tolerance for stress/ judgement in emergencies