Ranchos Los Amigos Revised Scale Flashcards
Ranchos Los Amigos assumption
observation of type, nature, and quality of patient’s behavior is representative of cognitive level
cutoff for Agitated Behavior Scale
< 21 - within normal limits
22-28 - mild agitation
29-35 - moderate agitation
> 35 - severe agitation
What is the hallmark transition between RLAS-R 4 and 5?
agitation goes away in level 5
What will a RLAS-R 5 score on agitated behavior scale?
21 or below
At what RLAS-R level does orientation start to come in?
6
What are hallmarks of RLAS-R 6?
become inconsistently oriented and begin to demo carryover for relearned familiar task
- can sit down and do something structured with patient with max assist and max external cues
- poor insight (safety risk)
At what stage is the patient no longer confused?
RLAS-R 7
At what stage does the patient start to have awareness of what their condition but think they are fine?
RLAS-R 7
RLAS-R 7 orientation
consistently oriented to person and place
How would you describe a RLAS-R 7 cognitive responses?
robot/automatic like cognitive responses
What is the difference between RLAS-R 7 and 8 in terms of orientation?
8 is consistently orientated to person, place, and time
What is behavior of RLAS-8?
- depression common - reality is setting in
- similar to a toddler
- defiant and underestimate abilities
- able to recognize inappropriate social behavior and correct w/ min assist
What is a defining factor of RLAS-R 9?
able to realize and ask for help when needed
What is the GOAT? What cutoff scores exist for it?
Galveston Orientation and Amnesia test - determines if person is in state of post-traumatic amnesia (state of disorientation)
normal - 76-100
borderline - 66-75
impaired - < 66
What is the O-Log? What cutoff scores exist for it?
basic A + O exam - determines if person is in state of post-traumatic amnesia (state of disorientation)
- scoring out of 30 and want > 25
How do we determine if someone is no longer in a post-traumatic amnesia state?
> 75/100 on GOAT and > 25/30 on O-log
Post-traumatic amnesia determined by _______ demonstrated even better prediction of rehabilitation outcomes than ______
O-log better predictor than GOAT
What is the MARS?
Moss Attention Rating Scale
- observational scale that measures behavioral responses that affect attention
MARS scoring
- negative items need to be flipped before scoring
- 22-110 scale w/ higher scores = better attention
What are the 3 major factors that the MARS rates?
- irritability
- initiation
- sustained attention
What are the options available to deal with an agitated patient?
talk calmly, quietly, slowly, and short sentences
- turn off lights, close shades, turn off TV, have less people in room, close/crack door
- lessen stimulus
Why are restraints a last-ditch option?
increase risk for delirium, worsening agitation, skin breakdown, and length of stay
At what stage does the patient become consistently oriented?
7 - consistently oriented to person and place in familiar environments; ModA for time
8-10 - consistently oriented to person, place, and time
At what stage does the patient begin to see confusion between STM and LTM?
5