Ranchos los amigos scale

Question 1

level I

Answer 1

No Response-total assistance

Patient does not respond to external stimuli and appears asleep

Question 2

level II

Answer 2

Generalized Response.
Patient reacts to external stimuli in nonspecific, inconsistent, and nonpurposeful manner with
stereotypic and limited responses.
-Generalized reflex response to painful stimulus

Question 3

level III

Answer 3

Localized response
Patient responds specifically and inconsistently with delays to stimuli, but -may follow simple
commands for motor action
-response is directly geared toward type of stimulus-looks towards auditory stimulus, blinks when strong light crosses visual field, follows moving object passed within visual field

Question 4

level IV

Answer 4

Confused/agitated: Maximal assistance
-Patient exhibits bizarre, nonpurposeful, incoherent or inappropriate behaviors, has no shortterm/absent shorterm memory
-pt. may scream and shout
recall, attention is short and non-selective
-may peform activities such as walking, reaching, and sitting but without any apparent purpose or upon another’s request
-unable to cooperate with treatment efforts

Question 5

level V

Answer 5

Confused/Innapropriate Non-Agitated: Maximal Assistance
-Alert not agitated
-may wonder randomly
-not oriented to person place or time
absent goal directed problem solving and self-monitoring behavior
-innapropriate use of objects without external direction
-may be able to perform previously learned task with structures and cues provided- but unable to learn new information
-verbalizations about present events become innapropriate and distorted when external structure and cues are not provided

Question 6

Level VI

Answer 6

Confused, Appropriate: Moderate Assistance

• a little oriented to person, place and time.
• Attend to familiar task in non-distracting environment for 30 minutes
• Supervised for old learning (ex. self-care)
• shows carryover for relearned familiar task (ex. self-care)
• moderate assisstance to problem solve for task completion
• Unaware of impairments disability and safety risk
• Expressions are appropriate in highly familiar and structured situations

Question 7

Level VII

Answer 7

Automatic, Appropriate: Minimal assistance for daily living skills
-Consistently oriented to person and place with highly familiar environments
-able to tend task for 30 to an 1 hour
-demonstrates carry over for new learning
-superficial awareness of his/her condition but unaware of specific defecits
-minimal assistance and supervision for safety in routine home and community activities
-unrealistic planning for the future
-unable to think about consequences of decisions or actions
-overestimate abilities
-unaware of the needs of others
-unable to recognize inappropriate and social interaction behavior
-

Question 8

Level VIII

Answer 8

Purposeful, Appropriate: Stand-By Assistance

• Able to recall and integrate past and recent events
• Completes familiar task for 1 hour in distracting environments
• recall recent and past events
• Use assistive memory devices to recall daily schedule “to do” lists and record critical information for later use with stand-by assistance
• performs independent once new tasks/ activities are learned
• Aware of and acknowledge impairments and disabilities when they interfere with task
• overestimates or underestimates abilities
• acknowledges others needs and feelings and responds appropriately with minimal assistance
• recognize and acknowledges inappropriate social interactions and takes corrective actions
• may think about some consequences but not certain

Question 9

Level XI

4

Answer 9

Purposeful, Appropriate: Stand-By assistance on Request

• independently shifts between tasks for at least 2 consecutive hours
• Accurately estimates abilities but requires stand-by assistance on request to adjust to task demands
• initiates and carries out task and routines
• Able to think about consequences of decisions or actions
• Initiates and carries out steps to complete household, work, leisure task, independently or assistance when requested
• may be depressed low frustration tolerance

Question 10

Level X

Answer 10

Purposeful, Appropriate: Modified Independent

-Anticipates impact of impairments and disabilities on ability to complete daily tasks and takes action to avoid
problems
-Able to handle multiple tasks simultaneously in all environments; may require periodic breaks.
- Independently initiates and carries out steps to complete familiar and unfamiliar personal, household,
community, work, and leisure tasks
-