Rancho Los Amigos Scale

Front 1

appears to be in deep sleep

Back 1

rancho 1

Front 2

unresponsive to any stimuli

Back 2

racho 1

Front 3

rancho 1

Back 3

no response

Front 4

individual reacts inconsistently and nonpurposefully to stimuli in a nonspecific manner

Back 4

rancho II

Front 5

responses limited in nature and often the same, regardless of the stimulus presented

Back 5

rancho II

Front 6

responses may be physiologic changes, gross body movement, or vocalizaiton

Back 6

rancho II

Front 7

responses are likely to be delayed

Back 7

rancho II

Front 8

earliest response is to deep pain

Back 8

rancho II

Front 9

rancho II

Back 9

generalized response

Front 10

individual reacts specifically but inconsistently to stimuli

Back 10

rancho III

Front 11

rancho III

Back 11

localiced response

Front 12

responses are directly related to the type of stimulus presented

Back 12

rancho III

Front 13

may withdraw an extremity or vocalize when presented with a noxius stimuli

Back 13

rancho III

Front 14

follow simple command in an inconsistent and delayed manner

Back 14

rancho III

Front 15

may show vague awareness of self and body by responding to discomfort (NGT< catheter or restraints)

Back 15

rancho III

Front 16

may show bias when responding to others

Back 16

rancho III

Front 17

rancho IV

Back 17

confused agitated

Front 18

individual is in the heightened stage of activity

Back 18

rancho IV

Front 19

decreased ability to process information

Back 19

rancho IV

Front 20

detached from the present and responds primarily to own confusion

Back 20

rancho IV

Front 21

behavior is frequently bizzare and nonpurposeful

Back 21

rancho IV

Front 22

may show aggressive behavior

Back 22

rancho IV

Front 23

attempt to remove restraints or tubes

Back 23

rancho IV

Front 24

may crawl out of bed

Back 24

rancho IV

Front 25

does not discriminate among persons or objects

Back 25

rancho IV

Front 26

unable to cooperate directly with treatment

Back 26

racho IV

Front 27

confabulation may be present

Back 27

rancho IV

Front 28

may be euphoric or hostile

Back 28

rancho IV

Front 29

gross attention is very short

Back 29

rancho IV

Front 30

selective attention is often nonexistent

Back 30

rancho IV

Front 31

lacks short-term recall and may be reacting to past events

Back 31

rancho IV

Front 32

unable to perform ADLs without maximal assistance

Back 32

rancho IV

Front 33

may perform motor activities , not as purposeful act but as part of the agitated state

Back 33

rancho IV

Front 34

rancho V

Back 34

confused, inappropriate, non-agitated

Front 35

individual appears alert

Back 35

rancho V

Front 36

able to respond to simple commands

Back 36

rancho V

Front 37

but with increase complexity of task or lack of structure, responses become nonpurposeful, random or fragmented

Back 37

rancho V

Front 38

may be agitated as a result of an external stimuli and is usually out or proportion

Back 38

rancho V

Front 39

may show gross attention to environment

Back 39

rancho V

Front 40

highly distractible

Back 40

rancho V

Front 41

lacks ability to focus attention to specific task without frequent redirection

Back 41

rancho V

Front 42

individual may be able to converse socially if environment is structured (short periods only)

Back 42

rancho V

Front 43

verbalization is inappropriate

Back 43

rancho V

Front 44

confabulation may be triggered by present events

Back 44

rancho V

Front 45

memory is severely impaired

Back 45

rancho V

Front 46

confusion of the past and present

Back 46

rancho V

Front 47

lacks initiation

Back 47

rancho V

Front 48

shows inappropriate use of objects without external direction

Back 48

rancho V

Front 49

unable to learn new information

Back 49

rancho V

Front 50

often responds to self, body, comfort and family members

Back 50

rancho V

Front 51

may perform self-care activities with assistance

Back 51

rancho V

Front 52

if physically mobile, may wander off

Back 52

rancho V

Front 53

rancho VI

Back 53

confused - appropriate

Front 54

individual shows goal-directed behavior but is dependent on external input for direction

Back 54

rancho VI

Front 55

response to discomfort is appropriate

Back 55

rancho VI

Front 56

individual is able to tolerate noxious stimuli when the need is explained

Back 56

rancho VI

Front 57

follows simple direction consistently and shows carry over of tasks that have been learned

Back 57

rancho VI

Front 58

responses may be incorrect because of memory problems but are appropriate to the situation

Back 58

rancho VI

Front 59

responses may be delayed

Back 59

rancho VI

Front 60

decreased ability to process information with little or no anticipation or prediction of events

Back 60

rancho VI

Front 61

past memories show more depth and detail than recent memory

Back 61

rancho VI

Front 62

may show beginning awareness of situation by realizing that one does not know the answer

Back 62

rancho VI

Front 63

no longer wanders

Back 63

rancho VI

Front 64

inconsistently oriented to time and place

Back 64

rancho VI

Front 65

selective attention may be impaired (difficult tasks)

Back 65

rancho VI

Front 66

functional in for common ADLs (30 min with structure)

Back 66

rancho VI

Front 67

vague recognition of some staff

Back 67

rancho VI

Front 68

has increased awareness of self, family and basic needs in an appropriate manner

Back 68

rancho VI

Front 69

rancho VII

Back 69

automatic appropriate

Front 70

appears inappropriate and oriented

Back 70

rancho VII

Front 71

goes through daily routine automatically (robot like)

Back 71

rancho VII

Front 72

minimal to absent confusion

Back 72

rancho VII

Front 73

shallow recall of what he/she has been doing

Back 73

rancho VII

Front 74

shows increased awareness of self, body, family, food, people, and interaction with the environment

Back 74

rancho VII

Front 75

has superficial awareness of one's condition but still lacks insight

Back 75

rancho VII

Front 76

decreased judgement or problem solving

Back 76

rancho VII

Front 77

lacks realistic planning for the future

Back 77

rancho VII

Front 78

shows carryover of learned tasks

Back 78

rancho VII

Front 79

requires minimal supervision for learning and safety purposes

Back 79

rancho VII

Front 80

independent in self care

Back 80

rancho VII

Front 81

supervised in home and community skills for safety

Back 81

rancho VII

Front 82

able to initiate social and recreational activities in a structured environemnt

Back 82

rancho VII

Front 83

judgment is still impaired (unable to drive a car)

Back 83

rancho VII

Front 84

rancho VIII

Back 84

purposeful and appropriate

Front 85

alert and oriented

Back 85

rancho VIII

Front 86

able to recall and integrate past and recent events

Back 86

rancho VIII

Front 87

aware and responsive

Back 87

rancho VIII

Front 88

shows carryover for new learning

Back 88

rancho VIII

Front 89

needs no supervision after activities are learned

Back 89

rancho VIII

Front 90

independent in home and community skills (driving)

Back 90

rancho VIII

Front 91

may continue to show decreased ability to premorbid abilities

Back 91

rancho VIII

Front 92

functional to society

Back 92

rancho VIII