Rancho Levels

Question 1

Level 1

Answer 1

No Response - Total Assistance

Question 2

Level 1 description

Answer 2

complete absence of observable change in behavior when presented with visual, auditory, tactile, proprioceptive, vestibular, or painful stimuli

Question 3

Level 2

Answer 3

generalized response - total assistance

Question 4

Level 2 description

Answer 4

• reflexive response to painful stimuli
• responds to auditory stimuli and external stimuli (not purposeful action)
• response significantly delayed
• inconsistent and non-purposefully respond to stimuli

Question 5

Level 3

Answer 5

Localized Response: total assistance

Question 6

Level 3 description

Answer 6

• withdrawal to painful stimuli
• turns towards auditory
• tracks objects
• pulls on tubes/restraints
• responds inconsistently to simple commands
• delay of response

Question 7

Level 4

Answer 7

Confused/Agitated: max assistance

Question 8

Level 4 description

Answer 8

• heightened state of activity
• remove restraints
• perform reaching
• absent ST memory
• exhibit aggressive or flight behavior
• mood swings
• unable to process/interpret external environment
• inconsistent response to stimuli

Question 9

Level 5

Answer 9

Confused, Inappropriate Non-agitated; max assistance

Question 10

level 5 description

Answer 10

• confused but responsive to surroundings
• behavior is socially inappropriate
• deficits in attention
• capacity to learn new exercises is impaired
• can follow simple instructions
• difficult for them to learn

Question 11

Level 6

Answer 11

Confused, Appropriate: moderate assistance

Question 12

Level 6 description

Answer 12

• appropriate response to environment
• follow simple instructions consistently
• experience significant improvement in memory function
• perform routine ADLs
• appear more/less cognitive functioning

Question 13

Level 7

Answer 13

Automatic, Appropriate: Minimal Assistance for Daily Living Skills

Question 14

Level 7 description

Answer 14

• minimal / no confusion
• cognitive performance decline in unfamiliar environments
• supervision for safety awareness
• flat affect and limited emotional range.
• unrealistic planning for the future

Question 15

Level 8

Answer 15

Purposeful, Appropriate: SBA

Question 16

Level 8 description

Answer 16

• consistently oriented
• requires no assistance once new task/activities are learned
• fatigue has impact
• difficulty with managing time, money, and planning for future
• appropriate emotional responses
• function at a fairly good level
• recognize and acknowledge inappropriate social interaction behavior while it occurs and takes corrective action

Question 17

what are treatment suggestions for Levels I, II, III

Answer 17

1. positioning/splinting
2. stimulation (pain, olfactory, visual)
3. ROM (PROM and progress to AAROM)
   * talk to patient and try to orient them with their environment

Question 18

what are the treatment strategies for Levels IV, V

Answer 18

1. question patient about their status regarding treatment (ex: WBing status, steps to a transfers, use of an AD)
2. incorporate personal questions into treatment session
3. activity log detailing the daily events to include treatments of all disciplines

Question 19

what are some treatment options for Level VI

Answer 19

1. memory
2. problem solving
3. simple to complex functional tasks
4. other ideas (safety awareness, red light/green light, simon says activities

Question 20

what are some treatment options for Level VII

Answer 20

1. treatment options from VI
2. gait
3. balance
4. ADLs

Question 21

what are treatment options for Level VIII

Answer 21

1. increase I attention
2. increase I with non-familiar activities
3. decreased self centered attitudes