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Rancho Los Amigos Levels of Cognitive Functioning Scale
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Level 7: automatic - appropriate

The person can now do daily routines with little or no confusion, but may not know what they have been doing. They usually have poor judgment, find it hard to find solutions to problems and make poor decisions about the future. They often do not realize they are having these problems (poor insight).

They can now learn new information, but at a slower speed and with more difficulty than before the injury. They may need someone to be with them as they are not safe to be alone. They are able to take part in and enjoy more recreation and social activities.


Suggestions for the family for level 7

  1. Talk about safety and emergency measures. Have them repeat what you have talked about.
  1. Ask the patient to write in their journal every day.
  1. If there are problems with memory or the person is easily distracted, encourage your family member to write things down.
  1. Each day, ask the patient to make a list of things they should do. Allow them time to make the list as they may be slow to think of ideas and write them down.
  1. Try to do activities together, such as using the phone or going grocery shopping, or doing laundry.
  1. Work on a computer to help the patient follow steps and instructions.
  1. Ask the team for ideas of how to teach the person ways of doing new tasks, for example cooking.
  1. Your words, actions and gestures must be all clear and consistent. Teasing and sarcasm can be misunderstood.
  1. Do not let your family member drive a car, take a boat out alone or operate any dangerous equipment unless the doctor has given permission to do these things.
  1. Your family member may say what is on their mind without showing good social manners. Offer calm and gentle feedback for such behaviour.