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Rancho Los Amigos Scale

Levels 5 and 6

Level 5

When someone is level 5, they:

  • are alert and can pay attention to what’s going on around them
  • have trouble focusing on the important parts of an event
  • have lost a lot of their memory (which affects learning new things)
  • get easily distracted and can’t focus their attention
  • may seem to forget how to use things that they knew how to use before the injury
  • will confuse the past and present
  • may be able to follow simple, everyday conversations
  • may be able to answer, “I’m fine, how are you?” but have trouble following deeper conversations
  • may swear, even though they never did before
  • depend on others to let them know when to do something
  • may be able to do simple activities for self-care, but will still need some help

Level 6

When someone is level 6, they:

  • mean to act a certain way
  • can follow simple directions
  • can follow a schedule with some support (but changes in their routine can confuse them)
  • need some direction
  • may have problems with memory that can lead to making mistakes and poor decisions
  • may have true memories of most things before the injury
  • can pay attention and concentrate better –They often know things like where they are, the time, and the date.
  • may know their healthcare providers and staff
  • may be very attached to family members and call them often
  • get easily overwhelmed with too much information
  • can’t plan or predict future events

How to help during levels 5 and 6

You can do the following things to help your loved one during levels 5 and 6:

  • Be patient. Repeat information as much as they need to help them learn ways to remember things.
  • Share information about family and friends. Show them photos to help them recall memories.
  • If they laugh or cry easily when you wouldn’t expect them to, act like it didn’t happen. Distract them by suggesting another activity, or change the topic until they calm down.
  • Help them with homework or assignments they get from their therapists. Encourage them to write in their journal, phone, or other electronic device.
  • Give them step-by-step instructions for basic tasks. Over time, give them fewer instructions for basic tasks so they can begin doing more things on their own.
  • Help them count money and make change. Ask them about the steps to make coffee or do laundry. You can then ask them to do the task they just described.
  • Let every situation be a learning experience. But don’t try to push them to do too many things on their own too quickly. Everyday tasks will still be hard for them. ​

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