Ranchos Los Amigos Levels of Cognitive Functioning (LOCF)

LOCF 1

no response to any stimuli

LOCF 2

• generalized response

• inconsistent and non-purposeful response to stimuli

• often the same response regardless of the stimulus

LOCF 3

• localized response

• specific response directly related to the stimulus

• inconsistent

• may follow simple commands, but inconsistently and delayed

LOCF 4

• confused - agitated

• behavior is bizarre and non-purposeful relative to the immediate environment

• verbalizations are frequently incoherent and/or inappropriate

• confabulation may be present

• nonexistent selective attention

• lacks short-term and long-term recall

• start to want to go home

LOCF 5

• confused - inappropriate

• follow simple commands consistently

• may be able to converse on a social automatic level for short periods of time

• highly distractable

• lots of confabulation

• inappropriate use of objects

• may perform previously learned tasks with structure but is unable to learn new info

• want to go home

LOCF 6

• confused - appropriate

• demonstrates goal-directed behavior but is dependent on external input or direction consistently

• shows carryover for relearned tasks

• responses may be incorrect, but appropriate to the situation

• unaware of impairments

LOCF 7

• automatic - appropriate

• appropriate and oriented within the hospital and home setting

• does daily routine automatically (robot-like)

• minimal to no confusion

• shallow recall of activities

• able to initiate social or recreational activities with structure

• overestimate their abilities

LOCF 8

• purposeful - appropriate

• able to recall and integrate past and recent events

• aware for response to environment

• shows carryover for new tasks

• no supervision needed once new activity is learned

• dec ability relative to premorbid abilities, abstract reasoning, tolerance for stress, and judgement in emergencies or unusual circumstances

LOCF 9

• purposeful - appropriate

• stand by assist on request for unfamiliar/uncommon activities

LOCF 10

• purposeful appropriate - modified independent

• full recovery but has had a brain injury