🧠 Rancho Los Amigos Levels of Cognitive Functioning

Level 1 — No Response

Completely unresponsive to any stimuli; key word: Nothing.

Level 2 — Generalized Response

Inconsistent reflex response to pain regardless of stimulus location; key word: Same.

Level 3 — Localized Response

Specific response to stimulus such as turning toward sound or blinking at light; key word: Specific.

Level 4 — Confused & Agitated

Alert/hyperactive and aggressive; unable to cooperate; key word: Fight.

Level 5 — Confused & Inappropriate

Calm but misuses familiar objects; performs tasks only with high structure; key word: Wrong.

Level 6 — Confused & Appropriate

Emerging awareness with organized and appropriate actions; key word: Right.

Level 7 — Automatic & Appropriate

Manages familiar tasks for 30 minutes and demonstrates new learning with carryover; key word: New Learning.

Level 8 — Purposeful & Appropriate

Attends to tasks for up to 1 hour and uses memory aids independently; key word: Purposeful.

Difference between Level 6 and Level 7

Level 6 is appropriate but cannot retain new learning; Level 7 introduces new learning with carryover.

Difference between Level 7 and Level 8

Level 7 manages tasks for 30 minutes with minimal assist, while Level 8 manages 1 hour in distracting environments.