Coma
Rancho Level IX - X Family Strategies for Interaction
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Based on recent research, Chris Hagan, Ph.D., one of the original developers of the Rancho Scale, has revised the higher levels of the scale to include a Rancho Level IX and X. These stages identify various changes in emerging cognitive functions that may be common to specific phases of later recovery. These relate to attentional abilities, short term memory, problem solving, awareness of impairments, pragmatics, and emotional status.
For instance, although functioning much better than at other stages, persons in Levels IX and X may be aware, angry, and depressed about having been injured and altered.
Identifying such markers can be helpful in providing clues as to what adapting and coping strategies may best help the person with brain injury to work through his/her emotional reaction to the injury.
When relating to a person beyond Rancho Level VII, family and friends should
• Be available to discuss emotions and feelings with the person
• Encourage individual and group counseling as appropriate
Visit the website for Rancho Los Amigos Hospital where the Rancho Scale was developed.
Dr. Kiefel holds both a Masters and Doctoral degree in psychology with a specialty in clinical neuropsychology. Her specialty training in clinical child psychology was completed at Mount Sinai Medical Center in New York City and postdoctoral training completed at Childrens Hospital in Columbus, Ohio. Dr. Kiefel, a licensed a Psychologist in Georgia has been on staff at Children's Healthcare of Atlanta since 1996.
References
Some information obtained from Family Guide to The Levels of Cognitive Functioning, Communication Disorders Department, Rancho Los Amigos Medical Center.