TBI Recovery – Ranchos Los Amigos Scale

The Ranchos Los Amigos Scale of Cognitive Recovery is a medical scale used to assess the cognitive progress of individuals after a closed head injury, including traumatic brain injury, based on cognitive and behavioural presentations as they emerge from coma[1]. It is named after the Rancho Los Amigos National Rehabilitation Center, located in Downey, California. The RLAS measures the levels of awareness, cognition, behavior and interaction with the environment.

Most Neuro Rehabilitation centers and hospitals use the scale as a guide in crafting and planning appropriate therapy for the patient. It is also important to view the scale only as a guide and not as a sacrosanct timeline in estimating brain injury recovery.


The Ranchos Los Amigos Scale

For more resources on understanding TBI recovery and the RLAS, click on the link or go to the sources listed in the infographic.

TBI survivors progress at different levels and at different paces based on their physical constitution, past experiences and medical prognosis. Some might skip levels through the Rancho scale, while others, such as Jitish, go through each level methodically and meticulously. While some might not progress beyond the first stage of recovery. A reality we had to get acquainted with early on, that Jitish might never make it out of coma, or even if he does, might not make it out of a vegetative state. I hate the term, and everything implied with it. I was mad, for days, about this. But we had to soon come to terms with the possible realities we might face. Recovery takes time. Lots of it. You just pray and hope for the best and leave everything else to fate and God, if you believe. The doctors at UWMadison told me, “Hope and pray. That is all anyone can do. It is now between him and God”.

Caregivers should gear up with the knowledge of the healing process, in order to provide the best support for their loved one.  In most cases, TBI survivors might go through the first three levels of recovery while at the Hospital. By this time, you should be looking at next steps, whether it is at a LTAC facility or a Coma Stim program at a Rehabilitation center. There are many options, know yours soon. It only takes a day for things to change and spin a 180. Making sure you have a Plan A, B and C, will become crucial.

We have documented each and every step of Jitish’s Journey, from medicines to movement. Each step gave us more hope, tested our patience and we fought with all the information and resources we could gather. I will share his journey on the RLAS scale with following posts.

Keep your eyes on the end goal, to get them back, a 100 percent.That is your goal.Or at least it should be.

Know of the worst, But Hope for the best.

6 Comments Add yours

  1. guest says:

    I came across your blog recently and feel really bad to read about the incident. I cannot say I completely understand what you are going through. All I can do is send my best wishes in your direction and hope for a quick and complete recovery for Jitish and a healthy and wonderful life for the both of you.


    1. Soumya Nair says:

      Thank you for your kind words and support. I draw strength and hope from your prayers.


  2. Usha says:

    I know jitish as my daughters classmate and was extremely sad and shocked to know about the incident from my daughter and I also happened to tead your blog. You and Jitish will always be there in my prayers. I pray that god gives you all the strenghth and courage during your difficult times and pray a speedy recovery for jitish.


  3. Pingback: Keeping Hope
  4. Nikita says:

    You are strong .. and keep going the spirit… my brother was jitesh frn but we lost him to cancer, an year before jiteshs accident… my brother too was a fighter he fought till the end .. but cudnt won the battle of life .. im happy that jitesh is fighting for a victory and he surely will get one .. with you being with him to achive that 100 perc.. my entire families best wishes are with you…stay blessed always


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