Medical studies have provided great insight as to how traumatic brain injuries (TBI) affect us. Medical scientists continue working to improve their understanding of TBI and its long term effects. Whether treating a mild concussion or a severe penetrating brain injury, healthcare teams and patients’ families must consult a roadmap for the days and weeks following a TBI.
The Rancho Los Amigos Scale Revised (or RLAS-R) describes ten levels of recovery after a TBI. “Cognitive functioning” refers to the workings of the brain, from the most basic (controlling breath and bodily functions) to the highest (social skills, advanced thought). When the patient arrives at the hospital, the medical team will observe their behavior and refer to the RLAS to describe it.
|Status of patient||Assistance level required|
|Level I||No response. Does not respond to any kind of stimulus—sound, movement, or sensation.||Total|
|Level II||Generalized response. Slow or inconsistent responses to stimuli, such as increased blood pressure, sweating, or groaning.||Total|
|Level III||Localized response. More specific responses, such as groaning at painful sensations. Periods of wakefulness. May recognize friends and family.||Total|
|Level IV||Confused/agitated. Does not understand what is happening; becomes upset and behaves badly. Cannot use short-term memory or concentrate for long.||Maximal|
|Level V||Confused, inappropriate non-agitated. Needs direction to complete daily activities such as dressing and brushing teeth. Slightly longer concentration, but may invent memories.||Maximal|
|Level VI||Confused, appropriate. Will know the month and the year; can understand why they are in the hospital, but will not understand the extent of their difficulties.||Moderate|
|Level VII||Automatic, appropriate. Can perform routine self-care with no help and follow a schedule but lacks insight into their new limitations. Makes plans but has difficulty following through.||Minimal assistance for daily living skills|
|Level VIII||Purposeful, appropriate. Can recognize their problems and limitations. Able to learn and to return to driving or job training, but may still become overwhelmed and need guidance.||Standby|
|Level IX||Able to shift between tasks and compensate for limitations, but has difficulty anticipating roadblocks due to impairment. Depression and frustration may continue.||Standby on request|
|Level X||Continued improvement at multitasking and new situations. Independently recognizing and adjusting for difficulties due to impairment. Appropriate social behavior.||Modified independent|
The original RLAS described eight levels of functioning, but the scale has recently been revised to add Levels IX and X to better describe the later stages of recovery.
Life After a TBI
Rancho Los Amigos National Rehabilitation Center, where the scale was developed, has provided a family guide to assisting a loved one during the first eight stages. TBI recovery takes time and patience from everyone. Even a concussion, the kind of injury that people used to shrug off as “getting your bell rung,” requires rest and care before a patient can return to complex activities.
Otherwise, the patient runs the risk of worsening their condition and ignoring serious or even fatal complications.
A TBI patient with a moderate or severe injury may find their life changed for years or forever. A TBI can alter cognitive skills, social functioning, and motor abilities.
According to the CDC’s data, 55% of moderate to severe TBI survivors were unemployed 5 years after their injury, and 57% were disabled. TBIs frequently result in:
- Lost wages
- Lost future earnings
- Ongoing medical bills
- Rehabilitation expenses
TBI sufferers undergo considerable emotional distress, pain, and suffering, even if no one is at fault for their injury. The shock and horror of an injury related to negligence or recklessness is even greater.
What Are the Next Steps for a Personal Injury Claim?
TBIs frequently result from:
As catastrophic injury lawyers, we work with plaintiffs who have suffered TBIs and with their families. We understand what these injuries do to people, and we know their costs. We also understand the tactics that insurance companies use to minimize their payouts. Without representation, an injured person might settle for much less than they need or even go without any compensation. Although money cannot replace lost opportunities, it can ease the fear and dread that come with expensive long-term medical problems. An experienced personal injury attorney can shield a plaintiff from the pressure of a corporate defendant and maximize their compensation award, allowing them as much comfort and peace of mind as possible.
If you or your loved one suffered a TBI and you think that another party may be liable, make sure that the patient has received all appropriate medical treatment and kept the documentation. Although the state of Washington generally gives you three years to file suit for a personal injury, a plaintiff may need to file more quickly under the particular circumstances of the accident. Contact Cascade Injury Law today at 425-654-8121 to schedule your appointment for a free consultation.