Electronic annex 2e
Checklist of features for families and care staff to look for
Name of patient:
Relative/staff members interviewed:
Assessor/expert:
Question
Observed
Describe what was seen and how often
By whom?
(Y/N)
Seeing
1 Do they follow
movement with their
eyes?
2 Do they look at people,
pictures, photos etc?
3 Do they follow written
instruction?
Sounds
4 Do they turn away or
look towards sound, eg
music or voice?
5 Do they follow spoken
instruction?
Touch
6 Do they move away or
towards touch?
Smell/taste
7 Do they move away or
towards smell or hold
their breath?
8 Do they make different
responses to certain
smells?
9 Do they pull faces to
different tastes?
(cont’d)
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Question
Observed
Describe what was seen and how often
By whom?
(Y/N )
Movement/function
10 Have you seen them
make purposeful
movements?
11 Do they hold objects
or move them?
12 Do they move
towards objects?
13 Do they move in
response to command?
Communication
14 Do they show a
preference for certain
people?
15 Do they smile in
response to a joke or
cry/grimace or moan in
response to something
unpleasant?
16 Do they make
gestures, eg thumbs up?
17 Do they communicate,
ie blink or say words, to
indicate ‘yes’ or ‘no’?
Wakefulness/arousal
18 Is there anything that
appears to keep them
more awake or alert?
Source: Royal College of Physicians. Prolonged disorders of consciousness: national clinical guidelines. London: RCP, 2013.
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