HHID Household Identifier
Section: E Level: Respondent CAI Reference: Q9001
Type: Character Width: 6 Decimals: 0
................................................................................
234 000000-099000. Household Identification Number
PN Person Number
Section: E Level: Respondent CAI Reference: Q9002
Type: Character Width: 3 Decimals: 0
................................................................................
124 010. Respondent Person Identification Number
1 011. Respondent Person Identification Number
51 020. Respondent Person Identification Number
26 030. Respondent Person Identification Number
32 040. Respondent Person Identification Number
CSUBHH 1994 Sub-household Identifier
Section: E Level: Respondent CAI Reference: Q9003
Type: Character Width: 1 Decimals: 0
................................................................................
231 0. 1994 Sub-Household Identification Number
1 1. 1994 Sub-Household Identification Number
2 2. 1994 Sub-Household Identification Number
PSUBHH 1996 Sub-household Identifier
Section: E Level: Respondent CAI Reference: Q9004
Type: Character Width: 1 Decimals: 0
................................................................................
232 3. 1996 Sub-Household Identification Number
2 4. 1996 Sub-Household Identification Number
PPN_SP 1996 Spouse / Partner Person Number
Section: E Level: Respondent CAI Reference: Q9005
Type: Character Width: 3 Decimals: 0
................................................................................
65 010. Spouse Person Identification Number
10 011. Spouse Person Identification Number
67 020. Spouse Person Identification Number
15 030. Spouse Person Identification Number
17 040. Spouse Person Identification Number
60 Blank. No Spouse
P1238 Ex1.HOSPITAL # NIGHTS - FINAL
Section: E Level: Respondent CAI Reference: Q1238
Type: Numeric Width: 2 Decimals: 0
Ex1.
Earlier you told me that
[Q371-R FIRST NAME] died while in a hospital.
How long had (he/she) been a patient in that hospital
before (his/her) death?
................................................................................
100 0-84. Actual Value
3 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
131 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 1)
P1238A Ex1.HOSPITAL # NIGHTS - FINAL -PER
Section: E Level: Respondent CAI Reference: Q11238
Type: Numeric Width: 1 Decimals: 0
................................................................................
16 1. HOURS
53 2. DAYS/NIGHTS
19 3. WEEKS
7 4. MONTHS
5. YEARS
4 8. DK (Don’t Know); NA (Not Ascertained)
9. RF (Refused)
135 Blank. INAP
P1239M1 Ex2.WHY ADMITTED - FINAL
Section: E Level: Respondent CAI Reference: Q1239
Type: Numeric Width: 1 Decimals: 0
Ex2.
Why had (he/she) been admitted to the hospital?
Was it to have surgery, receive other treatments, relieve
(his/her) symptoms, or what?
CHOOSE ALL THAT APPLY
User Note: Three mentions were allowed, maximum used was two.
................................................................................
12 1. SURGERY
38 2. OTHER TREATMENTS
46 3. RELIEVE SYMPTOMS
7 7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
131 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 1)
P1239M2 Ex2.WHY ADMITTED - FINAL
Section: E Level: Respondent CAI Reference: Q1239
Type: Numeric Width: 1 Decimals: 0
Ex2.
Why had (he/she) been admitted to the hospital?
Was it to have surgery, receive other treatments, relieve
(his/her) symptoms, or what?
CHOOSE ALL THAT APPLY
User Note: Three mentions were allowed, maximum used was two.
................................................................................
1 1. SURGERY
1 2. OTHER TREATMENTS
6 3. RELIEVE SYMPTOMS
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
226 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 1)
P1239M3 Ex2.WHY ADMITTED - FINAL
Section: E Level: Respondent CAI Reference: Q1239
Type: Numeric Width: 1 Decimals: 0
Ex2.
Why had (he/she) been admitted to the hospital?
Was it to have surgery, receive other treatments, relieve
(his/her) symptoms, or what?
CHOOSE ALL THAT APPLY
User Note: Three mentions were allowed, maximum used was two.
................................................................................
1. SURGERY
2. OTHER TREATMENTS
3. RELIEVE SYMPTOMS
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 1)
P1245 E1. HOSPITAL-YR
Section: E Level: Respondent CAI Reference: Q1245
Type: Numeric Width: 1 Decimals: 0
E1.
IF Q226 IS (1)
In addition to that hospital stay,
END
(Since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/In the last
two years before (he/she) died), had
[Q371-R FIRST NAME]
been a patient in a hospital overnight?
................................................................................
148 1. YES
84 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2)
P1246 E2. HOSPITAL TIMES
Section: E Level: Respondent CAI Reference: Q1246
Type: Numeric Width: 2 Decimals: 0
E2.
IF Q226 IS (1)
Including (his/her) final hospitalization,
END
How many different times was (he/she) a patient in a hospital
overnight (since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in
the last two years before (he/she) died)?
................................................................................
138 1-27. Range of Values
10 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
86 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (1) AND
[Q1245:E1] IS (5 OR DK OR RF); [Q1245:E1] IS (5 OR DK
OR RF)
P1247 E3. HOSP-1 #NIGHTS
Section: E Level: Respondent CAI Reference: Q1247
Type: Numeric Width: 3 Decimals: 0
E3.
(Altogether) How many nights was (he/she) a patient in the
hospital (since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in
the last two years before (he/she) died)?
................................................................................
178 0-996. Range of Values
16 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
40 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1245:E1] IS (5 OR DK OR
RF)
P1249 E3ax.HOSP - INTENSIVE CARE
Section: E Level: Respondent CAI Reference: Q1249
Type: Numeric Width: 1 Decimals: 0
E3ax.
IF Q1246 IS (GT1)
During any of those hospital stays
ELSE
During (his/her) hospital stay
END
did
[Q371-R FIRST NAME] spend any time in an
intensive care unit?
................................................................................
109 1. YES
82 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
40 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (5 OR DK OR RF)
P1250 E3bx.HOSP - LIFE SUPPORT
Section: E Level: Respondent CAI Reference: Q1250
Type: Numeric Width: 1 Decimals: 0
E3bx.
IF Q1246 IS (GT1)
(During any of those hospital stays)
ELSE
(During (his/her) hospital stay)
END
did (he/she) use life support equipment, such as a respirator?
................................................................................
70 1. YES
122 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
40 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (5 OR DK OR RF)
P1251 E3cx.HOSP - DIALYSIS
Section: E Level: Respondent CAI Reference: Q1251
Type: Numeric Width: 1 Decimals: 0
E3cx.
IF Q1246 IS (GT1)
(During any of those hospital stays)
ELSE
(During (his/her) hospital stay)
END
did (he/she) use kidney dialysis services?
................................................................................
15 1. YES
176 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
40 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (5 OR DK OR RF)
P1252 E3dx.HOSP - ANTIBIOTICS
Section: E Level: Respondent CAI Reference: Q1252
Type: Numeric Width: 1 Decimals: 0
E3dx.
IF Q1246 IS (GT1)
(During any of those hospital stays)
ELSE
(During (his/her) hospital stay)
END
did (he/she) receive antibiotics to treat pneumonia
or other infection?
................................................................................
109 1. YES
69 5. NO
16 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
40 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (5 OR DK OR RF)
P1253 E4. HOSP $ NOT COV
Section: E Level: Respondent CAI Reference: Q1253
Type: Numeric Width: 1 Decimals: 0
E4.
Were the costs for (his/her) hospital stay(s) completely covered by
IF Q373 IS (LE1931)
Medicare, Medicaid, or other
END
health insurance, partly covered by insurance, or not covered at
all by insurance?
................................................................................
110 1. FULLY COVERED
66 3. PARTLY COVERED (OR COVERED WITH A COPAY)
12 5. NOT COVERED AT ALL
2 7. COSTS NOT SETTLED YET
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
40 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (5 OR DK OR RF)
P1255 E4x.NURSING HOME # NIGHTS - FINAL
Section: E Level: Respondent CAI Reference: Q1255
Type: Numeric Width: 3 Decimals: 0
E4x.
IF Q249 IS (1)
Earlier you told me that
[Q371-R FIRST NAME] died while in a nursing home.
END
How long had (he/she) been a patient in that nursing home
before (his/her) death?
DAYS:
MONTHS:
DATE: //
................................................................................
6 0-996. Range of Values
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
228 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 2)
P1256 E4xax.MONTHS
Section: E Level: Respondent CAI Reference: Q1256
Type: Numeric Width: 2 Decimals: 0
................................................................................
5 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
229 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 2);
[Q1255:E4x] IS (1-996 OR Over Limit)
P1257 E4xbx.DATE-MONTH
Section: E Level: Respondent CAI Reference: Q1257
Type: Numeric Width: 2 Decimals: 0
................................................................................
1-12. Range of Values
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 2);
[Q1255:E4x] IS (1-996 OR Over Limit); [Q1256:E4xax]
IS (1-96 OR Over Limit)
P1259 E4xdx.DATE-YEAR
Section: E Level: Respondent CAI Reference: Q1259
Type: Numeric Width: 4 Decimals: 0
................................................................................
1900-1996. Range of Values
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 2);
[Q1255:E4x] IS (1-996 OR Over Limit); [Q1256:E4xax]
IS (1-96 OR Over Limit)
P1261M1 E4ax.WHY ADMITTED - FINAL
Section: E Level: Respondent CAI Reference: Q1261
Type: Numeric Width: 3 Decimals: 0
E4ax.
Why had (he/she) been admitted to the nursing home?
................................................................................
101-103. Cancers and tumors; skin conditions
111-119. Musculoskeletal system and connective tissue
121-129. Heart, circulatory and blood conditions
131-139. Allergies; hayfever; sinusitis; tonsillitis
141-149. Endocrine, metabolic and nutritional conditions
151-159. Digestive system (stomach, liver, gallbladder,
kidney, bladder)
161-169. Neurological and sensory conditions
171-179. Reproductive system and prostate conditions
181-189. Emotional and psychological conditions
191-196. Miscellaneous
595-597. Other symptoms
6 701. No other care arrangements available
4 702. Deteriorating health; health condition not specified
703. To recover/rehab for injury/surgery
990. No text displayed
996. None
997. Other health condition
998. DK (Don’t Know)
999. RF
224 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 2)
P1261M2 E4ax.WHY ADMITTED - FINAL
Section: E Level: Respondent CAI Reference: Q1261
Type: Numeric Width: 3 Decimals: 0
E4ax.
Why had (he/she) been admitted to the nursing home?
................................................................................
101-103. Cancers and tumors; skin conditions
111-119. Musculoskeletal system and connective tissue
121-129. Heart, circulatory and blood conditions
131-139. Allergies; hayfever; sinusitis; tonsillitis
141-149. Endocrine, metabolic and nutritional conditions
151-159. Digestive system (stomach, liver, gallbladder,
kidney, bladder)
161-169. Neurological and sensory conditions
171-179. Reproductive system and prostate conditions
181-189. Emotional and psychological conditions
191-196. Miscellaneous
595-597. Other symptoms
701. No other care arrangements available
3 702. Deteriorating health; health condition not specified
703. To recover/rehab for injury/surgery
990. No text displayed
996. None
997. Other health condition
998. DK (Don’t Know)
999. RF
231 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 2)
P1262 E5. NURSING HOME-YR
Section: E Level: Respondent CAI Reference: Q1262
Type: Numeric Width: 1 Decimals: 0
E5.
IF Q226 IS (2)
In addition to that nursing home stay,
END
(Since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/In the last
two years before (he/she) died), had
[Q371-R FIRST NAME] been
a patient overnight in a nursing home, convalescent home,
or other long-term health care facility?
................................................................................
8 1. YES
212 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
13 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1)
P1263 E6. NURHM # TIMES
Section: E Level: Respondent CAI Reference: Q1263
Type: Numeric Width: 2 Decimals: 0
E6.
IF Q226 IS (2)
Including (his/her) final stay,
END
How many different times was (he/she) a patient in
a nursing home or other long-term care facility
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
................................................................................
20 1-20. Range of Values
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
213 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (2) AND
[Q1262:E5] IS (5 OR DK OR RF); [Q1262:E5] IS (5 OR DK
OR RF)
P1264 E7. NURHM-1 NIGHTS
Section: E Level: Respondent CAI Reference: Q1264
Type: Numeric Width: 3 Decimals: 0
E7.
(Altogether) How many nights was (he/she) a patient
in a nursing home (since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW
YEAR/in the last two years before (he/she) died)?
USE 996 FOR CONTINUOUS SINCE ENTERED
NIGHTS:
OR
MONTHS:
................................................................................
15 0-996. Range of Values
1 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
218 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (2) AND
[Q1262:E5] IS (5 OR DK OR RF); [Q1262:E5] IS (5 OR DK
OR RF)
P1265 E7a.NURHM-1 MONTHS
Section: E Level: Respondent CAI Reference: Q1265
Type: Numeric Width: 2 Decimals: 0
................................................................................
4 1-36. Range of Values
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
229 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (2) AND
[Q1262:E5] IS (5 OR DK OR RF); [Q1262:E5] IS (5 OR DK
OR RF); [Q1264:E7] IS (1-996)
P1267 E8.NURHM NOT COV
Section: E Level: Respondent CAI Reference: Q1267
Type: Numeric Width: 1 Decimals: 0
E8.
Were the costs for (his/her) nursing home stay(s) completely covered by
IF Q373 IS (LE1931)
Medicare, Medicaid, or other
END
health insurance, partly covered by insurance, or not covered at
all by insurance?
................................................................................
14 1. FULLY COVERED
2 3. PARTLY COVERED (OR COVERED WITH A COPAY)
1 5. NOT COVERED AT ALL
2 7. COSTS NOT SETTLED YET
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
213 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1262:E5] IS (5 OR DK OR RF)
P1269 E10. NURHM OR HOSP R PAY $
Section: E Level: Respondent CAI Reference: Q1269
Type: Numeric Width: 6 Decimals: 0
E10.
About how much did (he/she) ((or (his/her) husband)/(or (his/her)
wife)/(or (his/her) partner)/...)
pay out-of-pocket for (nursing home/, hospital) bills
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
DO NOT PROBE DK/RF
AMOUNT:
................................................................................
50 0-999996. Range of Values
30 999998. DK (Don't Know); NA (Not Ascertained)
999999. RF (Refused)
154 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1267:E8] IS (NE 3-7)
AND [Q1253:E4] IS (NE 3-7)
P1270 E10a. NURHM OR HOSP DK-1
Section: E Level: Respondent CAI Reference: Q1270
Type: Numeric Width: 1 Decimals: 0
E10a.
Was it more than $10,000?
................................................................................
8 1. YES
17 5. NO
5 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
204 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1267:E8] IS (NE 3-7) AND [Q1253:E4] IS
(NE 3-7); [Q1269:E10] IS (NE DK AND NE RF)
P1271 E10b. NURHM OR HOSP DK-2
Section: E Level: Respondent CAI Reference: Q1271
Type: Numeric Width: 1 Decimals: 0
E10b.
Was it more than $20,000?
................................................................................
4 1. YES
4 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
226 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1267:E8] IS (NE 3-7) AND [Q1253:E4] IS
(NE 3-7); [Q1269:E10] IS (NE DK AND NE RF); [Q1270:E10a] IS (DK
OR RF); [Q1270:E10a] IS (5)
P1272 E10c. NURHM OR HOSP DK-3
Section: E Level: Respondent CAI Reference: Q1272
Type: Numeric Width: 1 Decimals: 0
E10c.
Was it more than $50,000?
................................................................................
3 1. YES
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
230 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1267:E8] IS (NE 3-7) AND [Q1253:E4] IS
(NE 3-7); [Q1269:E10] IS (NE DK AND NE RF); [Q1270:E10a] IS (DK
OR RF); [Q1270:E10a] IS (5); [Q1271:E10b] IS (5 OR DK OR RF)
P1273 E10d. NURHM OR HOSP DK-4
Section: E Level: Respondent CAI Reference: Q1273
Type: Numeric Width: 1 Decimals: 0
E10d.
Was it more than $5,000?
................................................................................
3 1. YES
14 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
217 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1267:E8] IS (NE 3-7) AND [Q1253:E4] IS
(NE 3-7); [Q1269:E10] IS (NE DK AND NE RF); [Q1270:E10a] IS (DK
OR RF); [Q1271:E10b] IS (5 OR DK OR RF); [Q1272:E10c] IS (A)
P1274 E10e. NURHM OR HOSP DK-5
Section: E Level: Respondent CAI Reference: Q1274
Type: Numeric Width: 1 Decimals: 0
E10e.
Was it more than $500?
................................................................................
10 1. YES
4 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
220 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1267:E8] IS (NE 3-7) AND [Q1253:E4] IS
(NE 3-7); [Q1269:E10] IS (NE DK AND NE RF); [Q1270:E10a] IS (DK
OR RF); [Q1271:E10b] IS (5 OR DK OR RF); [Q1272:E10c] IS (A);
[Q1273:E10d] IS (1 OR DK OR RF)
P1275 Ex10f.HOSPICE # NIGHTS - FINAL
Section: E Level: Respondent CAI Reference: Q1275
Type: Numeric Width: 2 Decimals: 0
Ex10f.
Earlier you told me that
[Q371-R FIRST NAME] died while in a hospice.
How long had (he/she) been a patient in that hospice
before (his/her) death?
DAYS:
MONTHS:
SINCE DATE:
(IWER: USE THE `/` TO MOVE BETWEEN MONTH/DAY/YEAR
IN THE DATE FIELD ONLY.) IF PROXY DK DAY IN DATE
FIELD, ENTER "15"
................................................................................
5 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
229 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 4)
P1276 Ex10fa.MONTHS
Section: E Level: Respondent CAI Reference: Q1276
Type: Numeric Width: 2 Decimals: 0
................................................................................
1 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
233 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (NE 4);
[Q1275:Ex10f] IS (1-96 OR Over Limit)
P1280 Ex10g.HOSPICE-YR
Section: E Level: Respondent CAI Reference: Q1280
Type: Numeric Width: 1 Decimals: 0
Ex10g.
IF Q226 IS (4)
In addition to that hospice stay,
END
(Since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/In the last
two years before (he/she) died) had
[Q371-R FIRST NAME]
been a patient overnight in a hospice?
................................................................................
8 1. YES
225 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2)
P1281 Ex10h.HOSPICE # TIMES
Section: E Level: Respondent CAI Reference: Q1281
Type: Numeric Width: 2 Decimals: 0
Ex10h.
IF Q226 IS (4)
Including (his/her) final stay,
END
How many different times was (he/she) a patient
in a hospice (since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW
YEAR/in the last two years before (he/she) died)?
................................................................................
4 1-20. Range of Values
4 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
226 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (4) AND
[Q1280:Ex10g] IS (5 OR DK OR RF); [Q1280:Ex10g] IS (5
OR DK OR RF)
P1282 Ex10j.HOSPICE-1 NIGHTS
Section: E Level: Respondent CAI Reference: Q1282
Type: Numeric Width: 3 Decimals: 0
Ex10j.
(Altogether) How many nights was (he/she) a patient in
a hospice (since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in
the last two years before (he/she) died)?
................................................................................
5 0-996. Range of Values
3 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
226 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q226:CS2cx] IS (4) AND
[Q1280:Ex10g] IS (5 OR DK OR RF); [Q1280:Ex10g] IS (5
OR DK OR RF)
P1283 Ex10k.HOSPICE NOT COV
Section: E Level: Respondent CAI Reference: Q1283
Type: Numeric Width: 1 Decimals: 0
Ex10k.
Were the costs for (his/her) hospice stay(s) completely covered by
IF Q373 IS (LE1931)
Medicare, Medicaid, or other
END
health insurance, partly covered by insurance, or not covered at all
by insurance?
................................................................................
9 1. FULLY COVERED
3. PARTLY COVERED (OR COVERED WITH A COPAY)
5. NOT COVERED AT ALL
7. COSTS NOT SETTLED YET
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
222 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1280:Ex10g] IS (5 OR DK OR RF)
P1284 Ex10m.HOSPICE R PAY $
Section: E Level: Respondent CAI Reference: Q1284
Type: Numeric Width: 5 Decimals: 0
Ex10m.
About how much did (he/she) ((or (his/her) husband)/(or (his/her)
wife)/(or (his/her) partner)/...)
pay out-of-pocket for hospice care (since Q95-PREV WAVE IW MONTH /
Q96-PREV WAVE IW YEAR/in the last two years before (he/she) died)?
DO NOT PROBE DK/RF
AMOUNT:
................................................................................
0-99996. Range of Values
3 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
231 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1280:Ex10g] IS (5 OR DK
OR RF); [Q1283:Ex10k] IS (1 OR NE A)
P1285 Ex10n.HOSPICE DK-1
Section: E Level: Respondent CAI Reference: Q1285
Type: Numeric Width: 1 Decimals: 0
Ex10n.
Was it more than $10,000?
................................................................................
1. YES
1 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
231 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1280:Ex10g] IS (5 OR DK OR RF);
[Q1283:Ex10k] IS (1 OR NE A); [Q1284:Ex10m] IS (NE DK AND NE
RF)
P1286 Ex10p.HOSPICE DK-2
Section: E Level: Respondent CAI Reference: Q1286
Type: Numeric Width: 1 Decimals: 0
Ex10p.
Was it more than $20,000?
................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1280:Ex10g] IS (5 OR DK OR RF);
[Q1283:Ex10k] IS (1 OR NE A); [Q1284:Ex10m] IS (NE DK AND NE
RF); [Q1285:Ex10n] IS (DK OR RF); [Q1285:Ex10n] IS (5)
P1287 Ex10q.HOSPICE DK-3
Section: E Level: Respondent CAI Reference: Q1287
Type: Numeric Width: 1 Decimals: 0
Ex10q.
Was it more than $50,000?
................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1280:Ex10g] IS (5 OR DK OR RF);
[Q1283:Ex10k] IS (1 OR NE A); [Q1284:Ex10m] IS (NE DK AND NE
RF); [Q1285:Ex10n] IS (DK OR RF); [Q1285:Ex10n] IS (5);
[Q1286:Ex10p] IS (5 OR DK OR RF)
P1288 Ex10r.HOSPICE DK-4
Section: E Level: Respondent CAI Reference: Q1288
Type: Numeric Width: 1 Decimals: 0
Ex10r.
Was it more than $5,000?
................................................................................
1 1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
233 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1280:Ex10g] IS (5 OR DK OR RF);
[Q1283:Ex10k] IS (1 OR NE A); [Q1284:Ex10m] IS (NE DK AND NE
RF); [Q1285:Ex10n] IS (DK OR RF); [Q1286:Ex10p] IS (5 OR DK OR
RF); [Q1287:Ex10q] IS (A)
P1289 Ex10s.HOSPICE DK-5
Section: E Level: Respondent CAI Reference: Q1289
Type: Numeric Width: 1 Decimals: 0
Ex10s.
Was it more than $500?
................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1280:Ex10g] IS (5 OR DK OR RF);
[Q1283:Ex10k] IS (1 OR NE A); [Q1284:Ex10m] IS (NE DK AND NE
RF); [Q1285:Ex10n] IS (DK OR RF); [Q1286:Ex10p] IS (5 OR DK OR
RF); [Q1287:Ex10q] IS (A); [Q1288:Ex10r] IS (1 OR DK OR RF)
P1290 E11. DR TIMES
Section: E Level: Respondent CAI Reference: Q1290
Type: Numeric Width: 3 Decimals: 0
E11.
IF Q1245 IS (1)
Aside from any hospital stays,
END
How many times did
[Q371-R FIRST NAME] see or talk to a medical doctor
about (his/her) health, including emergency room or clinic
visits (since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the
last two years before (he/she) died)?
USE ZERO FOR NONE
................................................................................
195 0-250. Range of Values
38 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2)
P1293 E13.DR, NOT COV
Section: E Level: Respondent CAI Reference: Q1293
Type: Numeric Width: 1 Decimals: 0
E13.
Were the costs for (his/her) doctor visit(s) completely covered by
IF Q373 IS (LE1931)
Medicare, Medicaid, or other
END
health insurance, partly covered by insurance, or not covered at
all by insurance?
................................................................................
88 1. FULLY COVERED
72 3. PARTLY COVERED (OR COVERED WITH A COPAY)
12 5. NOT COVERED AT ALL
1 7. COSTS NOT SETTLED YET
6 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
55 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1290:E11] IS (0 OR DK OR RF)
P1313 E18a.DOCTOR/OUT/DENTAL R PAY $
Section: E Level: Respondent CAI Reference: Q1313
Type: Numeric Width: 5 Decimals: 0
E18a.
IF Q692 IS (NE1-3)
About how much did (he/she)
ELSE
About how much did (he/she) (or (his/her)
(husband/wife/partner/...))
END
pay out-of-pocket for doctor bills
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
(Except any payments you told me about.)
DO NOT PROBE DK/RF
AMOUNT:
................................................................................
52 0-99996. Range of Values
33 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
149 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1293:E13] IS (NE 3-7)
P1314 E18b. DK-1
Section: E Level: Respondent CAI Reference: Q1314
Type: Numeric Width: 1 Decimals: 0
E18b.
Was it more than $1,000?
................................................................................
13 1. YES
17 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
202 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1293:E13] IS (NE 3-7); [Q1313:E18a] IS
(NE DK AND NE RF)
P1315 E18c. DK-2
Section: E Level: Respondent CAI Reference: Q1315
Type: Numeric Width: 1 Decimals: 0
E18c.
Was it more than $5,000?
................................................................................
4 1. YES
8 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
221 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1293:E13] IS (NE 3-7); [Q1313:E18a] IS
(NE DK AND NE RF); [Q1314:E18b] IS (DK OR RF); [Q1314:E18b] IS
(5)
P1316 E18d. DK-3
Section: E Level: Respondent CAI Reference: Q1316
Type: Numeric Width: 1 Decimals: 0
E18d.
Was it more than $20,000?
................................................................................
2 1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
230 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1293:E13] IS (NE 3-7); [Q1313:E18a] IS
(NE DK AND NE RF); [Q1314:E18b] IS (DK OR RF); [Q1314:E18b] IS
(5); [Q1315:E18c] IS (5 OR DK OR RF)
P1317 E18e. DK-4
Section: E Level: Respondent CAI Reference: Q1317
Type: Numeric Width: 1 Decimals: 0
E18e.
Was it more than $500?
................................................................................
8 1. YES
9 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
217 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1293:E13] IS (NE 3-7); [Q1313:E18a] IS
(NE DK AND NE RF); [Q1314:E18b] IS (DK OR RF); [Q1315:E18c] IS
(5 OR DK OR RF); [Q1316:E18d] IS (A)
P1318 E18f. DK-5
Section: E Level: Respondent CAI Reference: Q1318
Type: Numeric Width: 1 Decimals: 0
E18f.
Was it more than $200?
................................................................................
5 1. YES
3 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
225 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1293:E13] IS (NE 3-7); [Q1313:E18a] IS
(NE DK AND NE RF); [Q1314:E18b] IS (DK OR RF); [Q1315:E18c] IS
(5 OR DK OR RF); [Q1316:E18d] IS (A); [Q1317:E18e] IS (1 OR DK
OR RF)
P1325 E20. DRUGS-YR
Section: E Level: Respondent CAI Reference: Q1325
Type: Numeric Width: 1 Decimals: 0
E20.
Did (he/she) regularly take prescription medications
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
................................................................................
197 1. YES
35 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2)
P1329 E21. DRUGS, NOT COV
Section: E Level: Respondent CAI Reference: Q1329
Type: Numeric Width: 1 Decimals: 0
E21.
Were the costs of (his/her) prescription medications completely
covered by
IF Q373 IS (LE1930)
Medicare, Medicaid, or other
END
health insurance, partly covered by insurance, or not covered
at all by health insurance?
................................................................................
76 1. FULLY COVERED
92 3. PARTLY COVERED (OR COVERED WITH A COPAY)
25 5. NOT COVERED AT ALL
7. COSTS NOT SETTLED YET
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
37 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1325:E20] IS (5 OR DK OR RF)
P1330 E21a.PRESCR R PAY $
Section: E Level: Respondent CAI Reference: Q1330
Type: Numeric Width: 5 Decimals: 0
E21a.
On the average, about how much did (he/she)
((or (his/her) husband)/(or (his/her) wife)/(or (his/her)
partner)/...) pay out-of-pocket per
month for these prescriptions
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
DO NOT PROBE DK/RF
AMOUNT PER MONTH:
................................................................................
83 0-99996. Range of Values
34 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
117 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1325:E20] IS (5 OR DK
OR RF); [Q1329:E21] IS (1 OR DK OR RF)
P1331 E21b.PRESCR DK-1
Section: E Level: Respondent CAI Reference: Q1331
Type: Numeric Width: 1 Decimals: 0
E21b.
Was it more than $20 per month?
................................................................................
25 1. YES
4 5. NO
5 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
200 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1325:E20] IS (5 OR DK OR RF); [Q1329:E21]
IS (1 OR DK OR RF); [Q1330:E21a] IS (NE DK AND NE RF)
P1332 E21c.PRESCR DK-2
Section: E Level: Respondent CAI Reference: Q1332
Type: Numeric Width: 1 Decimals: 0
E21c.
Was it more than $100 per month?
................................................................................
10 1. YES
15 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
208 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1325:E20] IS (5 OR DK OR RF); [Q1329:E21]
IS (1 OR DK OR RF); [Q1330:E21a] IS (NE DK AND NE RF);
[Q1331:E21b] IS (DK OR RF); [Q1331:E21b] IS (5)
P1333 E21d.PRESCR DK-3
Section: E Level: Respondent CAI Reference: Q1333
Type: Numeric Width: 1 Decimals: 0
E21d.
Was it more than $500 per month?
................................................................................
1. YES
10 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
223 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1325:E20] IS (5 OR DK OR RF); [Q1329:E21]
IS (1 OR DK OR RF); [Q1330:E21a] IS (NE DK AND NE RF);
[Q1331:E21b] IS (DK OR RF); [Q1331:E21b] IS (5); [Q1332:E21c]
IS (5 OR DK OR RF)
P1334 E21e.PRESCR DK-4
Section: E Level: Respondent CAI Reference: Q1334
Type: Numeric Width: 1 Decimals: 0
E21e.
Was it more than $10 per month?
................................................................................
4 1. YES
5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
229 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1325:E20] IS (5 OR DK OR RF); [Q1329:E21]
IS (1 OR DK OR RF); [Q1330:E21a] IS (NE DK AND NE RF);
[Q1331:E21b] IS (DK OR RF); [Q1332:E21c] IS (5 OR DK OR RF);
[Q1333:E21d] IS (A)
P1335 E21f.PRESCR DK-5
Section: E Level: Respondent CAI Reference: Q1335
Type: Numeric Width: 1 Decimals: 0
E21f.
Was it more than $5 per month?
................................................................................
1. YES
5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
233 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1325:E20] IS (5 OR DK OR RF); [Q1329:E21]
IS (1 OR DK OR RF); [Q1330:E21a] IS (NE DK AND NE RF);
[Q1331:E21b] IS (DK OR RF); [Q1332:E21c] IS (5 OR DK OR RF);
[Q1333:E21d] IS (A); [Q1334:E21e] IS (1 OR DK OR RF)
P1341 E22.IN-HOME SERV
Section: E Level: Respondent CAI Reference: Q1341
Type: Numeric Width: 1 Decimals: 0
E22.
(Since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/In the last
two years before (he/she) died) did any medically-trained person
come to (his/her) home to help (him/her)?
................................................................................
83 1. YES
135 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
14 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1)
P1343 E23. IN-HOME R PAY $
Section: E Level: Respondent CAI Reference: Q1343
Type: Numeric Width: 1 Decimals: 0
E23.
Were the costs of (his/her) home medical care completely covered by
IF Q373 IS (LE1931)
Medicare, Medicaid, or other
END
health insurance, partly covered by insurance, or not covered at
all by insurance?
................................................................................
59 1. FULLY COVERED
13 3. PARTLY COVERED (OR COVERED WITH A COPAY)
4 5. NOT COVERED AT ALL
3 7. [VOL] COSTS NOT SETTLED YET
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
151 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1); [Q1341:E22] IS (5 OR DK
OR RF)
P1355 E24.R USE SERVICE
Section: E Level: Respondent CAI Reference: Q1355
Type: Numeric Width: 1 Decimals: 0
E24.
READ SLOWLY
(Since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/In the last
two years before (he/she) died), did (he/she)
use any special facility or service which we haven`t
talked about, such as:
an adult care center, a social worker, an outpatient
rehabilitation program, or transportation or meals for the
elderly or disabled?
................................................................................
35 1. YES
184 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
14 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1)
P1362 E24a.SPECIAL R PAY $
Section: E Level: Respondent CAI Reference: Q1362
Type: Numeric Width: 5 Decimals: 0
E24a.
About how much did (he/she) ((or (his/her) husband)/(or (his/her)
wife)/(or (his/her) partner)/...)
pay out-of-pocket for (in-home medical care/, special facilities or
services)
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
DO NOT PROBE DK/RF
AMOUNT:
................................................................................
38 0-99996. Range of Values
11 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
185 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q249:CS11] IS (1);
[Q1343:E23] IS (NE 3-7) AND [Q1355:E24] IS (5 OR DK
OR RF)
P1363 E24b.SPECIAL DK-1
Section: E Level: Respondent CAI Reference: Q1363
Type: Numeric Width: 1 Decimals: 0
E24b.
Was it more than $5,000?
................................................................................
3 1. YES
6 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
223 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1); [Q1343:E23] IS (NE 3-7)
AND [Q1355:E24] IS (5 OR DK OR RF); [Q1362:E24a] IS (NE DK AND
NE RF)
P1364 E24c.SPECIAL DK-2
Section: E Level: Respondent CAI Reference: Q1364
Type: Numeric Width: 1 Decimals: 0
E24c.
Was it more than $10,000?
................................................................................
2 1. YES
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
231 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1); [Q1343:E23] IS (NE 3-7)
AND [Q1355:E24] IS (5 OR DK OR RF); [Q1362:E24a] IS (NE DK AND
NE RF); [Q1363:E24b] IS (DK OR RF); [Q1363:E24b] IS (5)
P1365 E24d.SPECIAL DK-3
Section: E Level: Respondent CAI Reference: Q1365
Type: Numeric Width: 1 Decimals: 0
E24d.
Was it more than $20,000?
................................................................................
1. YES
1 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
232 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1); [Q1343:E23] IS (NE 3-7)
AND [Q1355:E24] IS (5 OR DK OR RF); [Q1362:E24a] IS (NE DK AND
NE RF); [Q1363:E24b] IS (DK OR RF); [Q1363:E24b] IS (5);
[Q1364:E24c] IS (5 OR DK OR RF)
P1366 E24e.SPECIAL DK-4
Section: E Level: Respondent CAI Reference: Q1366
Type: Numeric Width: 1 Decimals: 0
E24e.
Was it more than $1,000?
................................................................................
2 1. YES
4 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
228 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1); [Q1343:E23] IS (NE 3-7)
AND [Q1355:E24] IS (5 OR DK OR RF); [Q1362:E24a] IS (NE DK AND
NE RF); [Q1363:E24b] IS (DK OR RF); [Q1364:E24c] IS (5 OR DK OR
RF); [Q1365:E24d] IS (A)
P1367 E24f.SPECIAL DK-5
Section: E Level: Respondent CAI Reference: Q1367
Type: Numeric Width: 1 Decimals: 0
E24f.
Was it more than $500?
................................................................................
2 1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
230 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q249:CS11] IS (1); [Q1343:E23] IS (NE 3-7)
AND [Q1355:E24] IS (5 OR DK OR RF); [Q1362:E24a] IS (NE DK AND
NE RF); [Q1363:E24b] IS (DK OR RF); [Q1364:E24c] IS (5 OR DK OR
RF); [Q1365:E24d] IS (A); [Q1366:E24e] IS (1 OR DK OR RF)
P1372 E25x.OTHER OUT-OF-POCKET
Section: E Level: Respondent CAI Reference: Q1372
Type: Numeric Width: 1 Decimals: 0
E25x.
Aside from the medical expenses we already mentioned,
did
[Q371-R FIRST NAME] have any other out-of-pocket medical expenses,
that is, expenses not covered by insurance, such as
medications, special food, equipment such as a special
bed or chair, visits by doctors or other health professionals,
or other costs?
................................................................................
17 1. YES
44 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
172 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1343:E23] IS (NE 3-7) AND [Q1355:E24] IS
(5 OR DK OR RF)
P1373 E25ax.OTHER R PAY $
Section: E Level: Respondent CAI Reference: Q1373
Type: Numeric Width: 5 Decimals: 0
E25ax.
About how much did (he/she) ((or (his/her) husband)/(or (his/her)
wife)/(or (his/her) partner)/...)
pay out-of-pocket for those other expenses
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
DO NOT PROBE DK/RF
AMOUNT:
................................................................................
12 0-99996. Range of Values
5 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
217 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1372:E25x] IS (NE 1)
P1374 E25bx.OTHER DK-1
Section: E Level: Respondent CAI Reference: Q1374
Type: Numeric Width: 1 Decimals: 0
E25bx.
Was it more than $5,000?
................................................................................
3 1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
229 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1372:E25x] IS (NE 1); [Q1373:E25ax] IS
(NE DK AND NE RF)
P1375 E25cx.OTHER DK-2
Section: E Level: Respondent CAI Reference: Q1375
Type: Numeric Width: 1 Decimals: 0
E25cx.
Was it more than $10,000?
................................................................................
1 1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
231 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1372:E25x] IS (NE 1); [Q1373:E25ax] IS
(NE DK AND NE RF); [Q1374:E25bx] IS (DK OR RF); [Q1374:E25bx]
IS (5)
P1376 E25dx.OTHER DK-3
Section: E Level: Respondent CAI Reference: Q1376
Type: Numeric Width: 1 Decimals: 0
E25dx.
Was it more than $20,000?
................................................................................
1. YES
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
233 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1372:E25x] IS (NE 1); [Q1373:E25ax] IS
(NE DK AND NE RF); [Q1374:E25bx] IS (DK OR RF); [Q1374:E25bx]
IS (5); [Q1375:E25cx] IS (5 OR DK OR RF)
P1377 E25ex.OTHER DK-4
Section: E Level: Respondent CAI Reference: Q1377
Type: Numeric Width: 1 Decimals: 0
E25ex.
Was it more than $1,000?
................................................................................
2 1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
232 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1372:E25x] IS (NE 1); [Q1373:E25ax] IS
(NE DK AND NE RF); [Q1374:E25bx] IS (DK OR RF); [Q1375:E25cx]
IS (5 OR DK OR RF); [Q1376:E25dx] IS (A)
P1378 E25fx.OTHER DK-5
Section: E Level: Respondent CAI Reference: Q1378
Type: Numeric Width: 1 Decimals: 0
E25fx.
Was it more than $500?
................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1372:E25x] IS (NE 1); [Q1373:E25ax] IS
(NE DK AND NE RF); [Q1374:E25bx] IS (DK OR RF); [Q1375:E25cx]
IS (5 OR DK OR RF); [Q1376:E25dx] IS (A); [Q1377:E25ex] IS (1
OR DK OR RF)
P1380 E26x.TOTAL COST MEDICAL
Section: E Level: Respondent CAI Reference: Q1380
Type: Numeric Width: 1 Decimals: 0
E26.
I would like to get a rough idea of the total cost of (his/her)
IF Q1245 IS (1)
hospital stays
END
IF Q1262 IS (1) OR Q249 IS (1)
nursing home stays
END
IF Q1290 IS (GE1)
doctor and clinic visits
END
IF Q1294 IS (1)
outpatient surgery
END
IF Q1309 IS (1)
dental visits
END
IF Q1325 IS (1)
prescriptions
END
IF Q1341 IS (1)
in-home-medical care
END
IF Q1355 IS (1)
special services
END
(and) all other medical costs for (him/her)
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died), including costs covered by
IF Q373 IS (LE1931)
Medicare, Medicaid, or other
END
health insurance. Do you think the total costs were more
than $5,000?
................................................................................
181 1. YES
30 5. NO
16 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
7 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1)
P1381 E26a.TOTAL MEDICAL DK-1
Section: E Level: Respondent CAI Reference: Q1381
Type: Numeric Width: 1 Decimals: 0
E26a.
Was it more than $1,000?
................................................................................
18 1. YES
12 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
204 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1380:E26x] IS (DK OR RF OR Over
Limit); [Q1380:E26x] IS (1)
P1382 E26b.TOTAL MEDICAL DK-2
Section: E Level: Respondent CAI Reference: Q1382
Type: Numeric Width: 1 Decimals: 0
E26b.
Was it more than $25,000?
................................................................................
111 1. YES
65 5. NO
5 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
53 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1380:E26x] IS (DK OR RF OR Over
Limit); [Q1381:E26a] IS (A)
P1383 E26c.TOTAL MEDICAL DK-3
Section: E Level: Respondent CAI Reference: Q1383
Type: Numeric Width: 1 Decimals: 0
E26c.
Was it more than $100,000?
................................................................................
48 1. YES
61 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
123 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1380:E26x] IS (DK OR RF OR Over
Limit); [Q1381:E26a] IS (A); [Q1382:E26b] IS (NE 1)
P1384 E26d.TOTAL MEDICAL DK-4
Section: E Level: Respondent CAI Reference: Q1384
Type: Numeric Width: 1 Decimals: 0
E26d.
Was it more than $500,000?
................................................................................
7 1. YES
40 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
186 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1380:E26x] IS (DK OR RF OR Over
Limit); [Q1381:E26a] IS (A); [Q1382:E26b] IS (NE 1);
[Q1383:E26c] IS (NE 1)
P1385 E26dx.NON-MEDICAL EXPENSES
Section: E Level: Respondent CAI Reference: Q1385
Type: Numeric Width: 1 Decimals: 0
E26dx.
In addition to medical expenses, persons with serious
illnesses often have non-medical expenses. Did
[Q371-R FIRST NAME]
have other out-of-pocket non-medical expenses such as
modifying the house with ramps or lifts, hiring help
for housekeeping or other household chores or for
assisting with personal needs?
................................................................................
28 1. YES
198 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
7 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1)
P1386 E26dax.NON-MEDICAL R PAY $
Section: E Level: Respondent CAI Reference: Q1386
Type: Numeric Width: 5 Decimals: 0
E26dax.
About how much did (he/she) ((or (his/her) husband)/(or (his/her)
wife)/(or (his/her) partner)/...)
pay out-of-pocket for non-medical expenses
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
DO NOT PROBE DK/RF
AMOUNT:
................................................................................
20 0-99996. Range of Values
9 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
205 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND
[Q1262:E5] IS (NE 1) AND [Q1290:E11] IS (0 OR DK OR
RF) AND [Q1325:E20] IS (NE 1) AND [Q1341:E22] IS (NE
1) AND [Q1355:E24] IS (NE 1) AND [Q249:CS11] IS (NE
1); [Q1385:E26dx] IS (NE 1)
P1387 E26dbx.NON-MEDICAL DK-1
Section: E Level: Respondent CAI Reference: Q1387
Type: Numeric Width: 1 Decimals: 0
E26dbx.
Was it more than $5,000?
................................................................................
2 1. YES
6 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
225 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1385:E26dx] IS (NE 1); [Q1386:E26dax]
IS (NE DK AND NE RF)
P1388 E26dcx.NON-MEDICAL DK-2
Section: E Level: Respondent CAI Reference: Q1388
Type: Numeric Width: 1 Decimals: 0
E26dcx.
Was it more than $10,000?
................................................................................
1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
232 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1385:E26dx] IS (NE 1); [Q1386:E26dax]
IS (NE DK AND NE RF); [Q1387:E26dbx] IS (DK OR RF);
[Q1387:E26dbx] IS (5)
P1389 E26ddx.NON-MEDICAL DK-3
Section: E Level: Respondent CAI Reference: Q1389
Type: Numeric Width: 1 Decimals: 0
E26ddx.
Was it more than $20,000?
................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1385:E26dx] IS (NE 1); [Q1386:E26dax]
IS (NE DK AND NE RF); [Q1387:E26dbx] IS (DK OR RF);
[Q1387:E26dbx] IS (5); [Q1388:E26dcx] IS (5 OR DK OR RF)
P1390 E26dex.NON-MEDICAL DK-4
Section: E Level: Respondent CAI Reference: Q1390
Type: Numeric Width: 1 Decimals: 0
E26dex.
Was it more than $1,000?
................................................................................
4 1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
228 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1385:E26dx] IS (NE 1); [Q1386:E26dax]
IS (NE DK AND NE RF); [Q1387:E26dbx] IS (DK OR RF);
[Q1388:E26dcx] IS (5 OR DK OR RF); [Q1389:E26ddx] IS (A)
P1391 E26dfx.NON-MEDICAL DK-5
Section: E Level: Respondent CAI Reference: Q1391
Type: Numeric Width: 1 Decimals: 0
E26dfx.
Was it more than $500?
................................................................................
1 1. YES
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
232 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1385:E26dx] IS (NE 1); [Q1386:E26dax]
IS (NE DK AND NE RF); [Q1387:E26dbx] IS (DK OR RF);
[Q1388:E26dcx] IS (5 OR DK OR RF); [Q1389:E26ddx] IS (A);
[Q1390:E26dex] IS (1 OR DK OR RF)
P1393 E27. OTHERS HELP $
Section: E Level: Respondent CAI Reference: Q1393
Type: Numeric Width: 1 Decimals: 0
E27.
IF Q218 IS (2)
Did anyone help (him/her) and you pay
ELSE
Did anyone help (him/her) (and (his/her) husband/and (his/her)
wife/and (his/her) partner/...) pay
END
for (his/her) health care costs
(since Q95-PREV WAVE IW MONTH / Q96-PREV WAVE IW YEAR/in the last
two years before (he/she) died)?
DEF: APART FROM WHAT WAS COVERED BY INSURANCE.
................................................................................
13 1. YES
211 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
7 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1)
P1394 E28. WHO HELP
Section: E Level: Respondent CAI Reference: Q1394
Type: Numeric Width: 1 Decimals: 0
E28.
Was that a (child or other/...) relative of
IF Q218 IS (2)
you and
[Q371-R FIRST NAME] , or was that someone else?
ELSE
[Q371-R FIRST NAME] (and (his/her) husband's/and (his/her)
wife's/and (his/her) partner's/...), or was that someone else?
END
................................................................................
6 1. CHILD/CHILD-IN-LAW/GRANDCHILD
5 2. OTHER RELATIVE
2 3. SOMEONE ELSE
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
221 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1393:E27] IS (5 OR DK OR RF)
P1395M1 E29. WHICH CHILD HELP $-1
Section: E Level: Respondent CAI Reference: Q1395
Type: Character Width: 3 Decimals: 0
E29.
(Which child was that?)
CHOOSE ALL THAT APPLY
ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE:
Which child helped the most?
IF GRANDCHILD:
(Which of (his/her) children is the parent of that grandchild?)
User Note: Ten mentions were allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
1 038. ALL CHILDREN
5 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
228 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1393:E27] IS (5 OR DK OR RF);
[Q1394:E28] IS (NE 1)
P1395M2 E29. WHICH CHILD HELP $-1
Section: E Level: Respondent CAI Reference: Q1395
Type: Character Width: 3 Decimals: 0
E29.
(Which child was that?)
CHOOSE ALL THAT APPLY
ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE:
Which child helped the most?
IF GRANDCHILD:
(Which of (his/her) children is the parent of that grandchild?)
User Note: Ten mentions were allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
1 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
233 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1393:E27] IS (5 OR DK OR RF);
[Q1394:E28] IS (NE 1)
P1395M3 E29. WHICH CHILD HELP $-1
Section: E Level: Respondent CAI Reference: Q1395
Type: Character Width: 3 Decimals: 0
E29.
(Which child was that?)
CHOOSE ALL THAT APPLY
ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE:
Which child helped the most?
IF GRANDCHILD:
(Which of (his/her) children is the parent of that grandchild?)
User Note: Ten mentions were allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
1 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
233 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1393:E27] IS (5 OR DK OR RF);
[Q1394:E28] IS (NE 1)
P1395M4 E29. WHICH CHILD HELP $-1
Section: E Level: Respondent CAI Reference: Q1395
Type: Character Width: 3 Decimals: 0
E29.
(Which child was that?)
CHOOSE ALL THAT APPLY
ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE:
Which child helped the most?
IF GRANDCHILD:
(Which of (his/her) children is the parent of that grandchild?)
User Note: Ten mentions were allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND [Q1262:E5] IS (NE
1) AND [Q1290:E11] IS (0 OR DK OR RF) AND [Q1325:E20] IS (NE 1)
AND [Q1341:E22] IS (NE 1) AND [Q1355:E24] IS (NE 1) AND
[Q249:CS11] IS (NE 1); [Q1393:E27] IS (5 OR DK OR RF);
[Q1394:E28] IS (NE 1)
P1397 E30.AMOUNT OF OTH HELP
Section: E Level: Respondent CAI Reference: Q1397
Type: Numeric Width: 5 Decimals: 0
E30.
Altogether, about how much money did that help amount to?
AMOUNT:
................................................................................
10 0-99996. Range of Values
3 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
221 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1245:E1] IS (NE 1) AND
[Q1262:E5] IS (NE 1) AND [Q1290:E11] IS (0 OR DK OR
RF) AND [Q1325:E20] IS (NE 1) AND [Q1341:E22] IS (NE
1) AND [Q1355:E24] IS (NE 1) AND [Q249:CS11] IS (NE
1); [Q1393:E27] IS (5 OR DK OR RF)
P1400 E31x.DAYS IN BED
Section: E Level: Respondent CAI Reference: Q1400
Type: Numeric Width: 2 Decimals: 0
E31.
About how many days did
[Q371-R FIRST NAME] stay in bed more
than half the day because of illness or injury during the last
three months before (his/her) death?
USE 93 FOR EVERY DAY
................................................................................
225 0-93. Range of Values
8 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2)
P1415 E72fx.ADL WALK HELP
Section: E Level: Respondent CAI Reference: Q1415
Type: Numeric Width: 1 Decimals: 0
E72fx.
The next questions are about help
[Q371-R FIRST NAME] received with
various activities because of a physical, mental,
emotional, or memory problem. Please tell me whether
[Q371-R FIRST NAME] received any help doing each of the
everyday activities that I read to you.
We want to know about help that (he/she) received during
the last three months of (his/her) life.
Because of a health or memory problem did anyone
help
[Q371-R FIRST NAME] get across a room during the last three
months of (his/her) life?
................................................................................
47 1. YES
106 5. NO
6 6. COULDN'T DO
7. DIDN'T DO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
75 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85)
P1416 E72gx.WALK HELP WHEN
Section: E Level: Respondent CAI Reference: Q1416
Type: Numeric Width: 2 Decimals: 0
E72gx.
How long had (he/she) needed help with walking?
RECORD MONTHS OR YEARS, OR SINCE AGE, OR SINCE YEAR
MONTHS:
YEARS:
SINCE AGE:
SINCE YEAR:
................................................................................
45 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
189 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1415:E72fx] IS (NE 1)
P1417 E72hx.WALK YEARS
Section: E Level: Respondent CAI Reference: Q1417
Type: Numeric Width: 2 Decimals: 0
................................................................................
2 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
232 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1415:E72fx] IS (NE 1); [Q1416:E72gx] IS (1-96 OR DK
OR RF OR Over Limit)
P1418 E72hx.WALK SINCE AGE
Section: E Level: Respondent CAI Reference: Q1418
Type: Numeric Width: 3 Decimals: 0
................................................................................
0-996. Range of Values
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1415:E72fx] IS (NE 1); [Q1416:E72gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1417:E72hx] IS (1-96 OR DK OR
RF OR Over Limit)
P1419 E72hx.WALK SINCE YEAR
Section: E Level: Respondent CAI Reference: Q1419
Type: Numeric Width: 4 Decimals: 0
................................................................................
1900-1996. Range of Values
9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1415:E72fx] IS (NE 1); [Q1416:E72gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1417:E72hx] IS (1-96 OR DK OR
RF OR Over Limit); [Q1418:E72hx] IS (1-996 OR DK OR
RF OR Over Limit)
P1425 E73fx.ADL DRESS HELP
Section: E Level: Respondent CAI Reference: Q1425
Type: Numeric Width: 1 Decimals: 0
E73fx.
(Because of a health or memory problem)
Did anyone help (him/her) dress in the last
3 months of (his/her) life?
................................................................................
47 1. YES
108 5. NO
2 6. COULDN'T DO
2 7. DIDN'T DO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
75 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85)
P1426 E73gx.DRESS HELP WHEN
Section: E Level: Respondent CAI Reference: Q1426
Type: Numeric Width: 2 Decimals: 0
E73gx.
How long had (he/she) needed help with dressing?
RECORD MONTHS OR YEARS, OR SINCE AGE, OR SINCE YEAR
MONTHS:
YEARS:
SINCE AGE:
SINCE YEAR:
................................................................................
43 1-96. Actual Value
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
190 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1425:E73fx] IS (NE 1)
P1427 E72hx.DRESS YEARS
Section: E Level: Respondent CAI Reference: Q1427
Type: Numeric Width: 2 Decimals: 0
................................................................................
3 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
231 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1425:E73fx] IS (NE 1); [Q1426:E73gx] IS (1-96 OR DK
OR RF OR Over Limit)
P1428 E72hx.DRESS SINCE AGE
Section: E Level: Respondent CAI Reference: Q1428
Type: Numeric Width: 3 Decimals: 0
................................................................................
0-996. Range of Values
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1425:E73fx] IS (NE 1); [Q1426:E73gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1427:E72hx] IS (1-96 OR DK OR
RF OR Over Limit)
P1429 E72hx.DRESS SINCE YEAR
Section: E Level: Respondent CAI Reference: Q1429
Type: Numeric Width: 4 Decimals: 0
................................................................................
1900-1996. Range of Values
9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1425:E73fx] IS (NE 1); [Q1426:E73gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1427:E72hx] IS (1-96 OR DK OR
RF OR Over Limit); [Q1428:E72hx] IS (1-996 OR DK OR
RF OR Over Limit)
P1435 E74fx.ADL BATHE HELP
Section: E Level: Respondent CAI Reference: Q1435
Type: Numeric Width: 1 Decimals: 0
E74fx.
(Because of a health or memory problem)
Did anyone help (him/her) with bathing or showering
in the last 3 months of (his/her) life?
................................................................................
54 1. YES
102 5. NO
2 6. COULDN'T DO
7. DIDN'T DO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
75 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85)
P1436 E74gx.HOW LONG HELP BATH
Section: E Level: Respondent CAI Reference: Q1436
Type: Numeric Width: 2 Decimals: 0
E74gx.
How long had (he/she) needed help with bathing?
RECORD MONTHS OR YEARS, OR SINCE AGE, OR SINCE YEAR
MONTHS:
YEARS:
SINCE AGE:
SINCE YEAR:
................................................................................
50 1-96. Actual Value
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
184 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1435:E74fx] IS (NE 1)
P1437 E74hx.BATHE YEARS
Section: E Level: Respondent CAI Reference: Q1437
Type: Numeric Width: 2 Decimals: 0
................................................................................
4 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
230 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1435:E74fx] IS (NE 1); [Q1436:E74gx] IS (1-96 OR DK
OR RF OR Over Limit)
P1438 E74hx.BATHE SINCE AGE
Section: E Level: Respondent CAI Reference: Q1438
Type: Numeric Width: 3 Decimals: 0
................................................................................
0-996. Range of Values
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1435:E74fx] IS (NE 1); [Q1436:E74gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1437:E74hx] IS (1-96 OR DK OR
RF OR Over Limit)
P1439 E74hx.BATHE SINCE YEAR
Section: E Level: Respondent CAI Reference: Q1439
Type: Numeric Width: 4 Decimals: 0
................................................................................
1900-1996. Range of Values
9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1435:E74fx] IS (NE 1); [Q1436:E74gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1437:E74hx] IS (1-96 OR DK OR
RF OR Over Limit); [Q1438:E74hx] IS (1-996 OR DK OR
RF OR Over Limit)
P1445 E75fx.ADL EAT HELP
Section: E Level: Respondent CAI Reference: Q1445
Type: Numeric Width: 1 Decimals: 0
E75fx.
(Because of a health or memory problem)
Did anyone help (him/her) eat in the last 3
months of (his/her) life?
................................................................................
30 1. YES
126 5. NO
6. COULDN'T DO
2 7. DIDN'T DO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
75 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85)
P1446 E75gx.EAT HELP WHEN
Section: E Level: Respondent CAI Reference: Q1446
Type: Numeric Width: 2 Decimals: 0
E75gx.
How long had (he/she) needed help with eating?
RECORD MONTHS OR YEARS, OR SINCE AGE, OR SINCE YEAR
MONTHS:
YEARS:
SINCE AGE:
SINCE YEAR:
................................................................................
30 1-96. Actual Value
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
204 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1445:E75fx] IS (NE 1)
P1447 E75hx.EAT YEARS
Section: E Level: Respondent CAI Reference: Q1447
Type: Numeric Width: 2 Decimals: 0
................................................................................
0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1445:E75fx] IS (NE 1); [Q1446:E75gx] IS (1-96 OR DK
OR RF OR Over Limit)
P1448 E75hx.EAT SINCE AGE
Section: E Level: Respondent CAI Reference: Q1448
Type: Numeric Width: 3 Decimals: 0
................................................................................
0-996. Range of Values
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1445:E75fx] IS (NE 1); [Q1446:E75gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1447:E75hx] IS (1-96 OR DK OR
RF OR Over Limit)
P1449 E75hx.EAT SINCE YEAR
Section: E Level: Respondent CAI Reference: Q1449
Type: Numeric Width: 4 Decimals: 0
................................................................................
1900-1996. Range of Values
9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1445:E75fx] IS (NE 1); [Q1446:E75gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1447:E75hx] IS (1-96 OR DK OR
RF OR Over Limit); [Q1448:E75hx] IS (1-996 OR DK OR
RF OR Over Limit)
P1458 E76fx.ADL BED HELP
Section: E Level: Respondent CAI Reference: Q1458
Type: Numeric Width: 1 Decimals: 0
E76fx.
(Because of a health or memory problem)
Did anyone help (him/her) get in or out of bed
in the last 3 months of (his/her) life?
................................................................................
48 1. YES
109 5. NO
2 6. COULDN'T DO
7. DIDN'T DO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
75 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85)
P1459 E76gx.BED HELP WHEN
Section: E Level: Respondent CAI Reference: Q1459
Type: Numeric Width: 2 Decimals: 0
E76gx.
How long had (he/she) needed help with getting in
or out of bed?
RECORD MONTHS OR YEARS, OR SINCE AGE, OR SINCE YEAR
MONTHS:
YEARS:
SINCE AGE:
SINCE YEAR:
................................................................................
47 1-96. Actual Value
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
187 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1458:E76fx] IS (NE 1)
P1460 E76hx.BED YEARS
Section: E Level: Respondent CAI Reference: Q1460
Type: Numeric Width: 2 Decimals: 0
................................................................................
1 0-96. Range of Values
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
233 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1458:E76fx] IS (NE 1); [Q1459:E76gx] IS (1-96 OR DK
OR RF OR Over Limit)
P1461 E76hx.BED SINCE AGE
Section: E Level: Respondent CAI Reference: Q1461
Type: Numeric Width: 3 Decimals: 0
................................................................................
0-996. Range of Values
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1458:E76fx] IS (NE 1); [Q1459:E76gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1460:E76hx] IS (1-96 OR DK OR
RF OR Over Limit)
P1462 E76hx.BED SINCE YEAR
Section: E Level: Respondent CAI Reference: Q1462
Type: Numeric Width: 4 Decimals: 0
................................................................................
1900-1996. Range of Values
9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
234 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85);
[Q1458:E76fx] IS (NE 1); [Q1459:E76gx] IS (1-96 OR DK
OR RF OR Over Limit); [Q1460:E76hx] IS (1-96 OR DK OR
RF OR Over Limit); [Q1461:E76hx] IS (1-996 OR DK OR
RF OR Over Limit)
P1468 E77fx.ADL TOILET HELP
Section: E Level: Respondent CAI Reference: Q1468
Type: Numeric Width: 1 Decimals: 0
E77fx.
(Because of a health or memory problem)
Did anyone help (him/her) use the toilet
in the last 3 months of (his/her) life?
................................................................................
46 1. YES
110 5. NO
6. COULDN'T DO
2 7. DIDN'T DO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
75 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72] IS (3);
[Q1178:D72] IS (2); [Q1400:E31x] IS (GT 85)
P1469 E77gx.TOILET HELP WHEN
Section: E Level: Respondent CAI Reference: Q1469
Type: Numeric Width: 2 Decimals: 0
E77gx.
How long had (he/she) needed help with using the toilet?
RECORD MONTHS OR YEARS, OR SINCE AGE, OR SINCE YEAR
MONTHS:
YEARS:
SINCE AGE:
SINCE YEAR:
................................................................................
45 1-96. Actual Value
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
188 Blank. INAP (Inapplicable); [Q1178:D72] IS (4); [Q1178:D72]
IS (3); [Q1178:D72] IS (2); [Q140