HHID Household Identifier
Section: MD Level: Respondent CAI Reference: Q9001
Type: Character Width: 6 Decimals: 0
................................................................................
234 000000-099000. Household Identification Number
PN Person Number
Section: MD 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: MD 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: MD 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: MD 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
P2314 MX-0.INTRO
Section: MD Level: Respondent CAI Reference: Q2314
Type: Character Width: 1 Decimals: 0
MX-0.
Now we wish to ask some questions about healthcare decisions
toward the end of [Q371-R FIRST NAME]'s life.
User note: This preamble variable has been included in this data set in
order to document questionnaire flow; all data values are blanks.
................................................................................
234 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2315 MX-1.R PROVIDE WRITTEN INSTRUCTIONS
Section: MD Level: Respondent CAI Reference: Q2315
Type: Numeric Width: 1 Decimals: 0
MX-1.
Did
[Q371-R FIRST NAME] provide written instructions about the
treatment or care (he/she) wanted to receive during
the final days of (his/her) life?
IWER: EMPHASIZE THE PHRASE WRITTEN INSTRUCTIONS
................................................................................
55 1. YES
144 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
33 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2316 MX-1a.MONTH WRITTEN
Section: MD Level: Respondent CAI Reference: Q2316
Type: Numeric Width: 2 Decimals: 0
MX-1a.
About when were these written instructions dated (approximately)?
MONTH:
YEAR:
................................................................................
9 1. JAN
4 2. FEB
2 3. MAR
7 4. APR
5 5. MAY
5 6. JUN
7. JUL
4 8. AUG
2 9. SEP
3 10. OCT
3 11. NOV
4 12. DEC
7 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2317 MX-1a2.YEAR WRITTEN
Section: MD Level: Respondent CAI Reference: Q2317
Type: Numeric Width: 4 Decimals: 0
................................................................................
54 1900-1996. Range of Values
1 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND
[Q237:CS2mx] IS (1 OR 2 OR 3); [Q218:CS1a] IS (NE 2)
AND [Q557:CS49] IS (NE 1-10); [Q2315:MX-1] IS (NE 1)
P2322 MX-1b1.INST PROLONG LIFE
Section: MD Level: Respondent CAI Reference: Q2322
Type: Numeric Width: 1 Decimals: 0
MX-1b1.
Did these instructions express a desire to receive all
care possible under any circumstances in order to prolong life?
................................................................................
3 1. YES
51 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2323 MX-1b2.LIMIT CARE
Section: MD Level: Respondent CAI Reference: Q2323
Type: Numeric Width: 1 Decimals: 0
MX-1b2.
Did these instructions express a desire to limit care
in certain situations?
................................................................................
51 1. YES
4 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2324 MX-1b3.TREATMENT WITHHELD
Section: MD Level: Respondent CAI Reference: Q2324
Type: Numeric Width: 1 Decimals: 0
MX-1b3.
Did these instructions express a desire to have
any treatment withheld?
................................................................................
47 1. YES
8 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2325 MX-1b4.KEEP COMFORTABLE
Section: MD Level: Respondent CAI Reference: Q2325
Type: Numeric Width: 1 Decimals: 0
MX-1b4.
(Did these instructions express a desire to)
keep (him/her) comfortable and pain free but to
forego extensive measures to prolong life?
................................................................................
51 1. YES
4 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2326 MX-1c.APPLY TO ACTUAL SITU
Section: MD Level: Respondent CAI Reference: Q2326
Type: Numeric Width: 1 Decimals: 0
MX-1c.
Were these instructions applicable to the actual situation?
................................................................................
44 1. YES
10 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2327 MX-1d.CONSULTED INSTRUCTIONS
Section: MD Level: Respondent CAI Reference: Q2327
Type: Numeric Width: 1 Decimals: 0
MX-1d.
Were you consulted about whether these instructions
should be followed?
................................................................................
41 1. YES
14 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2328 MX-1e.OTHERS CONSULTED
Section: MD Level: Respondent CAI Reference: Q2328
Type: Numeric Width: 1 Decimals: 0
MX-1e.
Were any (other) family members or other persons consulted?
................................................................................
21 1. YES
34 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1)
P2329M1 MX-1f.WHO WAS THIS
Section: MD Level: Respondent CAI Reference: Q2329
Type: Numeric Width: 2 Decimals: 0
MX-1f.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
1 2. NON-SPOUSE PROXY RESPONDENT
4 3. SPOUSE
16 4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
213 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2328:MX-1e] IS (NE 1)
P2329M2 MX-1f.WHO WAS THIS
Section: MD Level: Respondent CAI Reference: Q2329
Type: Numeric Width: 2 Decimals: 0
MX-1f.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4 4. CHILD/CHILD-IN-LAW/GRANDCHILD
2 5. OTHER RELATIVE
6. FRIEND
1 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
227 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2328:MX-1e] IS (NE 1)
P2329M3 MX-1f.WHO WAS THIS
Section: MD Level: Respondent CAI Reference: Q2329
Type: Numeric Width: 2 Decimals: 0
MX-1f.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
1 3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
1 5. OTHER RELATIVE
1 6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
1 11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
229 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2328:MX-1e] IS (NE 1)
P2329M4 MX-1f.WHO WAS THIS
Section: MD Level: Respondent CAI Reference: Q2329
Type: Numeric Width: 2 Decimals: 0
MX-1f.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
1 11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
233 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2328:MX-1e] IS (NE 1)
P2329M5 MX-1f.WHO WAS THIS
Section: MD Level: Respondent CAI Reference: Q2329
Type: Numeric Width: 2 Decimals: 0
MX-1f.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
234 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2328:MX-1e] IS (NE 1)
P2330M1 MX-1g.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2330
Type: Character Width: 3 Decimals: 0
MX-1g.
Which child was that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentions allowed, maximum used was six.
................................................................................
037. DECEASED CHILD
10 038. ALL CHILDREN
10 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
214 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4)
P2330M2 MX-1g.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2330
Type: Character Width: 3 Decimals: 0
MX-1g.
Which child was that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentions allowed, maximum used was six.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
4 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
230 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4)
P2330M3 MX-1g.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2330
Type: Character Width: 3 Decimals: 0
MX-1g.
Which child was that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentions allowed, maximum used was six.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
2 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
232 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4)
P2330M4 MX-1g.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2330
Type: Character Width: 3 Decimals: 0
MX-1g.
Which child was that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentions allowed, maximum used was six.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4)
P2330M5 MX-1g.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2330
Type: Character Width: 3 Decimals: 0
MX-1g.
Which child was that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentions allowed, maximum used was six.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4)
P2330M6 MX-1g.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2330
Type: Character Width: 3 Decimals: 0
MX-1g.
Which child was that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentions allowed, maximum used was six.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4)
P2330M7 MX-1g.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2330
Type: Character Width: 3 Decimals: 0
MX-1g.
Which child was that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentions allowed, maximum used was six.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4)
P2332 MX-1h.PROBLEMS WITH WRITTEN
Section: MD Level: Respondent CAI Reference: Q2332
Type: Numeric Width: 1 Decimals: 0
MX-1h.
Did any problems come up in trying to follow
these written instructions?
................................................................................
2 1. YES
16 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
216 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2329:MX-1f] IS (NE 4); [Q2326:MX-1c]
IS (NE 1)
P2333 MX-1j.PHYSICIAL FOLLOW WRITTEN
Section: MD Level: Respondent CAI Reference: Q2333
Type: Numeric Width: 1 Decimals: 0
MX-1j.
Did the physician or any other health care worker
have problems following the written instructions?
................................................................................
1 1. YES
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
232 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2315:MX-1] IS (NE 1); [Q2326:MX-1c] IS (NE 1); [Q2332:MX-1h]
IS (NE 1)
P2337 MX-2.MAKE LEGAL ARRANGEMENTS
Section: MD Level: Respondent CAI Reference: Q2337
Type: Numeric Width: 1 Decimals: 0
MX-2.
Did
[Q371-R FIRST NAME] (also) make any legal arrangements
for a specific person or persons to make decisions about
(his/her) care or medical treatment if (he/she) could not
make those decisions (him/her)self? This is sometimes called
a Durable Power of Attorney for Health Care.
................................................................................
49 1. YES
152 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
33 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2338M1 MX-2a.WHO AUTHORITY
Section: MD Level: Respondent CAI Reference: Q2338
Type: Numeric Width: 2 Decimals: 0
MX-2a.
Who had that authority?
User Note: There were eleven mentions allowed, maximum used was one.
................................................................................
1. DECEASED R
4 2. NON-SPOUSE PROXY RESPONDENT
32 3. SPOUSE
13 4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
185 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2337:MX-2] IS (NE 1)
P2338M2 MX-2a.WHO AUTHORITY
Section: MD Level: Respondent CAI Reference: Q2338
Type: Numeric Width: 2 Decimals: 0
MX-2a.
Who had that authority?
User Note: There were eleven mentions allowed, maximum used was one.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
234 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2337:MX-2] IS (NE 1)
P2339M1 MX-2b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2339
Type: Character Width: 3 Decimals: 0
MX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
13 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
221 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2337:MX-2] IS (NE 1); [Q2338:MX-2a] IS (NE 4)
P2339M2 MX-2b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2339
Type: Character Width: 3 Decimals: 0
MX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones 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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2337:MX-2] IS (NE 1); [Q2338:MX-2a] IS (NE 4)
P2339M3 MX-2b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2339
Type: Character Width: 3 Decimals: 0
MX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones 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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2337:MX-2] IS (NE 1); [Q2338:MX-2a] IS (NE 4)
P2339M4 MX-2b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2339
Type: Character Width: 3 Decimals: 0
MX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones 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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2337:MX-2] IS (NE 1); [Q2338:MX-2a] IS (NE 4)
P2341 MX-2c.DURABLE P OF ATTORNEY
Section: MD Level: Respondent CAI Reference: Q2341
Type: Numeric Width: 2 Decimals: 0
MX-2c.
When was the Durable Power of Attorney for Health Care
made (approximately)?
MONTH:
YEAR:
................................................................................
5 1. JAN
2 2. FEB
5 3. MAR
8 4. APR
3 5. MAY
4 6. JUN
2 7. JUL
3 8. AUG
1 9. SEP
4 10. OCT
3 11. NOV
3 12. DEC
6 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
185 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2337:MX-2] IS (NE 1)
P2342 MX-2c2.YEAR WRITTEN
Section: MD Level: Respondent CAI Reference: Q2342
Type: Numeric Width: 4 Decimals: 0
................................................................................
45 1900-1996. Range of Values
4 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
185 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND
[Q237:CS2mx] IS (1 OR 2 OR 3); [Q218:CS1a] IS (NE 2)
AND [Q557:CS49] IS (NE 1-10); [Q2337:MX-2] IS (NE 1)
P2348 MX-3.DISCUSS TREATMENT
Section: MD Level: Respondent CAI Reference: Q2348
Type: Numeric Width: 1 Decimals: 0
MX-3.
Did
[Q371-R FIRST NAME] ever discuss with you or anyone else
the treatment or care (he/she) wanted to receive in the
final days of (his/her) life?
................................................................................
116 1. YES
85 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
33 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2349M1 MX-3a.WHO WAS THAT
Section: MD Level: Respondent CAI Reference: Q2349
Type: Numeric Width: 2 Decimals: 0
MX-3a.
Who was that?
User Note: There were eleven mentions allowed, maximum used was five.
................................................................................
1. DECEASED R
12 2. NON-SPOUSE PROXY RESPONDENT
88 3. SPOUSE
11 4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
1 6. FRIEND
2 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
119 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1)
P2349M2 MX-3a.WHO WAS THAT
Section: MD Level: Respondent CAI Reference: Q2349
Type: Numeric Width: 2 Decimals: 0
MX-3a.
Who was that?
User Note: There were eleven mentions allowed, maximum used was five.
................................................................................
1. DECEASED R
1 2. NON-SPOUSE PROXY RESPONDENT
2 3. SPOUSE
27 4. CHILD/CHILD-IN-LAW/GRANDCHILD
3 5. OTHER RELATIVE
1 6. FRIEND
4 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
2 9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
194 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1)
P2349M3 MX-3a.WHO WAS THAT
Section: MD Level: Respondent CAI Reference: Q2349
Type: Numeric Width: 2 Decimals: 0
MX-3a.
Who was that?
User Note: There were eleven mentions allowed, maximum used was five.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
2 5. OTHER RELATIVE
6. FRIEND
3 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
2 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
1 9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
226 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1)
P2349M4 MX-3a.WHO WAS THAT
Section: MD Level: Respondent CAI Reference: Q2349
Type: Numeric Width: 2 Decimals: 0
MX-3a.
Who was that?
User Note: There were eleven mentions allowed, maximum used was five.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
1 5. OTHER RELATIVE
1 6. FRIEND
1 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
231 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1)
P2349M5 MX-3a.WHO WAS THAT
Section: MD Level: Respondent CAI Reference: Q2349
Type: Numeric Width: 2 Decimals: 0
MX-3a.
Who was that?
User Note: There were eleven mentions allowed, maximum used was five.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
1 6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
233 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1)
P2349M6 MX-3a.WHO WAS THAT
Section: MD Level: Respondent CAI Reference: Q2349
Type: Numeric Width: 2 Decimals: 0
MX-3a.
Who was that?
User Note: There were eleven mentions allowed, maximum used was five.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
234 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1)
P2350M1 MX-3b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2350
Type: Character Width: 3 Decimals: 0
MX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was five.
................................................................................
037. DECEASED CHILD
17 038. ALL CHILDREN
21 041-995. Other Person Number
1 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
195 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1); [Q2349:MX-3a] IS (NE 4)
P2350M2 MX-3b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2350
Type: Character Width: 3 Decimals: 0
MX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was five.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
8 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
226 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1); [Q2349:MX-3a] IS (NE 4)
P2350M3 MX-3b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2350
Type: Character Width: 3 Decimals: 0
MX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was five.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
3 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
231 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1); [Q2349:MX-3a] IS (NE 4)
P2350M4 MX-3b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2350
Type: Character Width: 3 Decimals: 0
MX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was five.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1); [Q2349:MX-3a] IS (NE 4)
P2350M5 MX-3b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2350
Type: Character Width: 3 Decimals: 0
MX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was five.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1); [Q2349:MX-3a] IS (NE 4)
P2350M6 MX-3b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2350
Type: Character Width: 3 Decimals: 0
MX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was five.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2348:MX-3] IS (NE 1); [Q2349:MX-3a] IS (NE 4)
P2355M1 MX-4.WHO MADE DECISIONS
Section: MD Level: Respondent CAI Reference: Q2355
Type: Numeric Width: 2 Decimals: 0
MX-4.
Who was actually involved in making decisions about
the care and treatment of
[Q371-R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
43 1. DECEASED R
13 2. NON-SPOUSE PROXY RESPONDENT
94 3. SPOUSE
27 4. CHILD/CHILD-IN-LAW/GRANDCHILD
3 5. OTHER RELATIVE
6. FRIEND
8 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
1 11. OTHER (SPECIFY)
12 12. R died suddenly; no decision maker
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
33 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2355M2 MX-4.WHO MADE DECISIONS
Section: MD Level: Respondent CAI Reference: Q2355
Type: Numeric Width: 2 Decimals: 0
MX-4.
Who was actually involved in making decisions about
the care and treatment of
[Q371-R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
2 1. DECEASED R
3 2. NON-SPOUSE PROXY RESPONDENT
14 3. SPOUSE
20 4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
2 6. FRIEND
13 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
1 11. OTHER (SPECIFY)
12. R died suddenly; no decision maker
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
179 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2355M3 MX-4.WHO MADE DECISIONS
Section: MD Level: Respondent CAI Reference: Q2355
Type: Numeric Width: 2 Decimals: 0
MX-4.
Who was actually involved in making decisions about
the care and treatment of
[Q371-R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3 3. SPOUSE
4 4. CHILD/CHILD-IN-LAW/GRANDCHILD
3 5. OTHER RELATIVE
6. FRIEND
5 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
12. R died suddenly; no decision maker
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
219 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2355M4 MX-4.WHO MADE DECISIONS
Section: MD Level: Respondent CAI Reference: Q2355
Type: Numeric Width: 2 Decimals: 0
MX-4.
Who was actually involved in making decisions about
the care and treatment of
[Q371-R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
1 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
12. R died suddenly; no decision maker
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
233 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2355M5 MX-4.WHO MADE DECISIONS
Section: MD Level: Respondent CAI Reference: Q2355
Type: Numeric Width: 2 Decimals: 0
MX-4.
Who was actually involved in making decisions about
the care and treatment of
[Q371-R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
User Note: There were eleven mentions allowed, maximum used was four.
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
11. OTHER (SPECIFY)
12. R died suddenly; no decision maker
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
234 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2356M1 MX-4a.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2356
Type: Character Width: 3 Decimals: 0
MX-4a.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
13 038. ALL CHILDREN
33 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
188 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2355:MX-4] IS (1); [Q2355:MX-4] IS (NE 4)
P2356M2 MX-4a.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2356
Type: Character Width: 3 Decimals: 0
MX-4a.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
7 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
227 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2355:MX-4] IS (1); [Q2355:MX-4] IS (NE 4)
P2356M3 MX-4a.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2356
Type: Character Width: 3 Decimals: 0
MX-4a.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was three.
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN
2 041-995. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
232 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2355:MX-4] IS (1); [Q2355:MX-4] IS (NE 4)
P2356M4 MX-4a.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2356
Type: Character Width: 3 Decimals: 0
MX-4a.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones 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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2355:MX-4] IS (1); [Q2355:MX-4] IS (NE 4)
P2358 MX-4b.R ABLE MEDICAL DECIDE
Section: MD Level: Respondent CAI Reference: Q2358
Type: Numeric Width: 1 Decimals: 0
MX-4b.
Was
[Q371-R FIRST NAME] able to participate in decisions
about (his/her) medical care during the final days
of (his/her) life?
................................................................................
63 1. YES
8 3. R died suddenly; no decisions made
82 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
78 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2355:MX-4] IS (1); [Q2355:MX-4] IS (1)
P2359 MX-4c.HOW LONG R DECIDE BEFORE DYING
Section: MD Level: Respondent CAI Reference: Q2359
Type: Numeric Width: 2 Decimals: 0
MX-4c.
For about how long before
[Q371-R FIRST NAME] died was
(he/she) unable to participate in decisions about (his/her)
medical care?
# MONTHS:
# DAYS:
# YEARS:
................................................................................
28 0-96. Range of Values
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
205 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND
[Q237:CS2mx] IS (1 OR 2 OR 3); [Q218:CS1a] IS (NE 2)
AND [Q557:CS49] IS (NE 1-10); [Q2355:MX-4] IS (1);
[Q2358:MX-4b] IS (NE 5)
P2360 MX-4c1.DAYS AGO
Section: MD Level: Respondent CAI Reference: Q2360
Type: Numeric Width: 3 Decimals: 0
................................................................................
48 0-100. Range of Values
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
186 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND
[Q237:CS2mx] IS (1 OR 2 OR 3); [Q218:CS1a] IS (NE 2)
AND [Q557:CS49] IS (NE 1-10); [Q2355:MX-4] IS (1);
[Q2358:MX-4b] IS (NE 5); [Q2359:MX-4c] IS (1-96)
P2361 MX-4c2.YEARS AGO
Section: MD Level: Respondent CAI Reference: Q2361
Type: Numeric Width: 3 Decimals: 0
................................................................................
7 1-100. Range of Values
3 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
224 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND
[Q237:CS2mx] IS (1 OR 2 OR 3); [Q218:CS1a] IS (NE 2)
AND [Q557:CS49] IS (NE 1-10); [Q2355:MX-4] IS (1);
[Q2358:MX-4b] IS (NE 5); [Q2359:MX-4c] IS (1-96);
[Q2360:MX-4c1] IS (1-100)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) AND [Q2358:MX-4b] IS (NE 1) then [P2366.MX-5.MAIN DECISION
MAKER] = 2355U(111)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
P2366 MX-5.MAIN DECISION MAKER
Section: MD Level: Respondent CAI Reference: Q2366
Type: Numeric Width: 2 Decimals: 0
MX-5.
Who was the main decision-maker?
................................................................................
45 1. DECEASED R
3 2. NON-SPOUSE PROXY RESPONDENT
41 3. SPOUSE
6 4. CHILD/CHILD-IN-LAW/GRANDCHILD
2 5. OTHER RELATIVE
6. FRIEND
7 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
2 11. OTHER (SPECIFY)
6 12. R died suddenly; no decision maker
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
122 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10)
P2367M1 MX-5b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2367
Type: Character Width: 3 Decimals: 0
MX-5b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was one.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2366:MX-5] IS (NE 4)
P2367M2 MX-5b.WHICH CHILD-1
Section: MD Level: Respondent CAI Reference: Q2367
Type: Character Width: 3 Decimals: 0
MX-5b.
Which child is that?
CHOOSE ALL THAT APPLY
User Note: There were ten mentiones allowed, maximum used was one.
................................................................................
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); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q2366:MX-5] IS (NE 4)
ASSIGNMENT STATEMENTS
* Jump from P2366 when [Q0] IS (1) AND [Q2358:MX-4b] IS (NE 1)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
P2369 MX-6a.UNCONDITION PROLONG
Section: MD Level: Respondent CAI Reference: Q2369
Type: Numeric Width: 1 Decimals: 0
MX-6a.
Did the final decision involve a desire to give all
care possible unconditionally in order to prolong life?
................................................................................
28 1. YES
87 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
116 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q233:CS2jx] IS (2)
P2370 MX-6b.LIMIT CARE CERTAIN COND
Section: MD Level: Respondent CAI Reference: Q2370
Type: Numeric Width: 1 Decimals: 0
MX-6b.
Did the final decision involve limiting care in
certain situations?
................................................................................
71 1. YES
45 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
116 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q233:CS2jx] IS (2)
P2371 MX-6c.LIMIT CARE WITHHOLD TREATMENT
Section: MD Level: Respondent CAI Reference: Q2371
Type: Numeric Width: 1 Decimals: 0
MX-6c.
Did the final decision involve withholding any treatment?
................................................................................
52 1. YES
63 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
2 9. RF (Refused)
116 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q233:CS2jx] IS (2)
P2372 MX-6d.LIMIT CARE KEEP COMFORTABLE
Section: MD Level: Respondent CAI Reference: Q2372
Type: Numeric Width: 1 Decimals: 0
MX-6d.
Did the final decision rest largely on keeping
[Q371-R FIRST NAME]
comfortable and pain free without taking extensive
measures to prolong life?
................................................................................
102 1. YES
13 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
2 9. RF (Refused)
116 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q233:CS2jx] IS (2)
P2376 MX-7.REFUSED CARE TREATMENT
Section: MD Level: Respondent CAI Reference: Q2376
Type: Numeric Width: 1 Decimals: 0
MX-7.
Did any doctor(s) recommend any care or treatment that
the family or other decision-maker(s) ultimately refused?
................................................................................
16 1. YES
101 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
116 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q233:CS2jx] IS (2)
P2377 MX-7a.RECEIVE TREATMENT ANYWAY
Section: MD Level: Respondent CAI Reference: Q2377
Type: Numeric Width: 1 Decimals: 0
MX-7a.
Did
[Q371-R FIRST NAME] receive this treatment anyway?
................................................................................
2 1. YES
14 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
218 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q233:CS2jx] IS (2); [Q2376:MX-7] IS (NE 1)
P2378 MX-8.COST ENTER DECISION
Section: MD Level: Respondent CAI Reference: Q2378
Type: Numeric Width: 1 Decimals: 0
MX-8.
Did cost enter into the decisions about what care or
treatment (he/she) would receive in the final days
of (his/her) life?
................................................................................
2 1. YES
40 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
192 Blank. INAP (Inapplicable); [Q233:CS2jx] IS (2) AND [Q237:CS2mx] IS (1
OR 2 OR 3); [Q218:CS1a] IS (NE 2) AND [Q557:CS49] IS (NE 1-10);
[Q233:CS2jx] IS (2); [Q2327:MX-1d] IS (NE 1) AND [Q2338:MX-2a]
IS (NE 2) AND [Q2349:MX-3a] IS (NE 2) AND [Q2355:MX-4] IS (NE
2) AND [Q2366:MX-5] IS (NE 2)
PQNR Surveycraft Case Number
Section: MD Level: Respondent CAI Reference: Q9012
Type: Numeric Width: 3 Decimals: 0
................................................................................
234 0-250. Surveycraft Case Number
PVERSION 1996 EXIT RELEASE VERSION NUMBER
Section: MD Level: Respondent CAI Reference: Q9013
Type: Numeric Width: 1 Decimals: 0
................................................................................
234 1. Release Version 1
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