HHID HOUSEHOLD IDENTIFIER
Section: S Level: Respondent CAI Reference: Q9001
Type: Character Width: 6 Decimals: 0
................................................................................
1348 010003-213471. Household ID
PN PERSON NUMBER
Section: S Level: Respondent CAI Reference: Q9002
Type: Character Width: 3 Decimals: 0
................................................................................
929 010. Person Number
12 011. Person Number
320 020. Person Number
2 021. Person Number
36 030. Person Number
1 031. Person Number
47 040. Person Number
1 041. Person Number
RSUBHH 2000 SUB-HOUSEHOLD IDENTIFIER
Section: S Level: Respondent CAI Reference: Q9004
Type: Character Width: 1 Decimals: 0
................................................................................
1296 3. 1st deceased respondent from a household
52 4. 2nd deceased respondent from a household
FSUBHH 1998 SUB-HOUSEHOLD IDENTIFIER
Section: S Level: Respondent CAI Reference: Q9003
Type: Character Width: 1 Decimals: 0
................................................................................
1306 0. Original sample household - no split from divorce or separation
of spouses or partners
14 1. Split household - one half of couple from SUBHH 0 and new
spouse or partner, if any
13 2. Split household - other half of couple from SUBHH 0 and new
spouse or partner, if any
15 3. 1st deceased respondent from a household
5. Split household - one half of couple from SUBHH 1 or 2
6. Split household - one half of couple from SUBHH 1 or 2
7. Reunited household - respondents from split household reunite
RPN_SP 2000 SPOUSE/PARTNER PERSON NUMBER
Section: S Level: Respondent CAI Reference: Q9005
Type: Character Width: 3 Decimals: 0
................................................................................
276 010. Spouse Person Number
14 011. Spouse Person Number
292 020. Spouse Person Number
4 021. Spouse Person Number
25 030. Spouse Person Number
34 040. Spouse Person Number
703 Blank. No Spouse at Death
RQNR SURVEYCRAFT CASE NUMBER
Section: S Level: Respondent CAI Reference: Q9006
Type: Numeric Width: 5 Decimals: 0
................................................................................
999 80001-80999. AHEAD/CODA Surveycraft Case Number
349 90001-90349. HRS/WAR BABY Surveycraft Case Number
R2741 SX-0.INTRO
Section: S Level: Respondent CAI Reference: Q2741
Type: Numeric Width: 1 Decimals: 0
SX-0.
Now we wish to ask some questions about healthcare decisions
toward the end of
[Q754-CS22Y31.R FIRST NAME]'s life.
................................................................................
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18)
R2742 SX-1.R PROVIDE WRITTEN INSTRUCTIONS
Section: S Level: Respondent CAI Reference: Q2742
Type: Numeric Width: 1 Decimals: 0
SX-1.
Did
[Q754-CS22Y31.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
................................................................................
496 1. YES
830 5. NO
18 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18)
R2743 SX-1a.MONTH WRITTEN
Section: S Level: Respondent CAI Reference: Q2743
Type: Numeric Width: 2 Decimals: 0
SX-1a.
About when were these written instructions dated (approximately)?
MONTH:
YEAR:
................................................................................
137 1. JAN
20 2. FEB
25 3. MAR
26 4. APR
24 5. MAY
27 6. JUN
16 7. JUL
14 8. AUG
25 9. SEP
17 10. OCT
17 11. NOV
64 12. DEC
81 98. DK (Don't Know); NA (Not Ascertained)
3 99. RF (Refused)
852 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1)
R2744 SX-1a2.YEAR WRITTEN
Section: S Level: Respondent CAI Reference: Q2744
Type: Numeric Width: 4 Decimals: 0
................................................................................
457 1900-2001. Actual Value
38 9998. DK (Don't Know); NA (Not Ascertained)
1 9999. RF (Refused)
852 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS
(18); [Q2742:SX-1] IS (NE 1)
R2749 SX-1b.INST PROLONG LIFE
Section: S Level: Respondent CAI Reference: Q2749
Type: Numeric Width: 1 Decimals: 0
SX-1b.
Did these instructions express a desire to receive all
care possible under any circumstances in order to prolong life?
................................................................................
28 1. YES
464 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
852 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1)
R2750 SX-1c.LIMIT CARE
Section: S Level: Respondent CAI Reference: Q2750
Type: Numeric Width: 1 Decimals: 0
SX-1c.
Did these instructions express a desire to limit care
in certain situations?
................................................................................
451 1. YES
38 5. NO
7 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
852 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1)
R2751 SX-1d.TREATMENT WITHHELD
Section: S Level: Respondent CAI Reference: Q2751
Type: Numeric Width: 1 Decimals: 0
SX-1d.
Did these instructions express a desire to have
any treatment withheld?
................................................................................
402 1. YES
78 5. NO
15 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
852 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1)
R2752 SX-1e.KEEP COMFORTABLE
Section: S Level: Respondent CAI Reference: Q2752
Type: Numeric Width: 1 Decimals: 0
SX-1e.
(Did these instructions express a desire to)
keep (him/her) comfortable and pain free but to
forego extensive measures to prolong life?
................................................................................
459 1. YES
26 5. NO
10 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
852 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1)
R2753 SX-1f.APPLY TO ACTUAL SITUATION
Section: S Level: Respondent CAI Reference: Q2753
Type: Numeric Width: 1 Decimals: 0
SX-1f.
Were these instructions applicable to the actual situation?
................................................................................
359 1. YES
129 5. NO
8 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
852 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1)
R2754 SX-1g.CONSULTED INSTRUCTIONS
Section: S Level: Respondent CAI Reference: Q2754
Type: Numeric Width: 1 Decimals: 0
SX-1g.
Were you consulted about whether these instructions
should be followed?
................................................................................
272 1. YES
86 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
989 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1)
R2755 SX-1h.OTHERS CONSULTED
Section: S Level: Respondent CAI Reference: Q2755
Type: Numeric Width: 1 Decimals: 0
SX-1h.
Were any (other) family members or other persons consulted?
................................................................................
185 1. YES
169 5. NO
5 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
989 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1)
R2756M1 SX-1ha.WHO WAS THIS-1
Section: S Level: Respondent CAI Reference: Q2756
Type: Numeric Width: 2 Decimals: 0
SX-1ha.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
................................................................................
1. DECEASED R
7 2. NON-SPOUSE PROXY RESPONDENT
36 3. SPOUSE
116 4. CHILD/CHILD-IN-LAW/GRANDCHILD
22 5. OTHER RELATIVE
2 6. FRIEND
2 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1163 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1)
R2756M2 SX-1ha.WHO WAS THIS-2
Section: S Level: Respondent CAI Reference: Q2756
Type: Numeric Width: 2 Decimals: 0
SX-1ha.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
................................................................................
1. DECEASED R
1 2. NON-SPOUSE PROXY RESPONDENT
2 3. SPOUSE
23 4. CHILD/CHILD-IN-LAW/GRANDCHILD
8 5. OTHER RELATIVE
6. FRIEND
4 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
1 10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1308 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1)
R2756M3 SX-1ha.WHO WAS THIS-3
Section: S Level: Respondent CAI Reference: Q2756
Type: Numeric Width: 2 Decimals: 0
SX-1ha.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
2 4. CHILD/CHILD-IN-LAW/GRANDCHILD
2 5. OTHER RELATIVE
6. FRIEND
4 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
2 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
1 97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1337 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1)
R2756M4 SX-1ha.WHO WAS THIS-4
Section: S Level: Respondent CAI Reference: Q2756
Type: Numeric Width: 2 Decimals: 0
SX-1ha.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
................................................................................
1. DECEASED R
2 2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
1 9. ATTORNEY
10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1344 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1)
R2756M5 SX-1ha.WHO WAS THIS-5
Section: S Level: Respondent CAI Reference: Q2756
Type: Numeric Width: 2 Decimals: 0
SX-1ha.
Who was this?
CHECK ALL THAT APPLY.
Anyone else?
................................................................................
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
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1)
R2757M1 SX-1j.WHICH CHILD-1
Section: S Level: Respondent CAI Reference: Q2757
Type: Character Width: 3 Decimals: 0
SX-1j.
Which child was that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
70 038. ALL CHILDREN EQUALLY
70 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1208 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1);
[Q2756] IS (NE 4)
R2757M2 SX-1j.WHICH CHILD-2
Section: S Level: Respondent CAI Reference: Q2757
Type: Character Width: 3 Decimals: 0
SX-1j.
Which child was that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
20 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1328 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1);
[Q2756] IS (NE 4)
R2757M3 SX-1j.WHICH CHILD-3
Section: S Level: Respondent CAI Reference: Q2757
Type: Character Width: 3 Decimals: 0
SX-1j.
Which child was that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
7 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1341 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1);
[Q2756] IS (NE 4)
R2757M4 SX-1j.WHICH CHILD-4
Section: S Level: Respondent CAI Reference: Q2757
Type: Character Width: 3 Decimals: 0
SX-1j.
Which child was that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
1 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1347 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1);
[Q2756] IS (NE 4)
R2757M5 SX-1j.WHICH CHILD-5
Section: S Level: Respondent CAI Reference: Q2757
Type: Character Width: 3 Decimals: 0
SX-1j.
Which child was that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
1 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1347 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1);
[Q2756] IS (NE 4)
R2757M6 SX-1j.WHICH CHILD-6
Section: S Level: Respondent CAI Reference: Q2757
Type: Character Width: 3 Decimals: 0
SX-1j.
Which child was that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
1 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1347 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1);
[Q2756] IS (NE 4)
R2757M7 SX-1j.WHICH CHILD-7
Section: S Level: Respondent CAI Reference: Q2757
Type: Character Width: 3 Decimals: 0
SX-1j.
Which child was that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2755] IS (NE 1);
[Q2756] IS (NE 4)
R2759 SX-1k.PROBLEMS WITH WRITTEN
Section: S Level: Respondent CAI Reference: Q2759
Type: Numeric Width: 1 Decimals: 0
SX-1k.
Did any problems come up in trying to follow
these written instructions?
................................................................................
33 1. YES
325 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
989 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2753] IS (NE 1)
R2760 SX-1m.PHYSICIAN FOLLOW WRITTEN
Section: S Level: Respondent CAI Reference: Q2760
Type: Numeric Width: 1 Decimals: 0
SX-1m.
Did the physician or any other health care worker
have problems following the written instructions?
................................................................................
17 1. YES
15 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1315 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2742:SX-1] IS (NE 1); [Q2753] IS (NE 1); [Q2753] IS (NE 1);
[Q2759] IS (NE 1)
R2764 SX-2.MAKE LEGAL ARRANGEMENTS
Section: S Level: Respondent CAI Reference: Q2764
Type: Numeric Width: 1 Decimals: 0
SX-2.
Did
[Q754-CS22Y31.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.
................................................................................
566 1. YES
750 5. NO
28 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18)
R2765M1 SX-2a.WHO AUTHORITY-1
Section: S Level: Respondent CAI Reference: Q2765
Type: Numeric Width: 2 Decimals: 0
SX-2a.
Who had that authority?
................................................................................
1. DECEASED R
39 2. NON-SPOUSE PROXY RESPONDENT
163 3. SPOUSE
290 4. CHILD/CHILD-IN-LAW/GRANDCHILD
54 5. OTHER RELATIVE
14 6. FRIEND
2 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
2 9. ATTORNEY
10. SOCIAL WORKER
97. OTHER (SPECIFY)
2 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
782 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1)
R2765M2 SX-2a.WHO AUTHORITY-2
Section: S Level: Respondent CAI Reference: Q2765
Type: Numeric Width: 2 Decimals: 0
SX-2a.
Who had that authority?
................................................................................
1. DECEASED R
2 2. NON-SPOUSE PROXY RESPONDENT
3 3. SPOUSE
24 4. CHILD/CHILD-IN-LAW/GRANDCHILD
2 5. OTHER RELATIVE
6. FRIEND
7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1317 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1)
R2765M3 SX-2a.WHO AUTHORITY-3
Section: S Level: Respondent CAI Reference: Q2765
Type: Numeric Width: 2 Decimals: 0
SX-2a.
Who had that authority?
................................................................................
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
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1)
R2766M1 SX-2b.WHICH CHILD LEGAL AUTH-1
Section: S Level: Respondent CAI Reference: Q2766
Type: Character Width: 3 Decimals: 0
SX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
5 037. DECEASED CHILD
19 038. ALL CHILDREN EQUALLY
289 041-950. Other Person Number
1 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1034 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1); [Q2765] IS (NE 4)
R2766M2 SX-2b.WHICH CHILD LEGAL AUTH-2
Section: S Level: Respondent CAI Reference: Q2766
Type: Character Width: 3 Decimals: 0
SX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
25 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1323 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1); [Q2765] IS (NE 4)
R2766M3 SX-2b.WHICH CHILD LEGAL AUTH-3
Section: S Level: Respondent CAI Reference: Q2766
Type: Character Width: 3 Decimals: 0
SX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
2 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1346 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1); [Q2765] IS (NE 4)
R2766M4 SX-2b.WHICH CHILD LEGAL AUTH-4
Section: S Level: Respondent CAI Reference: Q2766
Type: Character Width: 3 Decimals: 0
SX-2b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1); [Q2765] IS (NE 4)
R2768 SX-2c.DURABLE P OF ATTORNEY
Section: S Level: Respondent CAI Reference: Q2768
Type: Numeric Width: 2 Decimals: 0
SX-2c.
When was the Durable Power of Attorney for Health Care
made (approximately)?
MONTH:
YEAR:
................................................................................
159 1. JAN
22 2. FEB
18 3. MAR
32 4. APR
16 5. MAY
39 6. JUN
25 7. JUL
19 8. AUG
24 9. SEP
27 10. OCT
12 11. NOV
58 12. DEC
114 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
782 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2764:SX-2] IS (NE 1)
R2769 SX-2c2.YEAR WRITTEN
Section: S Level: Respondent CAI Reference: Q2769
Type: Numeric Width: 4 Decimals: 0
................................................................................
511 1900-2001. Actual Value
55 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
782 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS
(18); [Q2764:SX-2] IS (NE 1)
R2775 SX-3.DISCUSS TREATMENT
Section: S Level: Respondent CAI Reference: Q2775
Type: Numeric Width: 1 Decimals: 0
SX-3.
Did
[Q754-CS22Y31.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?
................................................................................
682 1. YES
654 5. NO
8 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18)
R2776M1 SX-3a.WHO WAS THAT-1
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
1. DECEASED R
58 2. NON-SPOUSE PROXY RESPONDENT
252 3. SPOUSE
294 4. CHILD/CHILD-IN-LAW/GRANDCHILD
43 5. OTHER RELATIVE
19 6. FRIEND
12 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
1 9. ATTORNEY
10. SOCIAL WORKER
2 97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
666 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2776M2 SX-3a.WHO WAS THAT-2
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
1. DECEASED R
4 2. NON-SPOUSE PROXY RESPONDENT
6 3. SPOUSE
61 4. CHILD/CHILD-IN-LAW/GRANDCHILD
10 5. OTHER RELATIVE
8 6. FRIEND
21 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
2 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
4 9. ATTORNEY
10. SOCIAL WORKER
1 97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1231 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2776M3 SX-3a.WHO WAS THAT-3
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
1 3. SPOUSE
3 4. CHILD/CHILD-IN-LAW/GRANDCHILD
5 5. OTHER RELATIVE
2 6. FRIEND
11 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
2 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1324 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2776M4 SX-3a.WHO WAS THAT-4
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
1. DECEASED R
1 2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
4. CHILD/CHILD-IN-LAW/GRANDCHILD
1 5. OTHER RELATIVE
1 6. FRIEND
3 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
1 10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1340 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2776M5 SX-3a.WHO WAS THAT-5
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
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
2 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1346 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2776M6 SX-3a.WHO WAS THAT-6
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
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
1 9. ATTORNEY
10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1347 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2776M7 SX-3a.WHO WAS THAT-7
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
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
1 10. SOCIAL WORKER
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1347 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2776M8 SX-3a.WHO WAS THAT-8
Section: S Level: Respondent CAI Reference: Q2776
Type: Numeric Width: 2 Decimals: 0
SX-3a.
Who was that?
................................................................................
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
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1)
R2777M1 SX-3b.WHICH CHILD-1
Section: S Level: Respondent CAI Reference: Q2777
Type: Character Width: 3 Decimals: 0
SX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
4 037. DECEASED CHILD
99 038. ALL CHILDREN EQUALLY
254 041-950. Other Person Number
1 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
990 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1); [Q2776:SX-3a] IS (NE 4)
R2777M2 SX-3b.WHICH CHILD-2
Section: S Level: Respondent CAI Reference: Q2777
Type: Character Width: 3 Decimals: 0
SX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
1 037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
42 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1305 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1); [Q2776:SX-3a] IS (NE 4)
R2777M3 SX-3b.WHICH CHILD-3
Section: S Level: Respondent CAI Reference: Q2777
Type: Character Width: 3 Decimals: 0
SX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
7 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1341 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1); [Q2776:SX-3a] IS (NE 4)
R2777M4 SX-3b.WHICH CHILD-4
Section: S Level: Respondent CAI Reference: Q2777
Type: Character Width: 3 Decimals: 0
SX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
1 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1347 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1); [Q2776:SX-3a] IS (NE 4)
R2777M5 SX-3b.WHICH CHILD-5
Section: S Level: Respondent CAI Reference: Q2777
Type: Character Width: 3 Decimals: 0
SX-3b.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2775:SX-3] IS (NE 1); [Q2776:SX-3a] IS (NE 4)
R2781 SX-4.DECISIONS NECESSARY
Section: S Level: Respondent CAI Reference: Q2781
Type: Numeric Width: 1 Decimals: 0
SX-4.
Did any decisions have to be made about the care and
treatment of
[Q754-CS22Y31.R FIRST NAME] during the final days of
(his/her) life?
................................................................................
489 1. YES
846 5. NO
9 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18)
R2782M1 SX-5.WHO MADE DECISIONS-1
Section: S Level: Respondent CAI Reference: Q2782
Type: Numeric Width: 2 Decimals: 0
SX-5.
Who was actually involved in making decisions about
the care and treatment of
[Q754-CS22Y31.R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
................................................................................
33 1. DECEASED R
33 2. NON-SPOUSE PROXY RESPONDENT
141 3. SPOUSE
212 4. CHILD/CHILD-IN-LAW/GRANDCHILD
39 5. OTHER RELATIVE
4 6. FRIEND
18 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
1 9. ATTORNEY
10. SOCIAL WORKER
7 97. OTHER PERSON NOT ON LIST
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
859 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2782M2 SX-5.WHO MADE DECISIONS-2
Section: S Level: Respondent CAI Reference: Q2782
Type: Numeric Width: 2 Decimals: 0
SX-5.
Who was actually involved in making decisions about
the care and treatment of
[Q754-CS22Y31.R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
................................................................................
7 1. DECEASED R
4 2. NON-SPOUSE PROXY RESPONDENT
18 3. SPOUSE
62 4. CHILD/CHILD-IN-LAW/GRANDCHILD
12 5. OTHER RELATIVE
3 6. FRIEND
52 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
1 9. ATTORNEY
10. SOCIAL WORKER
1 97. OTHER PERSON NOT ON LIST
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1187 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2782M3 SX-5.WHO MADE DECISIONS-3
Section: S Level: Respondent CAI Reference: Q2782
Type: Numeric Width: 2 Decimals: 0
SX-5.
Who was actually involved in making decisions about
the care and treatment of
[Q754-CS22Y31.R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
................................................................................
1 1. DECEASED R
1 2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
7 4. CHILD/CHILD-IN-LAW/GRANDCHILD
7 5. OTHER RELATIVE
6. FRIEND
17 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
1 10. SOCIAL WORKER
2 97. OTHER PERSON NOT ON LIST
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1311 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2782M4 SX-5.WHO MADE DECISIONS-4
Section: S Level: Respondent CAI Reference: Q2782
Type: Numeric Width: 2 Decimals: 0
SX-5.
Who was actually involved in making decisions about
the care and treatment of
[Q754-CS22Y31.R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
................................................................................
1. DECEASED R
2. NON-SPOUSE PROXY RESPONDENT
3. SPOUSE
2 4. CHILD/CHILD-IN-LAW/GRANDCHILD
5. OTHER RELATIVE
6. FRIEND
2 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
1 8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
1 97. OTHER PERSON NOT ON LIST
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1342 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2782M5 SX-5.WHO MADE DECISIONS-5
Section: S Level: Respondent CAI Reference: Q2782
Type: Numeric Width: 2 Decimals: 0
SX-5.
Who was actually involved in making decisions about
the care and treatment of
[Q754-CS22Y31.R FIRST NAME] during the final days
of (his/her) life?
(Who else participated?)
................................................................................
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
97. OTHER PERSON NOT ON LIST
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2783 SX-5y1.OTHER PERSON
Section: S Level: Respondent CAI Reference: Q2783
Type: Numeric Width: 1 Decimals: 0
SX-5y1.
(Who was the "OTHER PERSON NOT ON LIST"?)
................................................................................
2 1. Hospital staff
4 2. Hospice staff
1 3. Nursing home staff
3 4. Other relative: nephew, granddaughter
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1338 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 97)
R2784M1 SX-5a.WHICH CHILD-1
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
277 041-950. Other Person Number
5 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1066 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M2 SX-5a.WHICH CHILD-2
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
115 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1233 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M3 SX-5a.WHICH CHILD-3
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
60 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1288 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M4 SX-5a.WHICH CHILD-4
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
30 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1318 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M5 SX-5a.WHICH CHILD-5
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
21 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1327 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M6 SX-5a.WHICH CHILD-6
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
12 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1336 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M7 SX-5a.WHICH CHILD-7
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
3 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1345 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M8 SX-5a.WHICH CHILD-8
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
1 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1347 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2784M9 SX-5a.WHICH CHILD-9
Section: S Level: Respondent CAI Reference: Q2784
Type: Character Width: 3 Decimals: 0
SX-5a.
Which child is that?
CHOOSE ALL THAT APPLY
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (NE 4)
R2785 SX-5b.R ABLE MEDICAL DECIDE
Section: S Level: Respondent CAI Reference: Q2785
Type: Numeric Width: 1 Decimals: 0
SX-5b.
Was
[Q754-CS22Y31.R FIRST NAME] able to participate in decisions
about (his/her) medical care during the final days
of (his/her) life?
................................................................................
134 1. YES
312 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
900 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2782:SX-5] IS (1)
R2786 SX-5c.HOW LONG R DECIDE BEFORE DYING
Section: S Level: Respondent CAI Reference: Q2786
Type: Numeric Width: 2 Decimals: 0
SX-5c.
For about how long before
[Q754-CS22Y31.R FIRST NAME] died was
(he/she) unable to participate in decisions about (his/her)
medical care?
# MONTHS:
# DAYS:
# YEARS:
................................................................................
102 0-96. Actual Value
4 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1242 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS
(18); [Q2781:SX-4] IS (NE 1); [Q2785:SX-5b] IS (NE 5)
R2787 SX-5c1.DAYS BEFORE DEATH
Section: S Level: Respondent CAI Reference: Q2787
Type: Numeric Width: 3 Decimals: 0
................................................................................
149 0-100. Actual Value
2 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1197 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS
(18); [Q2781:SX-4] IS (NE 1); [Q2785:SX-5b] IS (NE
5); [Q2786] IS (1-96)
R2788 SX-5c2.YEARS BEFORE DEATH
Section: S Level: Respondent CAI Reference: Q2788
Type: Numeric Width: 3 Decimals: 0
................................................................................
59 1-100. Actual Value
8 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1281 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS
(18); [Q2781:SX-4] IS (NE 1); [Q2785:SX-5b] IS (NE
5); [Q2786] IS (1-96); [Q2787:SX-5c1] IS (1-100)
ASSIGNMENT STATEMENTS
* if [Q0] IS (0 OR 1) AND [Q2785:SX-5b] IS (NE 1) then [R2793.SX-6.MAIN
DECISION MAKER] = calculation: (2782U(13,5/10,97)=)+(2784U(1/20)=)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2793 SX-6.MAIN DECISION MAKER
Section: S Level: Respondent CAI Reference: Q2793
Type: Numeric Width: 2 Decimals: 0
SX-6.
Who was the main decision-maker?
................................................................................
85 1. DECEASED R
12 2. NON-SPOUSE PROXY RESPONDENT
63 3. SPOUSE
101 4. CHILD/CHILD-IN-LAW/GRANDCHILD
10 5. OTHER RELATIVE
6. FRIEND
12 7. PHYSICIAN/HEALTHCARE PROFESSIONAL
8. MINISTER/RABBI/PRIEST/RELIGIOUS ADVISOR
9. ATTORNEY
10. SOCIAL WORKER
1 97. OTHER PERSON NOT ON LIST
4 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1060 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) then [R2794.SX-6b.WHICH CHILD-1] = 2784U(120)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2794M1 SX-6b.WHICH CHILD-1
Section: S Level: Respondent CAI Reference: Q2794
Type: Character Width: 3 Decimals: 0
SX-6b.
Which child is that?
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
66 041-950. Other Person Number
1 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1281 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2793:SX-6] IS (NE 4)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) then [R2794.SX-6b.WHICH CHILD-2] = 2784U(120)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2794M2 SX-6b.WHICH CHILD-2
Section: S Level: Respondent CAI Reference: Q2794
Type: Character Width: 3 Decimals: 0
SX-6b.
Which child is that?
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
24 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1324 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2793:SX-6] IS (NE 4)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) then [R2794.SX-6b.WHICH CHILD-3] = 2784U(120)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2794M3 SX-6b.WHICH CHILD-3
Section: S Level: Respondent CAI Reference: Q2794
Type: Character Width: 3 Decimals: 0
SX-6b.
Which child is that?
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
7 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1341 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2793:SX-6] IS (NE 4)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) then [R2794.SX-6b.WHICH CHILD-4] = 2784U(120)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2794M4 SX-6b.WHICH CHILD-4
Section: S Level: Respondent CAI Reference: Q2794
Type: Character Width: 3 Decimals: 0
SX-6b.
Which child is that?
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
3 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1345 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2793:SX-6] IS (NE 4)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) then [R2794.SX-6b.WHICH CHILD-5] = 2784U(120)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2794M5 SX-6b.WHICH CHILD-5
Section: S Level: Respondent CAI Reference: Q2794
Type: Character Width: 3 Decimals: 0
SX-6b.
Which child is that?
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
2 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1346 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2793:SX-6] IS (NE 4)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) then [R2794.SX-6b.WHICH CHILD-6] = 2784U(120)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2794M6 SX-6b.WHICH CHILD-6
Section: S Level: Respondent CAI Reference: Q2794
Type: Character Width: 3 Decimals: 0
SX-6b.
Which child is that?
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
2 041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1346 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2793:SX-6] IS (NE 4)
ASSIGNMENT STATEMENTS
* if [Q0] IS (1) then [R2794.SX-6b.WHICH CHILD-7] = 2784U(120)=
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2794M7 SX-6b.WHICH CHILD-7
Section: S Level: Respondent CAI Reference: Q2794
Type: Character Width: 3 Decimals: 0
SX-6b.
Which child is that?
................................................................................
037. DECEASED CHILD
038. ALL CHILDREN EQUALLY
041-950. Other Person Number
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1348 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2793:SX-6] IS (NE 4)
ASSIGNMENT STATEMENTS
* Jump from R2794 [SX-6b.WHICH CHILD-1] when [Q0] IS
(1)
* Jump from R2793 [SX-6.MAIN DECISION MAKER] when [Q0] IS
(0 OR 1) AND [Q2785:SX-5b] IS (NE 1)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
R2796 SX-7a.UNCONDITION PROLONG
Section: S Level: Respondent CAI Reference: Q2796
Type: Numeric Width: 1 Decimals: 0
SX-7a.
Did those last decisions involve a desire to give all
care possible unconditionally in order to prolong life?
................................................................................
105 1. YES
379 5. NO
5 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
859 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2797 SX-7b.LIMIT CARE CERTAIN COND
Section: S Level: Respondent CAI Reference: Q2797
Type: Numeric Width: 1 Decimals: 0
SX-7b.
Did those last decisions involve limiting care in
certain situations?
................................................................................
344 1. YES
138 5. NO
7 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
859 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2798 SX-7c.LIMIT CARE WITHHOLD TREATMENT
Section: S Level: Respondent CAI Reference: Q2798
Type: Numeric Width: 1 Decimals: 0
SX-7c.
Did those last decisions involve withholding any treatment?
................................................................................
301 1. YES
185 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
859 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2799 SX-7d.LIMIT CARE KEEP COMFORTABLE
Section: S Level: Respondent CAI Reference: Q2799
Type: Numeric Width: 1 Decimals: 0
SX-7d.
Did those last decisions rest largely on keeping
[Q754-CS22Y31.R FIRST NAME]
comfortable and pain free without taking extensive
measures to prolong life?
................................................................................
448 1. YES
32 5. NO
9 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
859 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2803 SX-8.REFUSED CARE TREATMENT
Section: S Level: Respondent CAI Reference: Q2803
Type: Numeric Width: 1 Decimals: 0
SX-8.
Did any doctor(s) recommend any care or treatment that
the family or other decision-maker(s) ultimately refused?
................................................................................
75 1. YES
409 5. NO
5 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
859 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1)
R2804 SX-8a.RECEIVE TREATMENT ANYWAY
Section: S Level: Respondent CAI Reference: Q2804
Type: Numeric Width: 1 Decimals: 0
SX-8a.
Did
[Q754-CS22Y31.R FIRST NAME] receive this treatment anyway?
................................................................................
6 1. YES
69 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1273 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2803] IS (NE 1)
R2805 SX-9.COST ENTER DECISION
Section: S Level: Respondent CAI Reference: Q2805
Type: Numeric Width: 1 Decimals: 0
SX-9.
Did cost enter into the decisions about what care or
treatment (he/she) would receive in the final days
of (his/her) life?
................................................................................
8 1. YES
181 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1159 Blank. INAP (Inapplicable): [Q2311] IS (18); [Q2581] IS (18);
[Q2781:SX-4] IS (NE 1); [Q2754] IS (NE 1) AND [Q2765] IS (NE 2)
AND [Q2776:SX-3a] IS (NE 2) AND [Q2782:SX-5] IS (NE 2) AND
[Q2793:SX-6] IS (NE 2)
RVERSION 2000 EXIT FINAL RELEASE VERSION NUMBER
Section: S Level: Respondent CAI Reference: Q9007
Type: Numeric Width: 1 Decimals: 0
................................................................................
1348 1. First Data Release
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