==========================================================================================
Section CG: INFORMANT CAREGIVING QUESTIONNAIRE - FOLLOW-UP VISIT (Respondent)
==========================================================================================
HHID HRS HOUSEHOLD IDENTIFIER
Section: CG Level: Respondent Type: Character Width: 6 Decimals: 0
This variable uniquely identifies an original HRS household across waves.
.................................................................................
240 010059-213467. Household Identification Number
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PN HRS PERSON NUMBER IDENTIFIER
Section: CG Level: Respondent Type: Character Width: 3 Decimals: 0
Each HRS respondent has a Person Number, PN, unique within an original
household. In combination, HHID and PN uniquely identify a respondent across
all waves of the study.
.................................................................................
144 010. Person Number
4 011. Person Number
59 020. Person Number
021. Person Number
16 030. Person Number
16 040. Person Number
1 041. Person Number
Blank. Item left blank
==========================================================================================
ADAMSSID ADAMS SUBJECT IDENTIFIER
Section: CG Level: Respondent Type: Character Width: 5 Decimals: 0
This variable identifies an ADAMS subject in the ADAMS data files.
.................................................................................
240 00021-21271. ADAMS Subject Identification Number
==========================================================================================
CGQ1A SAME INFORMANT AS LAST VISIT
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q1A
Category: INFORMANT QUESTIONNAIRE
1A. Were you the person who participated in the ADAMS visit last time we met
with your friend or relative?
.................................................................................
168 1. Yes
48 5. No
5 8. Not Sure
19 Blank. Item left blank
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CGQ1 WATCH TV OR NEWS PROGRAM
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q1
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
When you see the words "friend or relative" used in this questionnaire, please
think only about the person being visited today.
To begin, we have some questions about activities that your friend or relative
might do. Please check the one response per question that fits best.
1. How often does your friend or relative watch a TV show or news program?
.................................................................................
217 1. Daily or almost daily
9 2. Several times a month
3. Several times a year
9 4. Rarely or never
8. DK (Don't Know)
5 Blank. Item left blank
==========================================================================================
CGQ2 LISTEN TO RADIO PROGRAM
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q2
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
2. How often does your friend or relative listen to a program on the radio?
.................................................................................
86 1. Daily or almost daily
36 2. Several times a month
17 3. Several times a year
90 4. Rarely or never
2 8. DK (Don't Know)
9 Blank. Item left blank
==========================================================================================
CGQ3 READ NEWSPAPER/MAGAZINE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q3
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
3. How often does your friend or relative read a newspaper or magazine?
.................................................................................
156 1. Daily or almost daily
31 2. Several times a month
6 3. Several times a year
39 4. Rarely or never
8. DK (Don't Know)
8 Blank. Item left blank
==========================================================================================
CGQ4 READ A BOOK
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q4
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
4. How often does your friend or relative read a book?
.................................................................................
75 1. Daily or almost daily
34 2. Several times a month
31 3. Several times a year
89 4. Rarely or never
1 8. DK (Don't Know)
10 Blank. Item left blank
==========================================================================================
CGQ5 PLAY BOARD OR CARD GAMES
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q5
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
5. How often does your friend or relative play board or card games?
.................................................................................
30 1. Daily or almost daily
31 2. Several times a month
34 3. Several times a year
138 4. Rarely or never
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ6 DO JIGSAW OR CROSSWORD PUZZLES
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q6
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
6. How often does your friend or relative do jigsaw puzzles or crossword
puzzles?
.................................................................................
38 1. Daily or almost daily
17 2. Several times a month
16 3. Several times a year
162 4. Rarely or never
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ7 DO ARTS AND CRAFTS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q7
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
7. How often does your friend or relative do arts and crafts?
.................................................................................
17 1. Daily or almost daily
18 2. Several times a month
28 3. Several times a year
170 4. Rarely or never
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ8 WRITE LETTERS OR CARDS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q8
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
8. How often does your friend or relative write letters or cards?
.................................................................................
13 1. Daily or almost daily
53 2. Several times a month
75 3. Several times a year
93 4. Rarely or never
8. DK (Don't Know)
6 Blank. Item left blank
==========================================================================================
CGQ9 USE A COMPUTER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q9
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
9. How often does your friend or relative use a computer?
.................................................................................
48 1. Daily or almost daily
11 2. Several times a month
2 3. Several times a year
170 4. Rarely or never
8. DK (Don't Know)
9 Blank. Item left blank
==========================================================================================
CGQ10 DISCUSS CURRENT EVENTS OR TOPIC
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q10
Category: INFORMANT QUESTIONNAIRE
Measure: ACTIVITIES
10. How often does your friend or relative discuss current events or topics of
general interest?
.................................................................................
150 1. Daily or almost daily
52 2. Several times a month
15 3. Several times a year
15 4. Rarely or never
8. DK (Don't Know)
8 Blank. Item left blank
==========================================================================================
CGQ11 OVERALL MEMORY RATING
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q11
Category: INFORMANT QUESTIONNAIRE
Measure: MEMORY
11. How would you rate your friend or relative's memory at the present time?
.................................................................................
40 1. Excellent
84 2. Very Good
68 3. Good
31 4. Fair
7 5. Poor
8. DK (Don't Know)
10 Blank. Item left blank
==========================================================================================
CGQ12 ABILITY TO MAKE JUDGMENTS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q12
Category: INFORMANT QUESTIONNAIRE
Measure: JUDGMENT
12. How would you rate your friend or relative in making judgments and
decisions?
.................................................................................
54 1. Excellent
83 2. Very Good
57 3. Good
28 4. Fair
8 5. Poor
8. DK (Don't Know)
10 Blank. Item left blank
==========================================================================================
CGQ13 ABILITY TO ORGANIZE ACTIVITIES
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q13
Category: INFORMANT QUESTIONNAIRE
Measure: ORGANIZATION
13. How would you rate your friend or relative's ability to organize his/her
daily activities?
.................................................................................
65 1. Excellent
87 2. Very Good
47 3. Good
23 4. Fair
8 5. Poor
8. DK (Don't Know)
10 Blank. Item left blank
==========================================================================================
CGQ14 REMEMBERING THINGS ABOUT FAMILY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q14
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
Now we want you to remember what your friend or relative was like two years ago
and to compare that with what he/she is like now. Below are situations where
your friend or relative has to use his/her memory or intelligence, and we would
like you to indicate whether this has improved, stayed the same, or gotten worse
in each situation over the past two years. Note the importance of comparing
his/her present performance with two years ago. So if two years ago your friend
or relative always forgot where things were left, and he/she still does, then
this would be considered "not much change."
14. Compared with two years ago, how is your friend or relative at remembering
things about family and friends, such as occupations, birthdays and addresses?
.................................................................................
9 1. Much better
8 2. A bit better
176 3. Not much change
29 4. A bit worse
8 5. Much worse
8. DK (Don't Know)
10 Blank. Item left blank
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CGQ15 REMEMBERING RECENT EVENTS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q15
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
15. Compared with two years ago, how is your friend or relative at remembering
things that have happened recently?
.................................................................................
8 1. Much better
13 2. A bit better
167 3. Not much change
32 4. A bit worse
10 5. Much worse
8. DK (Don't Know)
10 Blank. Item left blank
==========================================================================================
CGQ16 RECALLING CONVERSATIONS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q16
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
16. Compared with two years ago, how is your friend or relative at recalling
conversations a few days later?
.................................................................................
6 1. Much better
9 2. A bit better
159 3. Not much change
49 4. A bit worse
7 5. Much worse
8. DK (Don't Know)
10 Blank. Item left blank
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CGQ17 REMEMBERING ADDRESS/PHONE NUMBER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q17
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
17. Compared with two years ago, how is your friend or relative at remembering
his/her address or phone number?
.................................................................................
11 1. Much better
5 2. A bit better
192 3. Not much change
21 4. A bit worse
4 5. Much worse
8. DK (Don't Know)
7 Blank. Item left blank
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CGQ18 REMEMBERING DATE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q18
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
18. Compared with two years ago, how is your friend or relative at remembering
what day and month it is?
.................................................................................
9 1. Much better
6 2. A bit better
186 3. Not much change
25 4. A bit worse
7 5. Much worse
8. DK (Don't Know)
7 Blank. Item left blank
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CGQ19 REMEMBERING WHERE THINGS ARE KEPT
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q19
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
19. Compared with two years ago, how is your friend or relative at remembering
where things are usually kept?
.................................................................................
8 1. Much better
8 2. A bit better
164 3. Not much change
46 4. A bit worse
6 5. Much worse
8. DK (Don't Know)
8 Blank. Item left blank
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CGQ20 REMEMBERING WHERE TO FIND THINGS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q20
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
20. Compared with two years ago, how is your friend or relative at remembering
where to find things that have been put in a different place than usual?
.................................................................................
6 1. Much better
9 2. A bit better
141 3. Not much change
69 4. A bit worse
7 5. Much worse
8. DK (Don't Know)
8 Blank. Item left blank
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CGQ21 KNOWING HOW TO WORK FAMILIAR THINGS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q21
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
21. Compared with two years ago, how is your friend or relative at knowing how
to work familiar machines around the house?
.................................................................................
11 1. Much better
8 2. A bit better
191 3. Not much change
14 4. A bit worse
6 5. Much worse
2 7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
8 Blank. Item left blank
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CGQ22 LEARNING TO USE A NEW GADGETS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q22
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
22. Compared with two years ago, how is your friend or relative at learning to
use a new gadget or machine around the house?
.................................................................................
10 1. Much better
10 2. A bit better
152 3. Not much change
48 4. A bit worse
11 5. Much worse
1 7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
8 Blank. Item left blank
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CGQ23 LEARNING NEW THINGS IN GENERAL
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q23
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
23. Compared with two years ago, how is your friend or relative at learning new
things in general?
.................................................................................
10 1. Much better
14 2. A bit better
145 3. Not much change
53 4. A bit worse
8 5. Much worse
1 7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
9 Blank. Item left blank
==========================================================================================
CGQ24 FOLLOWING A STORY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q24
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
24. Compared with two years ago, how is your friend or relative at following a
story in a book or on TV?
.................................................................................
13 1. Much better
6 2. A bit better
189 3. Not much change
22 4. A bit worse
4 5. Much worse
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
6 Blank. Item left blank
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CGQ25 MAKING EVERYDAY DECISIONS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q25
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
25. Compared with two years ago, how is your friend or relative at making
decisions on everyday matters?
.................................................................................
13 1. Much better
9 2. A bit better
180 3. Not much change
24 4. A bit worse
7 5. Much worse
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
7 Blank. Item left blank
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CGQ26 HANDLING MONEY FOR SHOPPING
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q26
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
26. Compared with two years ago, how is your friend or relative at handling
money for shopping?
.................................................................................
14 1. Much better
9 2. A bit better
184 3. Not much change
18 4. A bit worse
7 5. Much worse
1 7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
7 Blank. Item left blank
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CGQ27 HANDLING FINANCIAL MATTERS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q27
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
27. Compared with two years ago, how is your friend or relative at handling
financial matters, that is, the pension or dealing with the bank?
.................................................................................
12 1. Much better
12 2. A bit better
175 3. Not much change
21 4. A bit worse
10 5. Much worse
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
10 Blank. Item left blank
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CGQ28 EVERYDAY ARITHMETIC PROBLEMS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q28
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
28. Compared with two years ago, how is your friend or relative at handling
other everyday arithmetic problems, such as, knowing how much food to buy,
knowing how long between visits from family or friends?
.................................................................................
11 1. Much better
8 2. A bit better
177 3. Not much change
22 4. A bit worse
12 5. Much worse
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
10 Blank. Item left blank
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CGQ29 INTELLIGENCE FOR REASONING
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q29
Category: INFORMANT QUESTIONNAIRE
Measure: IQCODE
29. Compared with two years ago, how is your friend or relative at using his/her
intelligence to understand what's going on and to reason things through?
.................................................................................
13 1. Much better
13 2. A bit better
173 3. Not much change
26 4. A bit worse
8 5. Much worse
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
7 Blank. Item left blank
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CGQ30A ADL: GETTING ACROSS A ROOM
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C1
Category: INFORMANT QUESTIONNAIRE
Measure: ADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
A. Getting across a room
.................................................................................
51 1. Yes
181 5. No
8. DK (Don't Know)
8 Blank. Item left blank
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CGQ30B ADL: DRESSING
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C2
Category: INFORMANT QUESTIONNAIRE
Measure: ADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
B. Dressing
.................................................................................
42 1. Yes
191 5. No
8. DK (Don't Know)
7 Blank. Item left blank
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CGQ30C ADL: BATHING
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C3
Category: INFORMANT QUESTIONNAIRE
Measure: ADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
C. Bathing
.................................................................................
43 1. Yes
189 5. No
8. DK (Don't Know)
8 Blank. Item left blank
==========================================================================================
CGQ30D ADL: EATING
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C4
Category: INFORMANT QUESTIONNAIRE
Measure: ADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
D. Eating
.................................................................................
19 1. Yes
212 5. No
8. DK (Don't Know)
9 Blank. Item left blank
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CGQ30E ADL: GETTING OUT OF BED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C5
Category: INFORMANT QUESTIONNAIRE
Measure: ADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
E. Getting out of bed
.................................................................................
38 1. Yes
194 5. No
8. DK (Don't Know)
8 Blank. Item left blank
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CGQ30F ADL: USING THE TOILET
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C6
Category: INFORMANT QUESTIONNAIRE
Measure: ADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
F. Using the toilet
.................................................................................
32 1. Yes
198 5. No
8. DK (Don't Know)
10 Blank. Item left blank
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CGQ30G IADL: PREPARING A MEAL
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C7
Category: INFORMANT QUESTIONNAIRE
Measure: IADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
G. Preparing meals
.................................................................................
48 1. Yes
179 5. No
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
13 Blank. Item left blank
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CGQ30H IADL: SHOPPING FOR GROCERIES
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C8
Category: INFORMANT QUESTIONNAIRE
Measure: IADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
H. Shopping for groceries
.................................................................................
52 1. Yes
176 5. No
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
12 Blank. Item left blank
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CGQ30I IADL: MAKING TELEPHONE CALLS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C9
Category: INFORMANT QUESTIONNAIRE
Measure: IADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
I. Making telephone calls
.................................................................................
38 1. Yes
194 5. No
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
8 Blank. Item left blank
==========================================================================================
CGQ30J IADL: TAKING MEDICATION
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C10
Category: INFORMANT QUESTIONNAIRE
Measure: IADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
J. Taking medications
.................................................................................
36 1. Yes
197 5. No
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ30K IADL: MANAGING MONEY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q30_C11
Category: INFORMANT QUESTIONNAIRE
Measure: IADLs
Now we would like you to think about any difficulties your friend or relative
may have.
30. Does your friend or relative have any difficulty with the following because
of a physical, mental, emotional, or memory problem?
K. Managing money
.................................................................................
33 1. Yes
200 5. No
7. Inapplicable (e.g., "doesn't do" or "cannot do")
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ31 NEED TO WATCH/SUPERVISE SUBJECT
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q31
Category: INFORMANT QUESTIONNAIRE
Measure: SUPERVISION
31. Does your friend or relative need to be watched over or supervised to ensure
his/her personal safety or the safety of others?
.................................................................................
24 1. Yes
210 5. No
8. DK (Don't Know)
6 Blank. Item left blank
==========================================================================================
CGQ32 NEED TO STAY WITH SUBJECT
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q32
Category: INFORMANT QUESTIONNAIRE
Measure: SUPERVISION
32. Must someone stay with him/her to provide reassurance or to make sure that
nothing goes wrong?
.................................................................................
27 1. Yes
207 5. No
8. DK (Don't Know)
6 Blank. Item left blank
==========================================================================================
CGQ33 ARE YOU A CARE PROVIDER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q33
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
*IF ALL ANSWERS TO QUESTIONS 30_C1 THROUGH 32 ARE "NO," SKIP TO QUESTION 69
We are interested in learning about two types of care that people may provide to
individuals with a health or memory problem. In the questions below, "active
help" means tasks that you might perform such as helping your friend or relative
get across a room, cooking meals for him/her, or helping him/her with financial
matters. The other type of care, "supervision," means staying nearby your
friend or relative to ensure his/her safety, to provide reassurance, or to make
sure that nothing goes wrong.
33. In the past month, have you provided care to your friend or relative by
actively helping with any of the tasks in Question 30 or by supervising him/her
to ensure safety, provide reassurance, or to make sure that nothing goes wrong?
USER NOTE: QUESTIONS IN THIS SECTION ARE BASED ON A SELF-REPORT QUESTIONNAIRE
BY THE INFORMANT. PLEASE BE ADVISED THAT SOME RESPONDENTS ANSWERED QUESTIONS
THAT MAY NOT BE APPLICABLE TO THEM BUT THEIR DATA WERE RETAINED. PLEASE REFER
TO THE QUESTIONNAIRE FOR INTENDED SKIP PATTERNS.
.................................................................................
52 1. Yes (Go to Question 34)
67 5. No (Skip to Question 62)
101 6. Skipped (Not applicable)
8. DK (Don't Know)
20 Blank. Item left blank
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CGQ34 PERSON MOST RESPONSIBLE FOR CARE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q34
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
34. Are you the person most responsible for the care of your friend or relative?
.................................................................................
50 1. Yes (Go to Question 35)
23 5. No (Skip to Question 36)
150 6. Skipped (Not applicable)
8. DK (Don't Know)
17 Blank. Item left blank
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CGQ35 OTHER CARE PROVIDER AVAILABLE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q35
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
35. If you were unable to provide this care for a week or so, (for example, due
to illness), is there someone who would care for your friend or relative?
This question should have been skipped if the answer to Question 34 was "No"
(5).
.................................................................................
53 1. Yes
8 5. No
165 6. Skipped (Not applicable)
8. DK (Don't Know)
14 Blank. Item left blank
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CGQ36 DAYS HELPED DURING LAST MONTH
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q36
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
36. During the last month, on about how many days did you provide active help to
your friend or relative because of his/her health or memory problem?
If answer is "0 days" then skip to Question 39.
.................................................................................
60 0-31. Days
161 97. Skipped (Not applicable)
98. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ37 HOURS PER DAY HELPED
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q37
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
37. On the days you did this, about how many hours per day was that?
.................................................................................
45 1-24. Hours
173 97. Skipped (Not applicable)
98. DK (Don't Know)
22 Blank. Item left blank
==========================================================================================
CGQ38 LENGTH OF TIME HELPED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q38
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
38. How long have you been providing this level of active help?
.................................................................................
2 1. Less than 1 month
9 2. Between 1 and 6 months
8 3. Between 6 months and 1 year
11 4. Between 1 and 2 years
25 5. More than 2 years
167 7. Skipped (Not applicable)
8. DK (Don't Know)
18 Blank. Item left blank
==========================================================================================
CGQ39 DAYS OF SUPERVISION IN LAST MONTH
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q39
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
39. During the last month, on about how many days did you supervise your friend
or relative to ensure safety, provide reassurance, or to make sure that nothing
went wrong?
If answer is "0 days" then skip to Question 42.
.................................................................................
61 0-31. Days
159 97. Skipped (Not applicable)
98. DK (Don't Know)
20 Blank. Item left blank
==========================================================================================
CGQ40 HOURS PER DAY SUPERVISED
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q40
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
40. On the days you did this, about how many hours per day was that?
.................................................................................
33 1-24. Hours
186 97. Skipped (Not applicable)
98. DK (Don't Know)
21 Blank. Item left blank
==========================================================================================
CGQ41 LENGTH OF TIME SUPERVISED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q41
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
41. How long have you been providing this level of supervision?
.................................................................................
4 1. Less than 1 month
5 2. Between 1 and 6 months
7 3. Between 6 months and 1 year
7 4. Between 1 and 2 years
14 5. More than 2 years
184 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ42 PHYSICAL STRAIN: ADLS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q42
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING STRAIN
42. How much of a physical strain is it on you to help your friend or relative
with any of the following activities: getting across a room, dressing, bathing,
eating, getting out of bed, or using the toilet?
.................................................................................
39 1. No physical strain
10 2. Some physical strain
4 3. A lot of physical strain
21 6. I don't help with any of these
117 7. Skipped (Not applicable)
8. DK (Don't Know)
49 Blank. Item left blank
==========================================================================================
CGQ43 PHYSICAL STRAIN: IADLS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q43
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING STRAIN
43. How much of a physical strain is it on you to help your friend or relative
with any of the following activities: preparing meals, shopping for groceries,
making telephone calls, taking medications, or managing money?
.................................................................................
52 1. No physical strain
10 2. Some physical strain
2 3. A lot of physical strain
15 6. I don't help with any of these
114 7. Skipped (Not applicable)
8. DK (Don't Know)
47 Blank. Item left blank
==========================================================================================
CGQ44 PHYSICAL STRAIN: SUPERVISION
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q44
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING STRAIN
44. How much of a physical strain is it on you to stay with or supervise your
friend or relative?
.................................................................................
52 1. No physical strain
13 2. Some physical strain
1 3. A lot of physical strain
13 6. I don't help with any of these
114 7. Skipped (Not applicable)
8. DK (Don't Know)
47 Blank. Item left blank
==========================================================================================
CGQ45 MENTAL/EMOTIONAL STRAIN: ADLS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q45
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING STRAIN
45. How much of a mental or emotional strain is it on you to help your friend or
relative with any of the following activities -- either directly by doing it
yourself, or indirectly by arranging for someone else to do it: getting across a
room, dressing, bathing, eating, getting out of bed, or using the toilet?
.................................................................................
41 1. No mental or emotional strain
14 2. Some mental or emotional strain
4 3. A lot of mental or emotional strain
18 6. I don't help with any of these
114 7. Skipped (Not applicable)
8. DK (Don't Know)
49 Blank. Item left blank
==========================================================================================
CGQ46 MENTAL/EMOTIONAL STRAIN: IADLS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q46
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING STRAIN
46. How much of a mental or emotional strain is it on you to help your friend or
relative with any of the following activities - either directly by doing it
yourself, or indirectly by arranging for someone else to do it: preparing meals,
shopping for groceries, making telephone calls, taking medications, managing
money?
.................................................................................
45 1. No mental or emotional strain
16 2. Some mental or emotional strain
5 3. A lot of mental or emotional strain
12 6. I don't help with any of these
115 7. Skipped (Not applicable)
8. DK (Don't Know)
47 Blank. Item left blank
==========================================================================================
CGQ47 MENTAL/EMOT STRAIN: SUPERVISON
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q47
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING STRAIN
47. How much of a mental or emotional strain is it on you to stay with or
supervise your friend or relative - either directly by doing it yourself or
indirectly by arranging for someone else to do it?
.................................................................................
46 1. No mental or emotional strain
15 2. Some mental or emotional strain
3 3. A lot of mental or emotional strain
12 6. I don't help with any of these
116 7. Skipped (Not applicable)
8. DK (Don't Know)
48 Blank. Item left blank
==========================================================================================
CGQ48 FEEL USEFUL
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q48
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING BENEFITS
Now we have a few questions about your feelings about providing care for your
friend or relative because of his/her health, mental, emotional, or memory
problem.
48. Has providing care made you feel more useful?
.................................................................................
53 1. Yes
18 5. No
118 7. Skipped (Not applicable)
1 8. DK (Don't Know)
50 Blank. Item left blank
==========================================================================================
CGQ49 FEEL CLOSER TO FRIEND/RELATIVE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q49
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING BENEFITS
49. Has providing care made you feel closer to your friend or relative?
.................................................................................
56 1. Yes
15 5. No
118 7. Skipped (Not applicable)
8. DK (Don't Know)
51 Blank. Item left blank
==========================================================================================
CGQ50 FEEL GOOD ABOUT YOURSELF
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q50
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING BENEFITS
50. Has providing care made you feel good about yourself?
.................................................................................
61 1. Yes
10 5. No
118 7. Skipped (Not applicable)
8. DK (Don't Know)
51 Blank. Item left blank
==========================================================================================
CGQ51 LEARN NEW SKILLS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q51
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING BENEFITS
51. Has providing care allowed you to learn new skills?
.................................................................................
43 1. Yes
28 5. No
118 7. Skipped (Not applicable)
8. DK (Don't Know)
51 Blank. Item left blank
==========================================================================================
CGQ52 FEEL ABLE TO HANDLE MOST PROBLEMS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q52
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
52. In general, do you feel able to handle most problems in the care of your
friend or relative?
.................................................................................
63 1. Yes
8 5. No
118 7. Skipped (Not applicable)
8. DK (Don't Know)
51 Blank. Item left blank
==========================================================================================
CGQ53 PREVENT SUBJECT FROM GETTING WORSE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53. Do the things you do for your friend or relative keep him/her from getting
worse?
.................................................................................
51 1. Yes
22 5. No
118 7. Skipped (Not applicable)
2 8. DK (Don't Know)
47 Blank. Item left blank
==========================================================================================
CGQ53A NEED R PERSON AS MUCH AS R NEEDS ME
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53A
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53a. I feel like I need this person as much as they need me
.................................................................................
32 1. Strongly agree
19 2. Agree
19 3. Neither agree or disagree
7 4. Disagree
3 5. Strongly disagree
115 7. Skipped (Not applicable)
45 Blank. Item left blank
==========================================================================================
CGQ53B VERY DEPENDENT ON R
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53B
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53b. I am very dependent on this person
.................................................................................
10 1. Strongly agree
13 2. Agree
22 3. Neither agree or disagree
18 4. Disagree
16 5. Strongly disagree
116 7. Skipped (Not applicable)
45 Blank. Item left blank
==========================================================================================
CGQ53C WOULD RISK LIFE TO HELP R
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53C
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53c. I would risk my life to help this person
.................................................................................
36 1. Strongly agree
30 2. Agree
9 3. Neither agree or disagree
2 4. Disagree
1 5. Strongly disagree
116 7. Skipped (Not applicable)
46 Blank. Item left blank
==========================================================================================
CGQ53D FEEL UNCONDITIONAL LOVE FOR R
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53D
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53d. I feel unconditional love for this person
.................................................................................
51 1. Strongly agree
24 2. Agree
3 3. Neither agree or disagree
2 4. Disagree
1 5. Strongly disagree
115 7. Skipped (Not applicable)
44 Blank. Item left blank
==========================================================================================
CGQ53E UNCONDITIONALLY CARE FOR R
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53E
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53e. I unconditionally care for this person
.................................................................................
44 1. Strongly agree
27 2. Agree
4 3. Neither agree or disagree
3 4. Disagree
1 5. Strongly disagree
116 7. Skipped (Not applicable)
45 Blank. Item left blank
==========================================================================================
CGQ53F FEEL AFFECTIONATE TOWARD R
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53F
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53f. I feel very affectionate towards this person
.................................................................................
46 1. Strongly agree
27 2. Agree
6 3. Neither agree or disagree
1 4. Disagree
1 5. Strongly disagree
115 7. Skipped (Not applicable)
44 Blank. Item left blank
==========================================================================================
CGQ53G ENJOY TOUCHING R
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q53G
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
53g. I enjoy touching this person
.................................................................................
27 1. Strongly agree
23 2. Agree
20 3. Neither agree or disagree
7 4. Disagree
2 5. Strongly disagree
115 7. Skipped (Not applicable)
46 Blank. Item left blank
==========================================================================================
CGQ54 CHANGE IN SCHEDULE LAST YEAR
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q54
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
54. Sometimes people must make adjustments to their schedules to care for
others. In the last year, did providing help or supervision for your friend or
relative cause you to change your daily work schedule, such as going to work
late, leaving early, or taking time off?
.................................................................................
24 1. Yes (Go to Question 55)
46 5. No (Skip to Question 56)
119 7. Skipped (Not applicable)
8. DK (Don't Know)
51 Blank. Item left blank
==========================================================================================
CGQ55 HOURS OF WORK MISSED PER WEEK
Section: CG Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: Q55
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
55. Over the past year, on average, how many hours of work per week did you miss
for this reason?
This question should have been skipped if the answer to Question 54 was "No"
(5).
.................................................................................
33 0-40. Hours per week
157 997. Skipped (Not applicable)
998. DK (Don't Know)
50 Blank. Item left blank
==========================================================================================
CGQ56 GIVE UP WORK ENTIRELY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q56
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
56. In the last year, did providing care for your friend or relative cause you
to give up work entirely?
.................................................................................
3 1. Yes
73 5. No
120 7. Skipped (Not applicable)
8. DK (Don't Know)
44 Blank. Item left blank
==========================================================================================
CGQ57 REDUCE LEISURE TIME/VACATIONS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q57
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
57. In the last year, did providing care for your friend or relative cause you
to reduce leisure time or vacations?
.................................................................................
28 1. Yes
50 5. No
119 7. Skipped (Not applicable)
8. DK (Don't Know)
43 Blank. Item left blank
==========================================================================================
CGQ58 REDUCE HOBBY TIME
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q58
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
58. In the last year, did providing care for your friend or relative cause you
to reduce the time spent on hobbies or your own activities?
.................................................................................
24 1. Yes
55 5. No
119 7. Skipped (Not applicable)
8. DK (Don't Know)
42 Blank. Item left blank
==========================================================================================
CGQ59 REDUCE TIME WITH OTHER FAMILY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q59
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
59. In the last year, did providing care for your friend or relative cause you
to spend less time helping or being with other family members?
.................................................................................
21 1. Yes
57 5. No
119 7. Skipped (Not applicable)
8. DK (Don't Know)
43 Blank. Item left blank
==========================================================================================
CGQ60 MARITAL/RELATIONSHIP STRAIN
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q60
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
60. In the last year, did providing care for your friend or relative put a
strain on your marriage or other family relationships?
.................................................................................
11 1. Yes
67 5. No
119 7. Skipped (Not applicable)
1 8. DK (Don't Know)
42 Blank. Item left blank
==========================================================================================
CGQ61 RECEIVED CARE INSTRUCTIONS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q61
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
61. Have you ever had instruction in how to provide care to someone with a
memory problem?
.................................................................................
13 1. Yes
68 5. No
117 7. Skipped (Not applicable)
8. DK (Don't Know)
42 Blank. Item left blank
==========================================================================================
CGQ62 PAID HELPER ARRANGED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q62
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
The next set of instructions is about paid care that your friend or relative may
receive.
62. Has anyone ever arranged for a paid helper to care for your friend or
relative?
.................................................................................
24 1. Yes (Skip to Question 64)
93 5. No (Go to Question 63)
104 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ63 REASON FOR NO PAID HELPER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q63C_A
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
63. What is the main reason that you haven't arranged for a paid helper to care
for your friend or relative? (THEN SKIP TO QUESTION 69)
.................................................................................
73 1. Paid help is unnecessary
6 2. Paid help is too expensive
3. Paid help is not of good enough quality
2 4. Paid help is not available
13 5. My friend of relative would not be comfortable with someone
else
11 6. Other
118 7. Skipped (Not applicable)
8. DK (Don't Know)
17 Blank. Item left blank
==========================================================================================
CGQ64A HELPER TYPE: HOMEMAKER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q64_C1
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What type of help was provided? (CHECK ALL THAT APPLY)
A. Homemaker services (for example, help with the cooking or cleaning)
This question should have been skipped if the answer to Question 62 was not
"Yes" (1).
.................................................................................
22 1. Yes
18 5. No
184 7. Skipped (Not applicable)
8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ64B HELPER TYPE: PERSONAL SERVICES
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q64_C2
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What type of help was provided? (CHECK ALL THAT APPLY)
B. Personal services (for example, help with the dressing or bathing)
This question should have been skipped if the answer to Question 62 was not
"Yes" (1).
.................................................................................
17 1. Yes
23 5. No
184 7. Skipped (Not applicable)
8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ64C HELPER TYPE: NURSING SERVICES
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q64_C3
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What type of help was provided? (CHECK ALL THAT APPLY)
C. Nursing services
This question should have been skipped if the answer to Question 62 was not
"Yes" (1).
.................................................................................
15 1. Yes
25 5. No
184 7. Skipped (Not applicable)
8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ64D HELPER TYPE: GENERAL SUPERVISION
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q64_C4
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What type of help was provided? (CHECK ALL THAT APPLY)
D. General supervision
This question should have been skipped if the answer to Question 62 was not
"Yes" (1).
.................................................................................
6 1. Yes
34 5. No
184 7. Skipped (Not applicable)
8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ64E HELPER TYPE: OTHER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q64_C5A
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What type of help was provided? (CHECK ALL THAT APPLY)
E. Other
This question should have been skipped if the answer to Question 62 was not
"Yes" (1).
.................................................................................
8 1. Yes
32 5. No
184 7. Skipped (Not applicable)
8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ65 OUT OF POCKET EXPENSE: PAID HELP
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q65
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
65. About how much was paid out-of-pocket (that is, the amount paid that was not
covered by insurance) for this help in the past year?
.................................................................................
27 0. $0
4 1. $1 - $250
2 2. $251 - $500
2 3. $501 - $2,500
3 4. $2,501 - $5,000
2 5. $5,001 - $10,000
5 6. More than $10,000
181 7. Skipped (Not applicable)
8. DK (Don't Know)
14 Blank. Item left blank
==========================================================================================
CGQ66 INSURANCE COVERAGE FOR PAID HELP
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q66
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
66. Were any of the costs for a paid helper covered by insurance?
.................................................................................
21 1. Yes (Go to Question 67)
21 5. No (Skip to Question 68)
180 7. Skipped (Not applicable)
8. DK (Don't Know)
18 Blank. Item left blank
==========================================================================================
CGQ67A INSURANCE TYPE - MEDICARE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q67_C1
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What kind of insurance helped pay the costs of a paid helper for your friend or
relative? (CHECK ALL THAT APPLY)
A. Medicare
This question should have been skipped if the answer to Question 66 was "No"
(5).
.................................................................................
26 1. Yes
6 5. No
191 7. Skipped (Not applicable)
1 8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ67B INSURANCE TYPE - MEDICAID
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q67_C2
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What kind of insurance helped pay the costs of a paid helper for your friend or
relative? (CHECK ALL THAT APPLY)
B. Medicaid
This question should have been skipped if the answer to Question 66 was "No"
(5).
.................................................................................
10 1. Yes
22 5. No
191 7. Skipped (Not applicable)
1 8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ67C INSURANCE TYPE - PRIVATE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q67_C3
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What kind of insurance helped pay the costs of a paid helper for your friend or
relative? (CHECK ALL THAT APPLY)
C. Private Insurance
This question should have been skipped if the answer to Question 66 was "No"
(5).
.................................................................................
8 1. Yes
24 5. No
191 7. Skipped (Not applicable)
8. DK (Don't Know)
17 Blank. Item left blank
==========================================================================================
CGQ67D INSURANCE TYPE - OTHER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q67_C4A
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
What kind of insurance helped pay the costs of a paid helper for your friend or
relative? (CHECK ALL THAT APPLY)
D. Other
This question should have been skipped if the answer to Question 66 was "No"
(5).
.................................................................................
1 1. Yes
32 5. No
191 7. Skipped (Not applicable)
8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ68A PAID HELPER INFO: SOCIAL WORKER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C1
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
A. Social worker
.................................................................................
11 1. Yes
25 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68B PAID HELPER INFO: DOCTOR
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C2
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
B. Doctor
.................................................................................
7 1. Yes
29 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68C PAID HELPER INFO: FRIEND
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C3
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
C. Friend
.................................................................................
8 1. Yes
28 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68D PAID HELPER INFO: ORGANIZATION
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C4
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
D. Organization
.................................................................................
6 1. Yes
30 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68E PAID HELPER INFO: RELATIVE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C5
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
E. Relative
.................................................................................
3 1. Yes
33 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68F PAID HELPER INFO: YELLOW PAGES
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C6
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
F. Yellow pages
.................................................................................
4 1. Yes
32 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68G PAID HELPER INFO: INTERNET
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C7
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
G. Internet
.................................................................................
1 1. Yes
35 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68H PAID HELPER INFO: OTHER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C8A
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
H. Other
This question should have been skipped if the answer to Question 62 was not
"Yes" (1).
.................................................................................
5 1. Yes
31 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ68I SOMEONE ELSE ARRANGED HELP
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q68_C9
Category: INFORMANT QUESTIONNAIRE
Measure: PAID HELP
68. How did you find information on these paid helpers? (CHECK ALL THAT APPLY)
I. Someone else arranged help
.................................................................................
4 1. Yes
33 5. No
185 7. Skipped (Not applicable)
8. DK (Don't Know)
18 Blank. Item left blank
==========================================================================================
CGQ69 DAYS PROVIDED TRANSPORTATION
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q69
Category: INFORMANT QUESTIONNAIRE
Measure: TRANSPORTATION HELP
69. During the last month, on about how many days did you provide transportation
(for instance, to a doctor's appointment or to a store) for your friend or
relative?
.................................................................................
196 0-31. Days
96. Other
2 97. Skipped (Not applicable)
98. DK (Don't Know)
42 Blank. Item left blank
==========================================================================================
CGQ69A CHANGE IN AMT OF CARE FROM 2 YEARS AGO
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69A
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
Q69a. Compared with two years ago, the care you provide to your friend or
relative by actively helping him/her with tasks and/or by staying with or
supervising him/her is now
.................................................................................
19 1. Much more (Go to Question 69b)
35 2. A bit more (Go to Question 69b)
135 3. About the same
4 4. A bit less (Go to Question 69c)
5 5. Much less (Go to Question 69c)
42 Blank. Item left blank
==========================================================================================
CGQ69B1 REASON-PHYSICAL HEALTH HAS WORSENED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69B_C1
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69b. If you answered "Much more" or "A bit more" above, please indicate the
reasons that you provide MORE care to your friend or family member now than you
did two years ago. (CHECK ALL THAT APPLY)
1. His/her physical health has worsened
.................................................................................
36 1. Yes
17 5. No
8 7. Skipped (Not applicable)
179 Blank. Item left blank
==========================================================================================
CGQ69B2 REASON-MEMORY OR INTELLIGENCE HAS WORSENED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69B_C2
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69b. If you answered "Much more" or "A bit more" above, please indicate the
reasons that you provide MORE care to your friend or family member now than you
did two years ago. (CHECK ALL THAT APPLY)
2. His/her memory or intelligence has worsened
.................................................................................
22 1. Yes
31 5. No
8 7. Skipped (Not applicable)
179 Blank. Item left blank
==========================================================================================
CGQ69B3 REASON-R MOVED INTO INFORMANTS HOME
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69B_C3
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69b. If you answered "Much more" or "A bit more" above, please indicate the
reasons that you provide MORE care to your friend or family member now than you
did two years ago. (CHECK ALL THAT APPLY)
3. He/she moved into your home
.................................................................................
8 1. Yes
44 5. No
8 7. Skipped (Not applicable)
180 Blank. Item left blank
==========================================================================================
CGQ69B4 REASON-TOOK OVER CAREGIVING TASKS FROM FRIEND/REL
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69B_C4
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69b. If you answered "Much more" or "A bit more" above, please indicate the
reasons that you provide MORE care to your friend or family member now than you
did two years ago. (CHECK ALL THAT APPLY)
4. You took over these caregiving tasks from another friend or relative
.................................................................................
5 1. Yes
47 5. No
8 7. Skipped (Not applicable)
180 Blank. Item left blank
==========================================================================================
CGQ69B5 REASON-TOOK OVER CAREGIVING TASKS FROM A PAID HELPER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69B_C5
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69b. If you answered "Much more" or "A bit more" above, please indicate the
reasons that you provide MORE care to your friend or family member now than you
did two years ago. (CHECK ALL THAT APPLY)
5. You took over these caregiving tasks from a paid helper/caregiver
.................................................................................
2 1. Yes
50 5. No
8 7. Skipped (Not applicable)
180 Blank. Item left blank
==========================================================================================
CGQ69B6 REASON-PROVIDED MORE HELP - OTHER REASON
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69B_C6
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69b. If you answered "Much more" or "A bit more" above, please indicate the
reasons that you provide MORE care to your friend or family member now than you
did two years ago. (CHECK ALL THAT APPLY)
6. Other
.................................................................................
3 1. Yes
54 5. No
8 7. Skipped (Not applicable)
175 Blank. Item left blank
==========================================================================================
CGQ69C1 REASON-PHYSICAL HEALTH HAS IMPROVED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69C_C1
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69c. If you answered "Much less" or "A bit less" to question 69a, please
indicate the reasons that you provide LESS care to your friend or family member
now than you did two years ago. (CHECK ALL THAT APPLY)
1. His/her physical health has improved
.................................................................................
5 1. Yes
11 5. No
52 7. Skipped (Not applicable)
172 Blank. Item left blank
==========================================================================================
CGQ69C2 REASON-MEMORY OR INTELLIGENCE HAS IMPROVED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69C_C2
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69c. If you answered "Much less" or "A bit less" to question 69a, please
indicate the reasons that you provide LESS care to your friend or family member
now than you did two years ago. (CHECK ALL THAT APPLY)
2. His/her memory or intelligence has improved
.................................................................................
2 1. Yes
14 5. No
52 7. Skipped (Not applicable)
172 Blank. Item left blank
==========================================================================================
CGQ69C3 REASON-R ENTERED HEALTH CARE FACILITY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69C_C3
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69c. If you answered "Much less" or "A bit less" to question 69a, please
indicate the reasons that you provide LESS care to your friend or family member
now than you did two years ago. (CHECK ALL THAT APPLY)
3. He/she entered a nursing home or other healthcare facility
.................................................................................
1 1. Yes
15 5. No
52 7. Skipped (Not applicable)
172 Blank. Item left blank
==========================================================================================
CGQ69C4 REASON-FRIEND/REL TOOK OVER CAREGIVING TASKS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69C_C4
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69c. If you answered "Much less" or "A bit less" to question 69a, please
indicate the reasons that you provide LESS care to your friend or family member
now than you did two years ago. (CHECK ALL THAT APPLY)
4. Another friend or relative took over these caregiving tasks
.................................................................................
3 1. Yes
13 5. No
52 7. Skipped (Not applicable)
172 Blank. Item left blank
==========================================================================================
CGQ69C5 REASON-PAID HELPER TOOK OVER CAREGIVING TASKS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69C_C5
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69c. If you answered "Much less" or "A bit less" to question 69a, please
indicate the reasons that you provide LESS care to your friend or family member
now than you did two years ago. (CHECK ALL THAT APPLY)
5. A paid helper/caregiver took over these caregiving tasks
.................................................................................
1 1. Yes
15 5. No
52 7. Skipped (Not applicable)
172 Blank. Item left blank
==========================================================================================
CGQ69C6 REASON-PROVIDED LESS HELP - OTHER REASON
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q69C_C6
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVING
69c. If you answered "Much less" or "A bit less" to question 69a, please
indicate the reasons that you provide LESS care to your friend or family member
now than you did two years ago. (CHECK ALL THAT APPLY)
6. Other
.................................................................................
5 1. Yes
12 5. No
52 7. Skipped (Not applicable)
171 Blank. Item left blank
==========================================================================================
CGQ70 HOURS PER DAY FOR TRANSPORTATION
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q70
Category: INFORMANT QUESTIONNAIRE
Measure: TRANSPORTATION HELP
70. On the days you did this, about how many hours per day was that?
.................................................................................
78 1-20. Hours
119 97. Skipped (Not applicable)
98. DK (Don't Know)
43 Blank. Item left blank
==========================================================================================
CGQ71 NUMBER OF DOCTOR VISITS IN PAST YEAR
Section: CG Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: Q71
Category: INFORMANT QUESTIONNAIRE
Measure: NUMBER OF DOCTOR VISITS
71. How many times has your friend or relative seen a doctor in the past year?
.................................................................................
201 0-208. Times
3 997. Skipped (Not applicable)
4 998. DK (Don't Know)
32 Blank. Item left blank
==========================================================================================
CGQ72 OUT OF POCKET EXPENSE: DOCTOR BILLS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q72
Category: INFORMANT QUESTIONNAIRE
Measure: COST OF DOCTOR BILLS
72. About how much was paid out-of-pocket (that is, the amount paid that was not
covered by insurance) for these doctor's bills in the past year?
.................................................................................
63 0. $0
29 1. $1 - $100
31 2. $101 - $250
17 3. $251 - $500
18 4. $501 - $2,500
5 5. $2,501 - $10,000
2 6. More than $10,000
12 7. Skipped (Not applicable)
14 8. DK (Don't Know)
49 Blank. Item left blank
==========================================================================================
CGQ73 HAD MEDICAL TESTS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q73
Category: INFORMANT QUESTIONNAIRE
Measure: MEDICAL TESTS
73. Has your friend or relative had medical tests such as blood tests, X-rays,
or CAT scans, in the past year?
.................................................................................
179 1. Yes (Go to Question 74)
37 5. No (Skip to Question 75)
1 8. DK (Don't Know)
23 Blank. Item left blank
==========================================================================================
CGQ74 OUT OF POCKET EXPENSE: MEDICAL TESTS
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q74
Category: INFORMANT QUESTIONNAIRE
Measure: COST OF MEDICAL TESTS
74. About how much was paid out-of-pocket for these kinds of tests in the past
year?
.................................................................................
79 0. $0
30 1. $1 - $100
15 2. $101 - $250
9 3. $251 - $500
11 4. $501 - $2,500
1 5. $2,501 - $10,000
1 6. More than $10,000
16 8. DK (Don't Know)
36 97. Skipped (Not applicable)
42 Blank. Item left blank
==========================================================================================
CGQ75 OVERNIGHT HOSPITAL STAY IN PAST YEAR
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q75
Category: INFORMANT QUESTIONNAIRE
Measure: HOSPITAL STAYS
75. Has your friend or relative been a patient in a hospital overnight in the
past year?
.................................................................................
62 1. Yes (Go to Question 76)
159 5. No (Skip to Question 78)
8. DK (Don't Know)
19 Blank. Item left blank
==========================================================================================
CGQ76 NUMBER OF NIGHTS IN HOSPITAL
Section: CG Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: Q76
Category: INFORMANT QUESTIONNAIRE
Measure: HOSPITAL STAYS
76. Altogether, how many nights has your friend or relative been a patient in a
hospital in the past year?
.................................................................................
61 0-60. Nights
158 997. Skipped (Not applicable)
998. DK (Don't Know)
21 Blank. Item left blank
==========================================================================================
CGQ77 OUT OF POCKET EXPENSE: HOSPITAL STAYS
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q77
Category: INFORMANT QUESTIONNAIRE
Measure: COST OF HOSPITAL STAYS
77. About how much was paid out-of-pocket (that is, the amount paid that was not
covered by insurance) for these hospital stays in the past year?
.................................................................................
27 0. $0
9 1. $1 - $250
2. $251 - $500
6 3. $501 - $2,500
4 4. $2,501 - $5,000
3 5. $5,001 - $10,000
6. $10,000 - $25,000
7. More than $25,000
4 8. DK (Don't Know)
159 97. Skipped (Not applicable)
28 Blank. Item left blank
==========================================================================================
CGQ78 NURSING HOME PATIENT IN PAST YEAR
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q78
Category: INFORMANT QUESTIONNAIRE
Measure: NURSING HOME
78. Has your friend or relative been a patient in a nursing home or other
long-term care facility in the past year?
.................................................................................
21 1. Yes (Go to Question 79)
201 5. No (Skip to Question 81)
8. DK (Don't Know)
18 Blank. Item left blank
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CGQ79 NUMBER OF NIGHTS IN NURSING HOME
Section: CG Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: Q79
Category: INFORMANT QUESTIONNAIRE
Measure: NURSING HOME
79. Altogether, how many nights has your friend or relative been a patient in a
nursing home in the past year?
.................................................................................
17 0-365. Nights
201 997. Skipped (Not applicable)
2 998. DK (Don't Know)
20 Blank. Item left blank
==========================================================================================
CGQ80 OUT OF POCKET EXPENSE: NURSING HOME
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q80
Category: INFORMANT QUESTIONNAIRE
Measure: COST OF NURSING HOME CARE
80. About how much was paid out-of-pocket (that is, the amount paid that was not
covered by insurance) for these nursing home stays in the past year?
.................................................................................
9 0. $0
1 1. $1 - $250
2. $251 - $500
3. $501 - $2,500
4. $2,501 - $5,000
4 5. $5,001 - $10,000
6. $10,000 - $25,000
3 7. More than $25,000
1 8. DK (Don't Know)
201 97. Skipped (Not applicable)
21 Blank. Item left blank
==========================================================================================
CGQ81 PRESCRIPTION MED USE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q81
Category: INFORMANT QUESTIONNAIRE
Measure: PRESCRIPTION MEDICATIONS
81. Has your friend or relative used prescription medications during the past
year?
.................................................................................
210 1. Yes (Go to Question 82)
17 5. No (Skip to Question 83)
8. DK (Don't Know)
13 Blank. Item left blank
==========================================================================================
CGQ82 OUT OF POCKET EXPENSE: PRESCRIPTIONS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q82
Category: INFORMANT QUESTIONNAIRE
Measure: COST OF PRESCRIPTION MEDICATIONS
82. On average, about how much was paid out-of-pocket (that is, the amount paid
that was not covered by insurance) per month for these prescriptions in the past
year?
.................................................................................
23 0. $0
6 1. $1 - $5 per month
12 2. $6 - $10 per month
26 3. $11 - $20 per month
70 4. $21 - $100 per month
30 5. $101 - $500 per month
5 6. More than $500 per month
17 7. Skipped (Not applicable)
9 8. DK (Don't Know)
42 Blank. Item left blank
==========================================================================================
CGQ83 RATE OVERALL INFORMANT HEALTH
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q83
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVER WELL-BEING
To conclude, we have a few more questions about your own situation.
83. Overall, how would you rate your health?
.................................................................................
41 1. Excellent
76 2. Very Good
80 3. Good
34 4. Fair
2 5. Poor
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ84A INFORMANT: FELT MORE STRESSED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q84_C1
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVER WELL-BEING
84. Over the last year, have you: (PLEASE CHECK "YES" OR "NO" FOR EACH ITEM)
A. Felt more stressed than usual
.................................................................................
88 1. Yes
137 5. No
8. DK (Don't Know)
15 Blank. Item left blank
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CGQ84B INFORMANT: GOTTEN LESS EXERCISE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q84_C2
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVER WELL-BEING
84. Over the last year, have you: (PLEASE CHECK "YES" OR "NO" FOR EACH ITEM)
B. Gotten less exercise than usual
.................................................................................
84 1. Yes
144 5. No
8. DK (Don't Know)
12 Blank. Item left blank
==========================================================================================
CGQ84C INFORMANT: GOTTEN LESS SLEEP
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q84_C3
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVER WELL-BEING
84. Over the last year, have you: (PLEASE CHECK "YES" OR "NO" FOR EACH ITEM)
C. Gotten less sleep than usual
.................................................................................
50 1. Yes
179 5. No
8. DK (Don't Know)
11 Blank. Item left blank
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CGQ84D INFORMANT: GOTTEN LESS REST
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q84_C4
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVER WELL-BEING
84. Over the last year, have you: (PLEASE CHECK "YES" OR "NO" FOR EACH ITEM)
D. Gotten less rest than you needed
.................................................................................
59 1. Yes
163 5. No
8. DK (Don't Know)
18 Blank. Item left blank
==========================================================================================
CGQ84E INFORMANT: NOT ENOUGH TIME TO SEE DOCTOR
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q84_C5
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVER WELL-BEING
84. Over the last year, have you: (PLEASE CHECK "YES" OR "NO" FOR EACH ITEM)
E. Not had enough time to go to a physician
.................................................................................
18 1. Yes
206 5. No
8. DK (Don't Know)
16 Blank. Item left blank
==========================================================================================
CGQ84F INFORMANT: NOT ABLE TO SLOW DOWN
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q84_C6
Category: INFORMANT QUESTIONNAIRE
Measure: CAREGIVER WELL-BEING
84. Over the last year, have you: (PLEASE CHECK "YES" OR "NO" FOR EACH ITEM)
F. Not been able to slow down when you were sick
.................................................................................
45 1. Yes
177 5. No
8. DK (Don't Know)
18 Blank. Item left blank
==========================================================================================
CGQ85 CES-D - DEPRESSED
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q85
Category: INFORMANT QUESTIONNAIRE
Measure: CES-D
Now think about the past week and the feelings you have experienced. Please
tell us if each of the following was true for you much of the time this past
week.
85. Much of the time during the past week you felt depressed.
.................................................................................
18 1. Yes
215 5. No
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ86 CES-D - HAPPY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q86
Category: INFORMANT QUESTIONNAIRE
Measure: CES-D
86. Much of the time during the past week you were happy.
.................................................................................
209 1. Yes
19 5. No
8. DK (Don't Know)
12 Blank. Item left blank
==========================================================================================
CGQ87 CES-D - LONELY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q87
Category: INFORMANT QUESTIONNAIRE
Measure: CES-D
87. Much of the time during the past week you felt lonely.
.................................................................................
21 1. Yes
210 5. No
8. DK (Don't Know)
9 Blank. Item left blank
==========================================================================================
CGQ88 CES-D - ENJOYED LIFE
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q88
Category: INFORMANT QUESTIONNAIRE
Measure: CES-D
88. Much of the time during the past week you enjoyed life.
.................................................................................
216 1. Yes
15 5. No
8. DK (Don't Know)
9 Blank. Item left blank
==========================================================================================
CGQ89 CES-D - SAD
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q89
Category: INFORMANT QUESTIONNAIRE
Measure: CES-D
89. Much of the time during the past week you felt sad.
.................................................................................
23 1. Yes
208 5. No
8. DK (Don't Know)
9 Blank. Item left blank
==========================================================================================
CGQ90 CURRENTLY WORKING FOR PAY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q90
Category: INFORMANT QUESTIONNAIRE
Measure: WORK FOR PAY
90. Do you currently do any work for pay?
.................................................................................
73 1. Yes (Go to Question 91)
155 5. No (Skip to Question 94)
8. DK (Don't Know)
12 Blank. Item left blank
==========================================================================================
CGQ91 WORK HOURS PER WEEK
Section: CG Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: Q91
Category: INFORMANT QUESTIONNAIRE
Measure: WORK FOR PAY
91. On average, how many hours per week do you work for pay?
.................................................................................
69 2-79. Hours
156 997. Skipped (Not applicable)
998. DK (Don't Know)
15 Blank. Item left blank
==========================================================================================
CGQ92 WEEKS WORKED IN PAST YEAR
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q92
Category: INFORMANT QUESTIONNAIRE
Measure: WORK FOR PAY
92. In the past year, about how many weeks did you work for pay?
.................................................................................
67 4-52. Hours
155 97. Skipped (Not applicable)
1 98. DK (Don't Know)
17 Blank. Item left blank
==========================================================================================
CGQ93 GROSS ANNUAL EARNINGS
Section: CG Level: Respondent Type: Numeric Width: 5 Decimals: 0
Ref: Q93
Category: INFORMANT QUESTIONNAIRE
Measure: WORK FOR PAY
93. About how much did you earn on all jobs in the last year, before taxes?
.................................................................................
52 500-85000. Dollars
154 99997. Skipped (Not applicable)
99998. DK (Don't Know)
34 Blank. Item left blank
==========================================================================================
CGQ94 ESTIMATED HOURLY PAY
Section: CG Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: Q94
Category: INFORMANT QUESTIONNAIRE
Measure: WORK FOR PAY
94. If you were to take a job now, what do you think would be your approximate
hourly pay?
.................................................................................
116 0-350. Dollars
52 997. Skipped (Not applicable)
18 998. DK (Don't Know)
54 Blank. Item left blank
==========================================================================================
CGQ95 INFORMANT AGE
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q95
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
95. What is your age?
.................................................................................
228 24-94. Years
12 Blank. Item left blank
==========================================================================================
CGQ96 INFORMANT GENDER
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q96
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
96. Are you male or female?
.................................................................................
53 1. Male
177 2. Female
10 Blank. Item left blank
==========================================================================================
CGQ97 INFORMANT EDUCATION LEVEL
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q97
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
97. What is the highest level of education you completed?
.................................................................................
4 1. No formal education
13 2. Grades 1 - 8
28 3. Some high school
73 4. High school graduate
58 5. Some college
36 6. College graduate
21 7. Post-college
8. DK (Don't Know)
7 Blank. Item left blank
==========================================================================================
CGQ98 INFORMANT HISPANIC OR LATINO/A
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q98
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
98. Do you consider yourself Hispanic or Latino/Latina?
.................................................................................
23 1. Yes
208 5. No
8. DK (Don't Know)
9 Blank. Item left blank
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CGQ99 INFORMANT RACE/ETHNICITY
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q99
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
99. Do you consider yourself primarily White or Caucasian, Black or
African-American, American Indian, Asian, or something else?
User Note: American Indian, Asian, or something else are combined into "Other"
.................................................................................
180 1. White/Causcasian
42 2. Black/African American
9 7. Other
8. DK (Don't Know)
9 Blank. Item left blank
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CGQ100 INFORMANT MARITAL STATUS
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q100
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
100. What best describes your current marital status?
.................................................................................
157 1. Married
12 2. Never married
5 3. Living with partner
7 4. Separated
22 5. Divorced
30 6. Widowed
8. DK (Don't Know)
7 Blank. Item left blank
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CGQ101 INFORMANT RELATIONSHIP TO SUBJECT
Section: CG Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: Q101
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
101. What is your relationship to the person we are visiting today?
.................................................................................
97 1. Spouse (husband or wife)
67 2. Child (son or daughter)
6 3. Grandchild (grandson or granddaughter)
4 4. Professional (e.g., paid helper or nurse)
4 5. Child-in-law (son-in-law or daughter-in-law)
9 6. Sibling (brother or sister)
6 7. Niece or nephew
4 8. Sibling of spouse (brother-in-law or sister-on-law)
1 9. Parent or parent-in-law
4 10. Other relative
29 13. Other
14. DK (Don't Know)
9 15. Item left blank
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CGQ102 WHETHER INFORMANT LIVES WITH SUBJECT
Section: CG Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: Q102
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
102. Do you currently live with this friend or relative?
.................................................................................
120 1. Yes
107 5. No
8. DK (Don't Know)
13 Blank. Item left blank
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CGQ103 YEARS INFORMANT HAS KNOWN SUBJECT
Section: CG Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: Q103
Category: INFORMANT QUESTIONNAIRE
Measure: DEMOGRAPHICS
103. About how long have you known him or her?
.................................................................................
219 1-80. Years
6 997. Skipped (Not applicable)
998. DK (Don't Know)
15 Blank. Item left blank
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