09EX_1
|
|
What is the relationship between you and XX? [Card 09EX-1] |
09EX_2
|
|
Is it okay to ask questions about XX?This is voluntary and you can refuse to answer any question.The information obtained will not be used for purposes other than research. |
09EX_4
|
|
Tell me the year and month in which XX passed away. |
09EX_6
|
|
What was the cause of the death? |
09EX_7
|
|
Can you give me the details? |
09EX_8
|
|
What was the name of the disease? |
09EX_9
|
|
Where did XX pass away? |
09EX_10
|
|
Did he/she stay in the hospital or care facility before decease at home? |
09EX_11
|
|
How long did he/she stay in the hospital? |
09EX_11_2
|
|
Where was the hospital (based on the residence from the last interview)? |
09EX_11_3
|
|
[Interviewer:]Who chose the hospital? |
09EX_11_4
|
|
How much did the hospitalization cost in total? |
09EX_11_5
|
|
Was XX at home or in a care facility before he/she died of the disease? |
09EX_12
|
|
How long did XX stay in the facility? |
09EX_12_1
|
|
[Interviewer:]Where was the facility (based on the residence from the last interview)? |
09EX_12_2
|
|
[Interviewer:]Who chose the facility? |
09EX_12_3
|
|
How much did the facility cost per month? |
09EX_12_4
|
|
Did the facility require a down payment (initial payment)? |
09EX_13
|
|
At the last interview (month, year), XX (if h031=1 then received ; if h031=2 then did not receive; if h031=3 then was applying to; otherwise did not answer if he/she received) certification for Long-Term Care in the Long-Term Care Insurance program.Did he/she need the nursing care at home when he/she was alive? |
09EX_13_1
|
|
Who were the main caregiver(s)? Indicate all that apply up to three people. 1 |
09EX_13_2
|
|
Was he/she certified to receive Long-Term Care? Answer yes if he/she was certified to receive support 12 or Long-Term Care 1-5. Answer no if he/she did not apply or was certified as self-reliant. |
09EX_13_3
|
|
What was the level of the required care before death? |
09EX_13_4
|
|
Did he/she use the home nursing care service? |
09EX_13_5
|
|
How much was the self payment of the home nursing care service per month? |
09EX_14
|
|
Let me ask questions about XX's family. At the last investigation (XX, XX), XX (if a003=1 then answered he/she has a spouse; Did the status change before his/her death? |
09EX_15
|
|
At the last investigation (year and month), XX answered he/she (if a010=2 then has no child; if a_010=1 & a_011a=1 then has (a_011b) children). Did the situation change before his/her death? |
09EX_15_1_1
|
|
1st child Did the situation change before XX's death? |
09EX_15_1_10
|
|
10th child Did the situation change before XX's death? |
09EX_15_1_2
|
|
2nd child Did the situation change before XX's death? |
09EX_15_1_3
|
|
3rd child Did the situation change before XX's death? |
09EX_15_1_4
|
|
4th child Did the situation change before XX's death? |
09EX_15_1_5
|
|
5th child Did the situation change before XX's death? |
09EX_15_1_6
|
|
6th child Did the situation change before XX's death? |
09EX_15_1_7
|
|
7th child Did the situation change before XX's death? |
09EX_15_1_8
|
|
8th child Did the situation change before XX's death? |
09EX_15_1_9
|
|
9th child Did the situation change before XX's death? |
09EX_15_2_1
|
|
1h child was at the time (ifa012_3=1then married |
09EX_15_2_10
|
|
10h child was at the time (ifa012_3=1then married |
09EX_15_2_2
|
|
2h child was at the time (ifa012_3=1then married |
09EX_15_2_3
|
|
3h child was at the time (ifa012_3=1then married |
09EX_15_2_4
|
|
4h child was at the time (ifa012_3=1then married |
09EX_15_2_5
|
|
5h child was at the time (ifa012_3=1then married |
09EX_15_2_6
|
|
6th child was at the time (ifa012_3=1then married |
09EX_15_2_7
|
|
7h child was at the time (ifa012_3=1then married |
09EX_15_2_8
|
|
8h child was at the time (ifa012_3=1then married |
09EX_15_2_9
|
|
9h child was at the time (ifa012_3=1then married |
09EX_15_3_1
|
|
child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_10
|
|
At the time 10th child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_2
|
|
At the time 2nd child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_3
|
|
At the time 3rd child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_4
|
|
At the time 4th child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_5
|
|
At the time 5th child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_6
|
|
At the time 6th child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_7
|
|
At the time 7th child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_8
|
|
At the time 8th child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_3_9
|
|
At the time 9th child (ifa012_4=1then lived together (in a house sharing the same entrance);ifa012_4=2then lived together within the same premises;if a012_4=3 then lived separately within the same city; if a012_4=4 then lived separately within the same prefecture; if a012_4=5, then lived in a different prefecture; if a012_4=6 then lived outside the country; otherwise did not answer where the child lives)
Did the situation change before XX's death? |
09EX_15_4_1
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_10
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_2
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_3
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_4
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_5
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_6
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_7
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_8
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_4_9
|
|
The child was at the time (a012_5=1then living independently, feeding him/herself)(a012_5=2then living independently, feeding him/herself and paying for his/her own housing)(a012_5=3then not living independently, dependingfor both food and housing on others)(otherwisedid not answer whether the child was living independently)
Did the situation change before XX's death? ( |
09EX_15_5_1
|
|
What was the situation of the child when XX passed? |
09EX_15_5_2
|
|
2nd child What was the situation of the child when XX passed? |
09EX_15_5_3
|
|
3rd child What was the situation of the child when XX passed? |
09EX_15_5_4
|
|
4th childWhat was the situation of the child when XX passed? |
09EX_15_5_5
|
|
5th childWhat was the situation of the child when XX passed? |
09EX_15_5_6
|
|
6th childWhat was the situation of the child when XX passed? |
09EX_15_5_7
|
|
7th childWhat was the situation of the child when XX passed? |
09EX_15_5_8
|
|
8th childWhat was the situation of the child when XX passed? |
09EX_15_5_9
|
|
9th childWhat was the situation of the child when XX passed? |
09EX_15_6
|
|
Hearing that XX had more children after XX, xx, can you tell me how many more did he/she have? |
09EX_15_7_1_1
|
|
Let me ask questions about the h child (among the newly born children). What is the sex? |
09EX_15_7_1_2
|
|
Let me ask questions about the h child (among the newly born children). What is the sex? |
09EX_15_7_1_3
|
|
Let me ask questions about the h child (among the newly born children). What is the sex? |
09EX_15_7_1_4
|
|
Let me ask questions about the h child (among the newly born children). What is the sex? |
09EX_15_7_1_5
|
|
Let me ask questions about the h child (among the newly born children). What is the sex? |
09EX_15_7_2_1
|
|
1stIs the child XX's biological child? Or is he/shean adopted child? |
09EX_15_7_2_2
|
|
1stIs the child XX's biological child? Or is he/shean adopted child? |
09EX_15_7_2_3
|
|
1stIs the child XX's biological child? Or is he/shean adopted child? |
09EX_15_7_2_4
|
|
1stIs the child XX's biological child? Or is he/shean adopted child? |
09EX_15_7_2_5
|
|
1stIs the child XX's biological child? Or is he/shean adopted child? |
09EX_15_7_3_1
|
|
1stHow old is the child? What is the birth year? |
09EX_15_7_3_2
|
|
How old is the child? What is the birth year? |
09EX_15_7_3_3
|
|
3rdHow old is the child? What is the birth year? |
09EX_15_7_3_4
|
|
4thHow old is the child? What is the birth year? |
09EX_15_7_3_5
|
|
5tnHow old is the child? What is the birth year? |
09EX_15_7_4_1
|
|
Where is the child living (based on XX's residence from the last investigation)? |
09EX_15_7_4_2
|
|
Where is the child living (based on XX's residence from the last investigation)? |
09EX_15_7_4_3
|
|
Where is the child living (based on XX's residence from the last investigation)? |
09EX_15_7_4_4
|
|
Where is the child living (based on XX's residence from the last investigation)? |
09EX_15_7_4_5
|
|
Where is the child living (based on XX's residence from the last investigation)? |
09EX_15_7_5_1
|
|
Is the child financially independent? |
09EX_15_7_5_2
|
|
Is the child financially independent? |
09EX_15_7_5_3
|
|
Is the child financially independent? |
09EX_15_7_5_4
|
|
Is the child financially independent? |
09EX_15_7_5_5
|
|
Is the child financially independent? |
09EX_15_7_6_1
|
|
1stWhat was the situation of the child when XX passed? |
09EX_15_7_6_2
|
|
2ndWhat was the situation of the child when XX passed? |
09EX_15_7_6_3
|
|
3rdWhat was the situation of the child when XX passed? |
09EX_15_7_6_4
|
|
4thWhat was the situation of the child when XX passed? |
09EX_15_7_6_5
|
|
5tnWhat was the situation of the child when XX passed? |
09EX_15_7_7_1
|
|
What was the last level of school this child attended, and did he/she graduate? |
09EX_15_7_7_2
|
|
What was the last level of school this child attended, and did he/she graduate? |
09EX_15_7_7_3
|
|
What was the last level of school this child attended, and did he/she graduate? |
09EX_15_7_7_4
|
|
What was the last level of school this child attended, and did he/she graduate? |
09EX_15_7_7_5
|
|
What was the last level of school this child attended, and did he/she graduate? |
09EX_15_7_8_1
|
|
Is he/she married? |
09EX_15_7_8_2
|
|
Is he/she married? |
09EX_15_7_8_3
|
|
Is he/she married? |
09EX_15_7_8_4
|
|
Is he/she married? |
09EX_15_7_8_5
|
|
Is he/she married? |
09EX_16
|
|
Who were the people living together here before XX passed? (a) Number of spouses |
09EX_17
|
|
How do you classify the living circumstances right before XX's death? Choose one of the following. [Card 09EX-17] |
09EX_18
|
|
Last time we asked XX what he/she thought about bequests. Would you answer the following questions? |
09EX_19
|
|
Two years ago, XX answered he/she (if g0281=1 then considers making living donation/bequests; if g0281=2 then does not consider making living donation/bequests; if g0281=3 then has no one to make living donation/bequests to; if g0281=4 then is not sure about bequests). Did he/she make living donation/bequests? |
09EX_20
|
|
Two years ago, XX answered he/she (if g0282a=1 then will make (g0282b) yen living donation/bequests (if g0281=1&g0282aNE1 then has not decided how much to make) (if g0281NE1 then will not make donation/bequests or was not sure). How much was the actual amount in total? [To interviewer: Please input the amount in yen as an integer. If response was "Don't know," please prompt by asking the question below. If you obtain the answer, please fill in that number.] [Instructions for interviewer to read: A rough estimate is fine. Could you please answer the amount?] |
09EX_21
|
|
Two years ago, XX answered he/she (if g0281=1 then will make donation/bequests to a relative (if g0281NE1 then will not make donation/bequests or is not sure). Who received the donation/bequests eventually? [Interviewer] Ask the relationship with XX and fill in the standard code. |
09EX_22
|
|
Display the standard codes of 09EX-21 answers Please indicate how much each of the selected heirs obtained of the bequest. 09EX-21 list (for each heir) |