ES. Exit Survey

ES. Exit Survey module of ELSA 2008

item label type description
SERIAL Question Serial Number
FIRST Question INTERVIEWER: For your information:.. You are in the questionnaire for serial number [Serial] - To enter the questionnaire press and . - To update the Admin details, press .
EIMODE Question INTERVIEWER: Is this interview being conducted by telephone or in person?
INTDAT Question INTERVIEWER: Today's date. Amend if not correct. Else, press to continue.
EINAME1 Question ELSA respondent's first name
EINAME2 Question ELSA respondent's surname.
EIDATLA Question Date of last ELSA interview
EIINTRO Question You may be aware that [EiName1] generously participated in the ELSA study before [hisher] death. [CHisHer] contribution was very valuable. We would find it extremely helpful to have some information about the final year of [hisher] life. I appreciate that this may upset or distress you. All the information collected is strictly confidential, and will be held anonymously. INTERVIEWER: Press 1 and to continue.
EIINTR2 Question Before we begin, I'd like to ask you some questions about you.
EIRREL Question What was your relationship to [EiName1]? Were you [hisher]...
EIRFRI Question Would you say [heshe] was a close friend, or not?
SURVSP Question INTERVIEWER ASK OR CODE: Did [EiName1] have a surviving spouse/partner at the time of [hisher] death?
EIRKNO Question How long had you known [himher]? INTERVIEWER: Code how the question is answered.
NUMYR Question INTERVIEWER: Enter the number of years the respondent has known the deceased.
NUMMTH Question INTERVIEWER: Enter the number of months the respondent has known the deceased.
AGEMET Question INTERVIEWER: Enter the age of respondent when they met [EiName1]. If known [himher] since birth enter 'O'.
YRMET Question INTERVIEWER: Enter the year they met.
MTHMET Question INTERVIEWER: Enter the month they met.
EIRAGE Question What was your age last birthday?
EIRSEX Question INTERVIEWER: Ask or code respondent's sex.
EILONG Question I would now like to ask you a few questions about things that happened at the time of [EiName1]'s death. How long had [heshe] been ill before [heshe] died?
EISUDD Question Would you say [hisher] death was unexpected?
EISUDEX Question Why was [hisher] death expected?
EIEXPT Question Would you say [hisher] death was expected, or unexpected?
EIEXPTOT Question INTERVIEWER: Enter details.
EICAUS Question SHOW CARD EI2 What was the main cause of [EiName1]'s death?
EICAUSOT Question INTERVIEWER: Please enter details of the cause of death.
EIDATED Question May I ask, on what date did [heshe] die? INTERVIEWER: Enter the day of month at this question.
EIDATEM Question INTERVIEWER: Enter month at this question.
EIDATEY Question INTERVIEWER: Enter year at this question.
EIPLAC Question And where did [EiName1] die? Was it ...READ OUT...01 ...at home
EIPLACOT Question (What was this other place?) INTERVIEWER: Write in.
EIPLACOH Question In whose home did [EiName1] die?
EIPLCN Question On how many different occasions did [EiName1] stay in [place] in the last two years before [heshe] died? INTERVIEWER: If appropriate include more than one person's home INTERVIEWER: Specify the number of times.
EIPLCL Question In total, how long did [EiName1] stay in [place] in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILIVINT Question I would now like to ask you some questions about where [EiName1] lived or stayed overnight as a result of [hisher] health in the two years before [heshe] died.
EILIVE Question [Multiple responses to EILIVE are recorded in variables EILIVE1 to EILIVE9] SHOW CARD EI3 [Did] [heshe] live or stay in any of these places at any stage in the two years before [heshe] died? INTERVIEWER: Include NHS and privately-owned establishments CODE ALL THAT APPLY.
EIHOMESTY Question In whose home did [EiName1] stay?
EILOTHA Question On how many different occasions did [EiName1] stay in another person's home in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILOTHB Question In total, how long did [EiName1] stay in another person's home in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILHOSPA Question On how many different occasions did [EiName1] stay in a hospital in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILHOSPB Question In total, how long did [EiName1] stay in a hospital in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILHPCEA Question On how many different occasions did [EiName1] stay in a hospice in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILHPCEB Question In total, how long did [EiName1] stay in a hospice in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILNURSA Question On how many different occasions did [EiName1] stay in a nursing home in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILNURSB Question In total, how long did [EiName1] stay in a nursing home in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILRESA Question On how many different occasions did [EiName1] stay in a residential home in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILRESB Question In total, how long did [EiName1] stay in a residential home in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILMIXA Question On how many different occasions did [EiName1] stay in mixed nursing/residential home in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILMIXB Question In total, how long did [EiName1] stay in mixed nursing/residential home in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILSHELA Question On how many different occasions did [EiName1] stay in sheltered housing in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILSHELB Question In total, how long did [EiName1] stay in sheltered housing in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EILIVEA Question How many other types of places did [heshe] stay in during the two years before [heshe] died? INTERVIEWER: If more than one other place, record each place at a separate question.
EILIVEB Question (What was this other place)? INTERVIEWER: Write in the other place.
EILEXTA Question On how many different occasions did [EiName1] stay in this place in the last two years before [heshe] died? INTERVIEWER: Enter the number of times.
EILEXTB Question In total, how long did [EiName1] stay in this place in the last two years before [heshe] died? INTERVIEWER: If stayed on more than one occasion add the times together.
EIDISTPH Question SHOW CARD EI4 We'd like to ask you about [EiName1]'s physical health and activity. During [hisher] last year, which of these descriptions fits [hisher] experience best?1 ______ was active and disability free, and died suddenly 2 ______ was mostly active and disability free, but declined during the last few months before he died 3 ______ had times of being seriously disabled, mixed with times of being active 4 ______ gradually become more and more disabled, without times of being active
EIADLINT Question I would now like to ask you about problems [EiName1] might have had in [hisher] everyday life, before [heshe] died. The next questions are about help [heshe] may have received. Please tell me if [heshe] had received any help because of a physical, mental,emotional or memory problem during the last three months of [hisher] life. INTERVIEWER: Press and to continue.
EIADLA Question During the last three months of [hisher] life, did [einame1] need help with ...INTERVIEWER: READ OUT ... dressing, including putting on shoes and socks?
EIADLB Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... getting across a room?
EIADLC Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... bathing or showering?
EIADLD Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... eating their food or preparing the food to be eaten (e.g. cutting it up)?
EIADLE Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... getting in or out of bed?
EIADLF Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... using the toilet, including getting up and down?
EIADLG Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... preparing hot meals?
EIADLH Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... shopping for groceries?
EIADLI Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... making phone calls?
EIADLJ Question (During the last three months of [hisher] life, did [einame1] need help with ...) INTERVIEWER: READ OUT ... taking medication?
EIADLA2 Question In total, for how long had [heshe] needed help with dressing when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLA2A Question INTERVIEWER: Enter the number of years.
EIADLA2B Question INTERVIEWER: Enter the number of months.
EIADLA2C Question INTERVIEWER: Enter the age.
EIADLB2 Question For how long had [heshe] needed help with walking, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLB2A Question INTERVIEWER: Enter the number of years.
EIADLB2B Question INTERVIEWER: Enter the number of months.
EIADLB2C Question INTERVIEWER: Enter the age.
EIADLB3 Question During the last three months of [hisher] life, was [EiName1] able to walk 100 yards by [himherself] and without using any special equipment? Did [heshe] have ...READ OUT...1 ...no difficulty,
EIADLB4 Question During the last three months of [hisher] life, was [EiName1] able to walk for a quarter of a mile by [himherself] and without using any special equipment? Did [heshe] have ...READ OUT...1 ...no difficulty,
EIADLC2 Question In total, for how long had [heshe] needed help with bathing or showering, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLC2A Question INTERVIEWER: Enter the number of years.
EIADLC2B Question INTERVIEWER: Enter the number of months.
EIADLC2C Question INTERVIEWER: Enter the age.
EIADLD2 Question In total, for how long had [heshe] needed help with eating when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLD2A Question INTERVIEWER: Enter the number of years.
EIADLD2B Question INTERVIEWER: Enter the number of months.
EIADLD2C Question INTERVIEWER: Enter the age.
EIADLE2 Question In total, for how long had [heshe] needed help getting in or out of bed, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLE2A Question INTERVIEWER: Enter the number of years.
EIADLE2B Question INTERVIEWER: Enter the number of months.
EIADLE2C Question INTERVIEWER: Enter the age.
EIADLF2 Question In total, for how long had [heshe] needed help with using the toilet, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLF2A Question INTERVIEWER: Enter the number of years.
EIADLF2B Question INTERVIEWER: Enter the number of months.
EIADLF2C Question INTERVIEWER: Enter the age.
EIADLG1 Question (You said earlier that during the last three months of [hisher] life [einame1] received help to prepare hot meals.) Was that because of a health or memory problem? INTERVIEWER: If the respondent gives an actual reason, decide whether this was a problem with either their health or memory.
EIADLG2 Question In total, for how long had [heshe] needed help with preparing hot meals, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLG2A Question INTERVIEWER: Enter the number of years.
EIADLG2B Question INTERVIEWER: Enter the number of months.
EIADLG2C Question INTERVIEWER: Enter the age.
EIADLH1 Question (You said earlier that during the last three months of [hisher] life [einame1] received help with shopping for groceries.) Was that because of a health or memory problem? INTERVIEWER: If the respondent gives an actual reason, decide whether this was a problem with either their health or memory.
EIADLH2 Question In total, for how long had [heshe] needed help with shopping for groceries, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLH2A Question INTERVIEWER: Enter the number of years.
EIADLH2B Question INTERVIEWER: Enter the number of months.
EIADLH2C Question INTERVIEWER: Enter the age.
EIADLI1 Question (You said earlier that during the last three months of [hisher] life [einame1] received help to make phone calls.) Was that because of a health or memory problem? INTERVIEWER: If the respondent gives an actual reason, decide whether this was a problem with either their health or memory.
EIADLI2 Question In total, for how long had [heshe] needed help making telephone calls, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIADLI2A Question INTERVIEWER: Enter the number of years.
EIADLI2B Question INTERVIEWER: Enter the number of months.
EIADLI2C Question INTERVIEWER: Enter the age.
EIADLJ1 Question (You said earlier that during the last three months of [hisher] life [einame1] received help with taking medication.) Was that because of a health or memory problem? INTERVIEWER: If the respondent gives an actual reason, decide whether this was a problem with either their health or memory.
EIADLJ2 Question In total, for how long when [heshe] died had [heshe] needed help when taking medication?INTERVIEWER: Code how the answer is given.
EIADLJ2A Question INTERVIEWER: Enter the number of years.
EIADLJ2B Question INTERVIEWER: Enter the number of months.
EIADLJ2C Question INTERVIEWER: Enter the age.
EIADLK Question Were there any other activities that [EiName1] had problems with in the last 3 months of [hisher] life?
EIADLKO Question What other activities did they have problems with?
EIADLK2 Question Did anyone help [himher] with these activities?
EIWHLP Question SHOW CARD EI5 Thinking about the [acttxt] that [EiName1] had problems with, who usually helped [einame1] with [thacttxt]? PROBE: Did anyone else help [EiName1] with [thacttxt]? CODE ALL THAT APPLY. INTERVIEWER: Only code once for respondent. For example if respondent is son or daughter code 'Respondent', and not son or daughter. Only code 'Son' or 'Daughter' for those other than respondent.
EICOGINT Question Now I would like to ask you some questions about [EiName1]'s memory and concentration during [hisher] last year of life.
EICOGA Question Did [EiName1] have difficulty remembering things about [hisher] family and friends,like occupations, birthdays or addresses? Did he have ... READ OUT ...1 ...no difficulty,
EICOGB Question Did [heshe] have difficulty remembering things that had happened recently? Did hehave ... READ OUT ...1 ...no difficulty,
EICOGC Question Did [heshe] have difficulty recalling conversations a few days after they had taken place? Did he have ... READ OUT ...1 ...no difficulty,
EICOGD Question Did [heshe] have difficulty remembering [hisher] address and telephone number? Did he have ... READ OUT ...1 ...no difficulty,
EICOGE Question Did [heshe] have difficulty remembering what day and month it was? Did he have ... READ OUT ...1 ...no difficulty,
EICOGF Question Did [EiName1] have difficulty remembering where things were usually kept? Did he have ... READ OUT ...1 ...no difficulty,
EICOGG Question Did [heshe] have difficulty following a story in a book, on the radio or on the TV? Did he have ... READ OUT ...1 ...no difficulty,
EICOGH Question Did [heshe] have difficulty making decisions on everyday matters? Did he have ... READ OUT ...1 ...no difficulty,
EICOGI Question Did [heshe] have difficulty handling financial matters, like [hisher] pension or dealing with the bank? Did he have ... READ OUT ...1 ...no difficulty,
EICOGJ Question Did [heshe] ever forget what had been said and repeat the same question again and again? IF YES, PROBE: Did [heshe] do this occasionally or frequently?
EICOGK Question Did [EiName1] have difficulty in interpreting surroundings, such as knowing where [heshe] was, or distinguishing between different types of people, such as doctors, visitors and relatives? Did he have ... READ OUT ...1 ...no difficulty,
EICOGL Question Did [heshe] have difficulty finding the way about[the_home] or finding the toilet? Did he have ... READ OUT ...1 ...no difficulty,
EICOGM Question When speaking, did [heshe] sometimes have difficulty finding the right word, or sometimes use the wrong words? IF YES, PROBE: Did [heshe] do this occasionally or frequently?
EICOGN Question Did [EiName1] sometimes repeat the same word or phrase over and over again?
EICOGO Question Did [hisher] thinking seem muddled at times?
EICOGP Question How long were these changes or difficulties with memory and concentration present? PROBE: From about how long before [heshe] died? INTERVIEWER: Code how the answer is given.
EICOGPA Question INTERVIEWER: Enter the number of years.
EICOGPB Question INTERVIEWER: Enter the number of months.
EICOGPC Question INTERVIEWER: Enter the age.
EICOGQ Question Did these changes or difficulties develop gradually or did they come on suddenly?
EICOGR Question Were there marked fluctuations in [hisher] level of attention or alertness?
EICOGS Question How long were these fluctuations in [hisher] levels of attention or alertness present? PROBE: From about how long before [heshe] died? INTERVIEWER: Code how the answer is given.
EICOGSA Question INTERVIEWER: Enter the number of years.
EICOGSB Question INTERVIEWER: Enter the number of months.
EICOGSC Question INTERVIEWER: Enter the age.
EITIMEIN Question Now I'm going to describe some difficult behaviors, which only a minority of people experience, and which can make caring for them more of a challenge. I would like you to tell me how frequently, if at all [EiName1] engaged in these behaviors during [hisher] last year of life. We would like to know if [EiName1] engaged in the behavior often, sometimes, rarely, or never. INTERVIEWER: Press and to continue.
EIPBHA Question SHOW CARD EI6 During [hisher] last year of life, how often did [EiName1] have temper tantrums? Was it often, sometimes, rarely, or never?
EIPBHB Question SHOW CARD EI6 And did [EiName1] make violent threats or attempts? How often did [heshe] do this?
EIPBHC Question SHOW CARD EI6 How often did [EiName1] break things on purpose?
EIPBHD Question SHOW CARD EI6 How often did [EiName1] cause complaints from the community?
EIPBHE Question SHOW CARD EI6 During [hisher] last year of life, how often did [EiName1] engage in strange or peculiar behaviour?
EIPBHF Question SHOW CARD EI6 And how often did [EiName1]'s behaviour cause complaints from family members?
EIMHFINT Question I would now like to ask you a few questions about [EiName1]'s mood during the last year of [hisher] life.
EIMHFA Question Did [heshe] seem to lose interest or enjoyment in most things, during [hisher] last year of life?
EIMHFB Question Do you think that [heshe] was inclined to blame [himherself] or feel unreasonably guilty about things during [hisher] last year of life?
EIMHFC Question Do you think [heshe] was depressed during [hisher] last year of life? IF YES, PROBE: Was [heshe] depressed sometimes or frequently?
EIMHFD Question Do you think there was a reason for [himher] to [mhtxt] during this time?
EIMHFE Question Did [heshe] feel so bad that it affected every part of [hisher] life, (like [hisher] work, friendship and family life) during [hisher] last year of life?
EIMHFF Question How long had [heshe] felt like this, when [heshe] died? INTERVIEWER: Code how the answer is given.
EIMHFFA Question INTERVIEWER: Enter the number of years.
EIMHFFB Question INTERVIEWER: Enter the number of months.
EIMHFFC Question INTERVIEWER: Enter the age.
EIMHFG Question SHOW CARD EI6 How often do you think [EiName1] felt happy during [hisher] last year of life?
EIMHFH Question SHOW CARD EI6 How often do you think [EiName1] felt contented or at peace during [hisher] last year of life?
EIMHFI Question SHOW CARD EI6 And how about the last three months of [hisher] life, how often do you think [EiName1] felt contented or at peace during this time?
EIHRINT Question The next questions are about problems [EiName1] may have had with [hisher] eyesight or hearing, during the last 3 months of [hisher] life.
EIEYE Question Was [EiName1]'s eyesight (using glasses or corrective lens as usual)...READ OUT...
EIOPT Question Did a doctor ever tell [EiName1] that [heshe] had any of these conditions? INTERVIEWER:Read out each in turn and code all that apply. Include diabetic retinopathy in code 2. Include age related maculopathy in code 3.
EICAT Question Did [EiName1] ever have cataract surgery?
EILENS Question Do you know if [EiName1] ever had a lens implant? INTERVIEWER: Read if necessary: 'Sometimes the lenses of the eyes can be replaced with artificial ones called intraocular lenses'. Do not include corneal transplants.
EIHEAR Question Was [EiName1]'s hearing (using a hearing aid as usual)...READ OUT...
EICAINT Question I would now like to ask you a few questions about other conditions that [EiName1] may have suffered from.
EICAHA Question You told me earlier that [EiName1] died following a heart attack. Did a doctor ever tell [himher] that [heshe] had had a heart attack, before the one that led to [hisher] death?
EICAST Question You told me earlier that [EiName1] died following a stroke. Did a doctor ever tell [himher] that [heshe] had had a stroke, before the one that led to [hisher] death?
EIDIAA Question SHOW CARD EI7 [Did] a doctor ever tell [himher] that [heshe] had any [other_] of the conditions on this card? PROBE : What others? CODE ALL THAT APPLY. [Add1]
EIDIX Question INTERVIEWER: Enter the name of the other heart condition.
EIBP Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had high blood pressure? INTERVIEWER: Enter the age in years.
EIBPST Question Did [EiName1] have high blood pressure during the last 12 months of [hisher] life?
EIMDA Question Was [EiName1] taking any medicines, tablets or pills for high blood pressure during the last 12 months of [hisher] life?
EIAGA Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had angina? INTERVIEWER: Enter the age in years.
EIYR1 Question Did [EiName1] have angina during the last 12 months of [hisher] life?
EIAGB Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had had a heart attack (including myocardial infarction or coronary thrombosis)? INTERVIEWER: Enter the age in years.
EIYR2 Question Did [EiName1] have a heart attack or myocardial infarction during the last 12 months of [hisher] life?
EIAGC Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had congestive heart failure? INTERVIEWER: Enter the age in years.
EIAGK Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had a heart murmur? INTERVIEWER: Enter the age in years.
EIAGK2 Question Did [EiName1] have a heart murmur during the last 12 months of [hisher] life?
EIAGL Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had an abnormal heart rhythm? INTERVIEWER: Enter the age in years.
EIAGL2 Question Did [EiName1] have an abnormal heart rhythm during the last 12 months of [hisher] life?
EIAGD Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had diabetes or high blood sugar? INTERVIEWER: Enter the age in years.
EIAGDI Question Did [EiName1] inject insulin for diabetes during the last 12 months of [hisher] life?
EIMDB Question Did [EiName1] take any tablets, pills or other medicines for diabetes during the last 12 months of [hisher] life?
EIAGM Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had had a stroke? INTERVIEWER: Enter the age in years.
EIAGM2 Question Did [EiName1] have a stroke during the last 12 months of [hisher] life?
EIAGN Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had [EiDIX]? INTERVIEWER: Enter the age in years.
EIAGN2 Question Did [EiName1] have [EiDIX] during the last 12 months of [hisher] life?
EICACA Question You told me earlier that [EiName1] died of cancer. Did a doctor ever tell [himher] that [heshe] had cancer?
EIDIAB Question SHOW CARD EI8 [Do_] you know if [EiName1] was ever told by a doctor that [heshe] had any[other_] of the conditions on this card? INTERVIEWER PROBE - 'What others?' CODE ALL THAT APPLY. [Add1]
EILNG Question Was [EiName1] taking medication or other treatment for [hisher] lung condition during the last 12 months of [hisher] life?
EIAMA Question Was [EiName1] taking medication or other treatment for [hisher] asthma during the last 12 months of [hisher] life?
EIART Question Do you know which type or types of arthritis [EiName1] had? Was it ...READ OUT... CODE ALL THAT APPLY.
EIAGF Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had arthritis? INTERVIEWER: Enter the age in years.
EIAGG Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had cancer or a malignant tumour? INTERVIEWER: Enter the age in years.
EICANA Question SHOW CARD EI9 In which organ or part of [hisher] body did the cancer or tumour start? CODE ONE ONLY
EIPRK Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had Parkinson's disease? INTERVIEWER: Enter the age in years.
EIAGH Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had emotional, nervous or psychiatric problems? INTERVIEWER: Enter the age in years.
EIPSY Question SHOW CARD EI10 What type of emotional, nervous or psychiatric problems did [heshe] have? PROBE: What others? CODE ALL THAT APPLY.
EIYRC Question Did [heshe] have these problems during the last 12 months of [hisher] life?
EIAGI Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had Alzheimer's Disease? INTERVIEWER: Enter the age in years.
EIAGJ Question Approximately how old was [EiName1] when [heshe] was first told by a doctor that [heshe] had dementia, senility or any other serious memory impairment? INTERVIEWER: Enter the age in years.
EIAGO Question Did [heshe] have any other major illnesses in the year preceding [hisher] death?
EIAGOA Question INTERVIEWER: Write in any other major illnesses.
EIMEDINT Question I would now like to ask you about any artificial implants [EiName1] may have had.
EIMEDA Question Did [heshe] ever have an artificial joint, such as an artificial hip, knee or finger joint implanted?
EIMEDN Question How many such joints did [heshe] have implanted?
EIMEDB Question Which was the [order[pno]] joint [heshe] had implanted?
EIMEDC Question In what year was the [EiMedB] implanted? INTERVIEWER: Specify the year.
EIMEDCA Question Was the [EiMedB] implanted during [hisher] last year of life?
EIMEDDA Question In what month was the [EiMedB] implanted? INTERVIEWER: Specify the month.
EIMEDE Question Was the [EiMedB] removed or replaced?
EIMEDEA Question Was the [EiMedB] removed or replaced during the last year of life?
EIMEDF Question In what month was the [EiMedB] (removed/replaced)? INTERVIEWER: Enter month.
EIEXPINT Question I'd now like to ask you some questions about any expenses which [EIName1] incurred as a result of the medical care [heshe] received in the year before [heshe] died. Before I do that, though, I'd like to assure you again that everything you have already told me and anything else you tell me will be kept completely confidential.I TERVIEWER: Press and to continue.
EIEXPS Question Did [EIName1] receive any medical treatments other than on the NHS?
EIPHI Question Were any of the costs of these medical treatments covered by private health insurance?
EIFHLP Question [Did] [EIName1] receive any financial help to pay for any of these medical treatments?
EIFWHO Question [Who] else did [EIName1] receive financial help from? CODE ALL THAT APPLY.
EIFWHOA Question INTERVIEWER: Record who [EIName1] received financial help from.
EITOTL Question How much money in total did [EIName1] receive from others to pay for these treatments? INTERVIEWER: Enter amount to the nearest pound.
EITOTLB Question Was it...... BRACKETS (250, 1000, 5000, 10000)
EIFAMT Question How much did [EIName1][and_you] pay for the treatment[yourselves]? INTERVIEWER: Enter amount to the nearest pound.
EIFAMTB Question Was it...... BRACKETS (250, 1000, 5000, 10000)
EIHPAY Question [Multiple responses to EIHPAY are recorded in variables EIHPAY1 to EIHPAY4] [Finance]? CODE ALL THAT APPLY
EIHPAYO Question INTERVIEWER: Write in how the costs are financed.
EIFUN Question I asked you earlier about expenses incurred for the heath care that [EiName1] received. Now I would like to ask you about expenses which were associated with [hisher] funeral, or legal fees related to [hisher] death.INTERVIEWER: Press and to continue.
EIDCSTB Question Did [EiName1] have an insurance policy specifically designed to cover [hisher] funeral expenses?
EIFUINS Question In total, how much did this insurance pay out?
EIDCSTA Question What was the total cost of the funeral expenses and legal fees[after_ins]?
EIFUNREL Question SHOW CARD EI11 Who [elsetxt] paid for the funeral expenses (that is what is their relationship to [EiName1])? CODE ALL THAT APPLY. INTERVIEWER: Only code once for respondent. For example if respondent is son or daughter code 'Respondent', and not son or daughter. Only code 'Son' or 'Daughter' for those other than respondent.
EIRRELOT Question INTERVIEWER: The respondent has answered 'other' relationship: Write in relationship to [EIName1].
EITOTRES Question In total, how much did you pay towards [einame1]'s funeral expenses?
EITOTSPS Question In total, how much did the husband/wife pay towards [einame1]'s funeral expenses?
EITOTPRT Question In total, how much did the partner/cohabitee pay towards [einame1]'s funeral expenses?
EIFUNUM Question How many [relatives] paid towards the funeral expenses? INTERVIEWER: If same relationship, do not include respondent here.
EITOTREL Question In total, how much did the [order[idx]] [relative] pay towards the funeral expenses? INTERVIEWER: Enter amount in pounds.
EIWORINT Question Now I'd like to ask you some questions about [EIName1]'s employment situation since we last spoke to [himher].
EIWORKA Question Did [EIName1] do any paid work in the time since we last interviewed [himher] on [EIDatLa].
EIWHNTM Question When was the last time [EiName1] worked? INTERVIEWER: Enter month.
EIWHNTY Question (When was the last time [EiName1] worked?) INTERVIEWER: Enter year.
EISTOP Question Had [EiName1] stopped working before [hisher] death?
EIWHEN Question In what month and year did [heshe] stop working? INTERVIEWER: Enter month.
EIWHENY Question INTERVIEWER: Enter year.
EIWHY Question SHOW CARD EI12 Why did [heshe] stop working? INTERVIEWER: Code all that apply.
EIWHYOTH Question What was the reason? INTERVIEWER: Write in.
EIPENM Question Was [heshe] a member of a private pension plan, including employer provided, personal, stakeholder, or any other scheme?
EIPENN Question How many pension funds did [EiName1] have?
EIPTYPE Question SHOW CARD EI13 What type of pension scheme was this [order[PSeq]] scheme?
EIEMP Question What is the name of the employer provided scheme? INTERVIEWER: If police, local authority etc, probe for name of force/local authority etc. WRITE IN.
EIPEN Question When [heshe] died, what happened to [hisher] [EiPType]? ...READ OUT...CODE ALL THAT APPLY.
EIPENO Question INTERVIEWER: Enter details.
EIPENWHO Question SHOW CARD EI14 Who is receiving or expects to receive payments? INTERVIEWER: Code one only. If respondent is son or daughter code 'Respondent', and not son/daughter. Only code 'Son' or 'Daughter' for those other than respondent
EIPENWR Question INTERVIEWER: Please specify the other relative.
EIPENWN Question INTERVIEWER: Please specify the other non-relative.
EIPENXPM Question In what month and year do [you] expect to start receiving these regular payments? INTERVIEWER: Enter month.
EIPENXPY Question INTERVIEWER: Enter year.
EIPENXPA Question How much do [you] expect to receive per month?
EIPENXPB Question Is it...... BRACKETS (250, 500, 1000, 2500)
EIPENXLM Question In what month and year do [you] expect to receive the lump sum? INTERVIEWER: Enter month.
EIPENXLY Question INTERVIEWER: Enter year.
EIPENXLA Question How much do [you] expect the lump sum to amount to?
EIPENXLB Question Is it...... BRACKETS (5000, 10000, 50000, 100000)
EIPENPD Question Thinking about the last regular payment [you] received, what period did this cover?
EIPENPA Question How much did [you] receive?
EIPENPW Question Was it...... BRACKETS (50, 100, 250, 500)
EIPENPM Question Was it...... BRACKETS (250, 500, 1000, 2500)
EIPENPO Question Was it...... BRACKETS (250, 500, 1000, 2500)
EIPENLA Question Thinking about the lump sum payment [you] received, how much was this?
EIPENLB Question Was it...... BRACKETS (5000, 10000, 50000, 100000)
EIASSINT Question I would now like to ask you some questions about what happened to [EIName1]'s assets after [hisher] death.
EIWILLA Question Did [EIName1] have a Will?
EIKIN Question SHOW CARD EI14 Who was [EIName1]'s next of kin? INTERVIEWER: Code one only. If respondent is son or daughter code 'Respondent', and not son/daughter. Only code 'Son' or 'Daughter' for those other than respondent.
EIKINO Question INTERVIEWER: The respondent has answered 'other' relationship: Write in relationship to [EIName1].
EIEXEC Question Are you the legal executor of the Will?
EIBEN Question Are you a beneficiary of the Will?
EIPROB Question Did/Does [EiName1]'s Will need to go to probate?
EIWILLB Question Has [hisher] Will been through probate?
EIWILLPRO Question What is the total value of [eiName1]'s assets?
EIHOME Question Did [EiName1] own [hisher] main home or share of [hisher] main home when [heshe] died? By main home I mean the place where [heshe] lived most of the time (before they moved into an institution). INTERVIEWER: Other properties [heshe] may have owned will be covered later.
EIJOINT Question Did [einame1] own this home jointly with someone else?
EIPRP Question Did [EiName1] own any property, or share of any property, other than their main home when [heshe] died? (Exclude business property and other non-residential property, include holiday homes and timeshares.)
EIPRPN Question How many other properties did [EiName1] own?
EISP Question Did [yousp] inherit the [order[pseq]] home or [einame1]'s share of the home?
EISPOWN Question [cDoyou] currently own a share of the home?
EISPSH Question What share of the home [doyou] currently own? INTERVIEWER: Code how question will be answered
EISPP Question (What share of the home [doyou] currently own?) INTERVIEWER: Give the answer as a percentage.
EISPF Question (What share of the home [doyou] currently own?) INTERVIEWER: Give the answer as a fraction.
EISPA Question (What share of the home [doyou] currently own?) INTERVIEWER: Give the answer as an amount.
EISPINH Question Did [yousp] inherit the home (or [einame1]'s share of the home) solely or jointly with some other people?
EISHARE Question What share of the home did [einame1] own? INTERVIEWER: Code how question will be answered
EISHP Question (What share of the home did [einame1] own?) INTERVIEWER: Give the answer as a percentage.
EISHF Question (What share of the home did [einame1] own?) INTERVIEWER: Give the answer as a fraction.
EISHA Question (What share of the home did [einame1] own?) INTERVIEWER: Give the answer as an amount.
EIHOWH Question SHOW CARD EI14 [howtxt] (that is, what is their relationship to [einame1])? CODE ALL THAT APPLY INTERVIEWER: Only code once for respondent. For example if respondent is son or daughter code 'Respondent', and not son or daughter. Only code 'Son' or 'Daughter' for those other than respondent.
EIHOWOR Question INTERVIEWER: Please specify the other relative.
EIHOWON Question INTERVIEWER: Please specify the other non-relative.
EIHOWN Question How many [relyouplur[idy]] are you referring to?
EIHOLIV Question INTERVIEWER ASK OR CODE: Does this person live in this home at present?
EIHOLW Question SHOW CARD EI14 Who lives in the house at present? CODE ALL THAT APPLY.
EISPLIVE Question INTERVIEWER ASK OR CODE: Does [einame1]'s spouse/partner live in that home at present?
EIHOSLD Question What has happened to that home?
EIHOSOTH Question INTERVIEWER: Record what has happened to the home.
EIHOA Question What [was] the [value] of that home?
EIHOAB Question Was it......BRACKETS (50000, 75000, 125000, 500000)
EIHOMG Question Was there any outstanding mortgage on this home (before any insurance might have paid the outstanding balance)?
EIHOMGI Question Did [EiName1] have any insurance policies that will pay off or have paid off the mortgage either in full or partially?
EIHOMGA Question How much was the outstanding balance on this mortgage [mgtxt]?
EIHOMGAB Question Was it......BRACKETS (2500, 5000, 15000, 50000)
EIOTHO Question Who else owned the house with [einame1] when [heshe] died? INTERVIEWER: CODE ALL THAT APPLY
EIOTHN Question How many [relyouplur[idy]] are you referring to?
EIOSHARE Question What share of the house did [einame1] own?
EIOSHP Question (What share of the home did [einame1] own?) INTERVIEWER: Give the answer as a percentage.
EIOSHF Question (What share of the home did [einame1] own?) INTERVIEWER: Give the answer as a fraction.
EIOSHA Question (What share of the home did [einame1] own?) INTERVIEWER: Give the answer as an amount.
EIOIN Question Did only those with joint ownership inherit [einame1]'s share of the house?
EIOINW Question Who else inherited [einame1]'s share of the home? INTERVIEWER: DO NOT CODE JOINT OWNERS AGAIN
EIOINN Question How many [relyouplur[idy]] are you referring to?
EIOHWN Question How many [relyouplur[idy]] are you referring to?
EIOHLIV Question INTERVIEWER: ASK OR CODE: Does this person live in the home at present?
EIOHLW Question Who lives in the house at present? CODE ALL THAT APPLY.
EIOHSLD Question What has happened to that home?
EIOHSO Question INTERVIEWER: Record what has happened to the home.
EIOHA Question What [was] the [value] of that home?
EIOHAB Question Was it...... BRACKETS (50000, 75000, 125000, 500000)
EIOHMG Question Was there any outstanding mortgage on this home (before any insurance might have paid the outstanding balance)?
EIOHMGI Question Did [EiName1] have any insurance policies that will pay off or have paid off the mortgage either in full or partially?
EIOHMGA Question How much was the outstanding balance on this mortgage [mgtxt]?
EIOHMGAB Question Was it......BRACKETS (2500, 5000, 15000, 50000)
EIPHY Question Did [EiName1] own a business or share in a business, including land or premises?
EIPHYA Question In total, how much were these business assets worth (after any debts had been paid off on them)?
EIPHYAB Question Was it......BRACKETS (10000, 50000, 150000, 500000)
EIPHYWH Question SHOW CARD EI14 Who inherited these business assets? CODE ALL THAT APPLY. INTERVIEWER: Only code once for respondent. For example if respondent is son or daughter code 'Respondent', and not son or daughter. Only code 'Son' or 'Daughter' for those other than respondent.
EIPHYWR Question INTERVIEWER: Please specify the other relative(s).
EIPHYWN Question INTERVIEWER: Please specify the other non-relative(s).
EIPHYRES Question In total, how much did you inherit from these business assets?
EIINHSPS Question In total, how much did the husband/wife inherit from these business assets?
EIINHPRT Question In total, how much did the partner/cohabitee inherit from these business assets?
EIOTHAS Question SHOW CARD EI14 Excluding any housing, pensions, or businesses [EiName1] had, who inherited the rest of [hisher] assets? CODE ALL THAT APPLY. INTERVIEWER: Only code once for respondent. For example if respondent is son or daughter code 'Respondent', and not son or daughter. Only code 'Son' or 'Daughter' for those other than respondent.
EIOTHWR Question INTERVIEWER: Please specify the other relative(s).
EIOTHWN Question INTERVIEWER: Please specify the other non-relative(s).
EIOTHRES Question In total, how much did you inherit from the rest of [hisher] assets?
EIOTHSPS Question In total, how much did the husband/wife inherit from the rest of [hisher] assets?
EIOTHPRT Question In total, how much did the partner/cohabitee inherit from the rest of [hisher] assets?
EINUMREL Question How many [relatives] are you referring to? INTERVIEWER: If same relationship, do not include respondent here.
EIAMT Question In total, how much did the [order[idx]] [relative] inherit [fromthese]? INTERVIEWER: Enter amount in pounds.
EIAMPROB Question Excluding any housing, pensions, or businesses [EiName1] had, what was the total value of these other assets?
EILI Question Did [EiName1] have any life insurance policies which paid out on [hisher] death?
EILIWH Question SHOW CARD EI14 Who were the beneficiaries of the life insurance polices? CODE ALL THAT APPLY. INTERVIEWER: Only code once for respondent. For example if respondent is son or daughter code 'Respondent', and not son or daughter. Only code 'Son' or 'Daughter' for those other than respondent.
EILIWR Question INTERVIEWER: Please specify the other relative(s).
EILIWN Question INTERVIEWER: Please specify the other non-relative(s).
EILIA Question How much in total was the pay out from the life insurance?
EILIB Question How much did [you] receive from these life insurance policies.
EILIAB Question Was it.....BRACKETS (2000, 10000, 50000, 300000)
EIENDA Question We have asked you many questions about numerous aspects of [EIName1]'s health and finances, and we want to thank you very much for your assistance with them. Is there anything else you would like to add about [EIName1] in [hisher] last year of life? INTERVIEWER: If nothing to say, type None and press
EIENDB Question Thank you once again for all the information you have given us. It will prove extremely useful in helping us to understand how people fare at the end of their lives, and in forming policies which can help them. END
ADRSTOP Question NURSE: You need to satisfy the address check (AdrField) before going any further in this questionnaire. Press and select ELSAExit to enter the first line of the address on the NRF label.
MENUNOTE Question Reminder/note for opening menu (optional).
CHOICE Question INTERVIEWER: Do you now want to...1 ..return to the main menu,
OUTCOME Question INTERVIEWER: Record final outcome code.
INFO Question INTERVIEWER: Were you given contact details for a potential exit respondent?
NUMTRACE Question INTERVIEWER: Including the address on the front of the ERF, how many addresses did you personally visit? Only include addresses you tried to contact because you thought a potential exit respondent was resident.
LIVSITU Question INTERVIEWER:Code situation of (potential) exit interview respondent. If more than one person nominated, code answer for last exit respondent.
STADCO Question INTERVIEWER: Is he/she the stable address contact?
NAMCH Question INTERVIEWER:Enter the name of the exit respondent if different to that entered in the ELSA main admin block. Else, press
ADRCHA Question INTERVIEWER:Enter address for exit respondent if different to that entered in the ELSA main admin block. Else, press Address line 1:
ADRCHB Question INTERVIEWER:Enter address for exit respondent. Address line 2: (Just press if no more to add.)
ADRCHF Question INTERVIEWER:Enter address for exit respondent. Postcode: (Just press if none.)
ADRCHC Question INTERVIEWER:Enter address for exit respondent. Address line 3: (Just press if no more to add.)
ADRCHD Question INTERVIEWER:Enter address for exit respondent. Address line 4: (Just press if no more to add.)
ADRCHE Question INTERVIEWER:Enter address for exit respondent. Address line 5: (Just press if no more to add.)
TELCH Question INTERVIEWER:Enter telephone number if different to that entered in the ELSA main admin block. Include standard code. If not obtained, press .
INTDONE Question INTERVIEWER: Have you finished this questionnaire? Code 1 (Yes) signals that this questionnaire is ready for return to the Head Office.
Start of ES. Exit Survey
 

 
End of ES. Exit Survey