ES. Exit Survey

ES. Exit Survey module of ELSA 2012

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.
INTDAT Question (See INTDATMM and INTDATYY for month and year of interview) INTERVIEWER:Today's date. Amend if not correct. Else, press to continue.
EINAME1 Question First name of ELSA respondent
EINAME2 Question Surname of ELSA respondent
EIDATLA Question Date of last ELSA interview
EIINTRO Question You may be aware that [______ ELSA respondent's name] generously participated in the ELSA study before [______/her] death. [______/Her] contribution was very valuable. We would find it extremely helpful to have some information about the final year of [______/her] 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 [______ ELSA respondent's name]? Were you [______/her]...
EIRFRI Question Would you say [______/she] was a close friend, or not?
SURVSP Question INTERVIEWER ASK OR CODE:Did [______ ELSA respondent's name] have a surviving spouse/partner at the time of [______/her] death?
NUMMTH Question INTERVIEWER:Enter the number of months the respondent has known the deceased.
NUMYR Question INTERVIEWER:Enter the number of years the respondent has known the deceased.
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 [______ ELSA respondent's name]'s death. How long had [______/she] been ill before [______/she] died?
EISUDD Question Would you say [______/her] death was unexpected?
EISUDEX Question Why was [______/her] death expected?
EIEXPT Question Would you say [______/her] death was expected, or unexpected?
EIEXPTOT Question INTERVIEWER:Enter details.
EICAUS Question What was the main cause of [______ ELSA respondent's name]'s death?
EICAUSOT Question INTERVIEWER:Please enter details of the cause of death.
EIDATED Question May I ask, on what date did [______/she] 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 [______ ELSA respondent's name] die? Was it ...READ OUT...
EIPLACOT Question (What was this other place?) INTERVIEWER:Write in.
EIPLACOH Question In whose home did [______ ELSA respondent's name] die?
EIPLCN Question On how many different occasions did [[______ ELSA respondent's name] stay in [place] in the last two years before [______/she] died? INTERVIEWER:If appropriate include more than one person's home INTERVIEWER:Specify the number of times.
EIPLCL Question In total, how long did [______ ELSA respondent's name] stay in [______ from EiPlac] in the last two years before [______/she] 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 [______ ELSA respondent's name] lived or stayed overnight as a result of [______/her] health in the two years before [______/she] died.
EILIVE Question How many other types of places did [______ ELSA respondent's name] stay in overnight during the two years before [______/she] died, because of [______/her] health? INTERVIEWER:Include NHS and privately-owned establishments CODE ALL THAT APPLY.
EIHOMESTY Question In whose home did [______ ELSA respondent's name] stay?
EILOTHA Question On how many different occasions did [______ ELSA respondent's name] stay in another person's home in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILOTHB Question In total, how long did [______ ELSA respondent's name] stay in another person's home in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EILHOSPA Question On how many different occasions did [______ ELSA respondent's name] stay in a hospital in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILHOSPB Question In total, how long did [______ ELSA respondent's name] stay in a hospital in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EILHPCEA Question On how many different occasions did [______ ELSA respondent's name] stay in a hospice in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILHPCEB Question In total, how long did [______ ELSA respondent's name] stay in a hospice in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EILNURSA Question On how many different occasions did [______ ELSA respondent's name] stay in a nursing home in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILNURSB Question In total, how long did [______ ELSA respondent's name] stay in a nursing home in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EILRESA Question On how many different occasions did [______ ELSA respondent's name] stay in a residential home in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILRESB Question In total, how long did [______ ELSA respondent's name] stay in a residential home in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EILMIXA Question On how many different occasions did [______ ELSA respondent's name] stay in mixed nursing/residential home in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILMIXB Question In total, how long did [______ ELSA respondent's name] stay in mixed nursing/residential home in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EILSHELA Question On how many different occasions did [______ ELSA respondent's name] stay in sheltered housing in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILSHELB Question In total, how long did [______ ELSA respondent's name] stay in sheltered housing in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EILIVEA Question How many other types of places did [______/she] stay in during the two years befor [______/she] 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 [______ ELSA respondent's name] stay in this place in the last two years before [______/she] died? INTERVIEWER:Enter the number of times.
EILEXTB Question In total, how long did [______ ELSA respondent's name] stay in this place in the last two years before [______/she] died? INTERVIEWER:If stayed on more than one occasion add the times together.
EIDISTPH Question We'd like to ask you about [______ ELSA respondent's name]'s physical health and activity. During [______/her] last year, which of these descriptions fits [______/her] experience best?1 [______/She] was active and disability free, and died suddenly 2 [______/She] was mostly active and disability free, but declined during the last few months before [______/she] died 3 [______/She] had times of being seriously disabled, mixed with times of being active 4 [______/She] gradually become more and more disabled, without times of being active
EIADLINT Question I would now like to ask you about problems [______ ELSA respondent's name] might have had in [______/her] everyday life, before [______/she] died. The next questions are about help [______/she] may have received. Please tell me if [______/she] had received any help because of a physical, mental, emotional or memory problem during the last three months of [______/her] life. INTERVIEWER:Press and to continue.
EIADLA Question During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ... INTERVIEWER:READ OUT ... dressing, including putting on shoes and socks?
EIADLB Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... walking across a room?
EIADLC Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... bathing or showering?
EIADLD Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... eating such as cutting up [______/her] food?
EIADLE Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... getting in or out of bed?
EIADLF Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... using the toilet, including getting up and down?
EIADLG Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... preparing hot meals?
EIADLH Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... shopping for groceries?
EIADLI Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... making telephone calls?
EIADLJ Question (During the last three months of [______/her] life, did [______ ELSA respondent's name] need help with ...) INTERVIEWER:READ OUT ... taking medication?
EIADLA2 Question In total, for how long had [______/she] needed help with dressing when [______/she] died?
EIADLA2W Question In total, how many weeks was this?
EIADLA2M Question In total, how many months was this?
EIADLA2Y Question In total, how many years was this?
EIADLB2 Question For how long had [______/she] needed help with walking, when [______/she] died?
EIADLB2W Question In total, how many weeks was this?
EIADLB2M Question In total, how many months was this?
EIADLB2Y Question In total, how many years was this?
EIADLC2 Question In total, for how long had [______/she] needed help with bathing or showering, when [______/she] died?
EIADLC2W Question In total, how many weeks was this?
EIADLC2M Question In total, how many months was this?
EIADLC2Y Question In total, how many years was this?
EIADLD2 Question In total, for how long had [______/she] needed help with eating when [______/she] died?
EIADLD2W Question In total, how many weeks was this?
EIADLD2M Question In total, how many months was this?
EIADLD2Y Question In total, how many years was this?
EIADLE2 Question In total, for how long had [______/she] needed help getting in or out of bed, when [______/she] died?
EIADLE2W Question In total, how many weeks was this?
EIADLE2M Question In total, how many months was this?
EIADLE2Y Question In total, how many years was this?
EIADLF2 Question In total, for how long had [______/she] needed help with using the toilet, when [______/she] died?
EIADLF2W Question In total, how many weeks was this?
EIADLF2M Question In total, how many months was this?
EIADLF2Y Question In total, how many years was this?
EIADLG1 Question (You said earlier that during the last three months of [______/her] life [______ ELSA respondent's name] received help to preparehot 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 [______/she] needed help with preparing hot meals, when [______/she] died?
EIADLG2W Question In total, how many weeks was this?
EIADLG2M Question In total, how many months was this?
EIADLG2Y Question In total, how many years was this?
EIADLH1 Question (You said earlier that during the last three months of [______/her] life [______ ELSA respondent's name] 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 [______/she] needed help with shopping for groceries, when [______/she] died?
EIADLH2W Question In total, how many weeks was this?
EIADLH2M Question In total, how many months was this?
EIADLH2Y Question In total, how many years was this?
EIADLI1 Question (You said earlier that during the last three months of [______/her] life [______ ELSA respondent's name] 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 [______/she] needed help making telephone calls, when [______/she] died?
EIADLI2W Question In total, how many weeks was this?
EIADLI2M Question In total, how many months was this?
EIADLI2Y Question In total, how many years was this?
EIADLJ1 Question (You said earlier that during the last three months of [______/her] life [______ ELSA respondent's name] 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 [______/she] died had [______/she] needed help when taking medication?
EIADLJ2W Question In total, how many weeks was this?
EIADLJI2M Question total, how many months was this?
EIADLJI2Y Question In total, how many years was this?
EIADLK Question Were there any other activities that [______ ELSA respondent's name] had problems with in the last 3 months of [______/her] life?
EIADLKO Question What other activities did they have problems with?
EIWHLP Question Thinking about the [______ from EiADLA..K] that [______ ELSA respondent's name] had problems with, who usually helped [______ ELSA respondent's name] with [______\these activity\ies]? CODE ALL THAT APPLY.
EIWHLPF Question Thinking about the [______ from EiADLA..K] that [______ ELSA respondent's name] had problems with, who usually helped [______ ELSA respondent's name] with [______\these activity\ies]? PROBE:Did anyone else help [______ ELSA respondent's name] with [______\these activity\ies]? CODE ALL THAT APPLY.
EICOGINT Question Now I would like to ask you some questions about [______ ELSA respondent's name]'s memory and concentration during [______/her] last year of life.
EICOGA Question Did [______ ELSA respondent's name] have difficulty remembering things about [______/her] family and friends, like occupations, birthdays or addresses? Did he have ... READ OUT ...
EICOGB Question Did [______/she] have difficulty remembering things that had happened recently? Did he have ... READ OUT ...
EICOGC Question Did [______/she] have difficulty recalling conversations a few days after they had taken place? Did he have ... READ OUT ...
EICOGD Question Did [______/she] have difficulty remembering [______/her] address and telephone number? Did he have ... READ OUT ...
EICOGE Question Did [______/she] have difficulty remembering what day and month it was? Did he have ... READ OUT ...
EICOGF Question Did [______ ELSA respondent's name] have difficulty remembering where things were usually kept? Did he have ... READ OUT ...
EICOGG Question Did [______/she] have difficulty following a story in a book, on the radio or on the TV? Did he have ... READ OUT ...
EICOGH Question Did [______/she] have difficulty making decisions on everyday matters? Did he have ... READ OUT ...
EICOGI Question Did [______/she] have difficulty handling financial matters, like [______/her] pension or dealingwith the bank? Did he have ... READ OUT ...
EICOGJ Question Did [______/she] ever forget what had been said and repeat the same question again and again? IF YES, PROBE:Did [______/she] do this occasionally or frequently?
EICOGK Question Did [______ ELSA respondent's name] have difficulty in interpreting surroundings, such as knowing where [______/she] was, or distinguishing between different types of people, such as doctors, visitors and relatives? Did he have ... READ OUT ...
EICOGL Question Did [______/she] have difficulty finding the way about [______/ his/her home] or finding the toilet? Did he have ... READ OUT ...
EICOGM Question When speaking, did [______/she] sometimes have difficulty finding the right word, or sometimes use the wrong words? IF YES, PROBE:Did [______/she] do this occasionally or frequently?
EICOGN Question Did [______ ELSA respondent's name] sometimes repeat the same word or phrase over and overagain?
EICOGO Question Did [______/her] 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 [______/she] died?
EICOGPW Question In total, how many weeks was this?
EICOGPM Question In total, how many months was this?
EICOGPY Question In total, how many years was this?
EICOGQ Question Did these changes or difficulties develop gradually or did they come on suddenly?
EICOGR Question Were there marked fluctuations in [______/her] level of attention or alertness?
EICOGS Question How long were these fluctuations in [______/her] levels of attention or alertness present? PROBE:From about how long before [______/she] died?
EICOGSW Question In total, how many weeks was this?
EICOGSM Question In total, how many months was this?
EICOGSY Question In total, how many years was this?
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 [______ ELSA respondent's name] engaged in these behaviors during [______/her] last year of life. We would like to know if [______ ELSA respondent's name] engaged in the behavior often, sometimes, rarely, or never. INTERVIEWER:Press and to continue.
EIPBHA Question During [______/her] last year of life, how often did [______ ELSA respondent's name] have temper tantrums? Was it often, sometimes, rarely, or never?
EIPBHB Question And did [______ ELSA respondent's name] make violent threats or attempts? How often did [______/she] do this?
EIPBHC Question How often did [______ ELSA respondent's name] break things on purpose?
EIPBHD Question How often did [______ ELSA respondent's name] cause complaints from the community?
EIPBHE Question During [______/her] last year of life, how often did [______ ELSA respondent's name] engage in st[range or peculiar behaviour?
EIPBHF Question And how often did [______ ELSA respondent's name]'s behaviour cause complaints from family members?
EIMHFINT Question I would now like to ask you a few questions about [______ ELSA respondent's name]'s mood during the last year of [______/her] life.
EIMHFA Question Did [______/she] seem to lose interest or enjoyment in most things, during [______/her] last year of life?
EIMHFC Question Do you think [______/she] was depressed during [______/her] last year of life? IF YES, PROBE: Was [______/she] depressed sometimes or frequently?
EIMHFE Question Did [______/she] feel so bad that it affected every part of [______/her] life, (like [______/her] work, friendship and family life) during [______/her] last year of life?
EIMHFF Question How long had [______/she] felt like this, when [______/she] died? INTERVIEWER:Code how the answer is given.
EIMHFFW Question In total, how many weeks was this?
EIMHFFM Question In total, how many months was this?
EIMHFFY Question In total, how many years was this?
EIMHFG Question How often do you think [______ ELSA respondent's name] felt happy during [______/her] last year of life?
EIMHFH Question How often do you think [______ ELSA respondent's name] felt contented or at peace during [______/her] last year of life?
EIMHFI Question And how about the last three months of [______/her] life, how often do you think [______ ELSA respondent's name] felt contented or at peace during this time?
EIHRINT Question The next questions are about problems [______ ELSA respondent's name] may have had with [______/her] eyesight or hearing, during the last 3 months of [______/her] life.
EIEYE Question Was [______ ELSA respondent's name]'s eyesight (using glasses or corrective lens as usual)...READ OUT...
EIOPT Question Did a doctor ever tell [______ ELSA respondent's name] that [______/she] 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 [______ ELSA respondent's name] ever have cataract surgery?
EIHEAR Question Was [______ ELSA respondent's name]'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 [______ ELSA respondent's name] may have suffered from.
EICAHA Question You told me earlier that [______ ELSA respondent's name] died following a heart attack. Did a doctor ever tell [______/her] that [______/she] had had a heart attack, before the one that led to [______/her] death?
EICAST Question You told me earlier that [______ ELSA respondent's name] died following a stroke. Did a doctor ever tell [______/her] that [______/she] had had a stroke, before the one that led to [______/her] death?
EIDIAA Question [^ And apart from this did\ Did] a doctor ever tell [______/her] that [______/she] had any [______ of the conditions on this card? PROBE:What others? CODE ALL THAT APPLY.
EIDIX Question INTERVIEWER:Enter the name of the other heart condition.
EIBPST Question Did [______ ELSA respondent's name] have high blood pressure during the last 12 months of [______/her] life?
EIMDA Question Was [______ ELSA respondent's name] taking any medicines, tablets or pills for high blood pressure during the last 12 months of [______/her] life?
EIAGA Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had angina? INTERVIEWER:Enter the age in years.
EIYR1 Question Did [______ ELSA respondent's name] have angina during the last 12 months of [______/her] life?
EIHMED Question Was [______ ELSA respondent's name]taking any taking any medication to thin the blood such as Warfarin, Plavix, Ticlid, or other blood-thinning medication during the last 12 months of [______/her] life?
EIAGB Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had had a heart attack (including myocardial infarction or coronary thrombosis)? INTERVIEWER:Enter the age in years.
EINMMI Question How many heart attacks (including myocardial infarction or coronary thrombosis), if any, did [______ ELSA respondent's name] have in the last 12 months according to a doctor?"
EIAGC Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had congestive heart failure? INTERVIEWER:Enter the age in years.
EIAGK2 Question Did [______ ELSA respondent's name] have a heart murmur during the last 12 months of [______/her] life?
EIAGL Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had an abnormal heart rhythm? INTERVIEWER:Enter the age in years.
EIAGL2 Question Did [______ ELSA respondent's name] have an abnormal heart rhythm during the last 12 months of [______/her] life?
EIAGD Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had diabetes or high blood sugar? INTERVIEWER:Enter the age in years.
EIAGDI Question Did [______ ELSA respondent's name] inject insulin for diabetes during the last 12 months of [______/her] life?
EIMDB Question Did [______ ELSA respondent's name] take any tablets, pills or other medicines for diabetes during the last 12 months of [______/her] life?
EIAGM Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had had a stroke? INTERVIEWER:Enter the age in years.
EINMST Question How many strokes, if any, did [______ ELSA respondent's name] have in the last 12 months according to a doctor?"0 1 2 3 3 or more EiCYR. Did [______ ELSA respondent's name] have high cholesterol during the last 12 months [______/her] life?"
EIMDC Question Was [______ ELSA respondent's name] taking medication to lower [______/her[ cholesterol level during the last 12 months of [______/her] life?"
EIAGN Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had [[PERSON NAME] of other condition from EiDix]? INTERVIEWER:Enter the age in years.
EIAGN2 Question Did [______ ELSA respondent's name] have [[PERSON NAME] of other condition from EiDix] during the last 12 months of [______/her] life?
EICACA Question You told me earlier that [______ ELSA respondent's name] died of cancer. Did a doctor ever tell[______/her] that [______/she] had cancer?
EILNG Question Was [______ ELSA respondent's name] taking medication or other treatment for [______/her] lung condition during the last 12 months of [______/her] life?
EIAMA Question Was [______ ELSA respondent's name] taking medication or other treatment for [______/her] asthma during the last 12 months of [______/her] life?
EIART Question Do you know which type or types of arthritis [______ ELSA respondent's name] had? Was it CODE ALL THAT APPLY.
EIAGF Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had arthritis? INTERVIEWER:Enter the age in years.
EIAGG Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had cancer or a malignant tumour? INTERVIEWER:Enter the age in years.
EICANA Question In which organ or part of [______/her] body did the cancer or tumour start? CODE ONE ONLY
EICANO Question INTERVIEWER:Record where cancer or tumour started."
EICANM Question Had [______ ELSA respondent's name] received any treatment for [______/her] cancer or malignant tumour in the last 12 months of [______/her] life?"
EIPRK Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had Parkinson's disease? INTERVIEWER:Enter the age in years.
EIAGH Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had emotional, nervous or psychiatric problems? INTERVIEWER:Enter the age in years.
EIPSY Question What type of emotional, nervous or psychiatric problems did [______/she] have? PROBE: What others? CODE ALL THAT APPLY.
EIYRC Question Did [______/she] have these problems during the last 12 months of [______/her] life?
EIAGI Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by a doctor that [______/she] had Alzheimer's Disease? INTERVIEWER:Enter the age in years.
EIAGJ Question Approximately how old was [______ ELSA respondent's name] when [______/she] was first told by adoctor that [______/she] had dementia, senility or any other serious memory impairment? INTERVIEWER:Enter the age in years.
EILEUK Question Did [______ ELSA respondent's name] have any of the following blood disorders... CODE ALL THAT APPLY
EIAGK Question Approximately how old was [______ ELSA respondent's name] first told by a doctor that [______/she ] had leukaemia or lymphoma? INTERVIEWER:Enter age in years."[range:0..110] EIAGO. Did [______/she] have any other major illnesses in the year preceding [______/her] death?
EIAGOA Question INTERVIEWER:Write in any other major illnesses.
EIMEDINT Question I would now like to ask you about any joint replacement or resurfacing [______ ELSA respondent's name] may have had.
EIMEDA Question Did [______/she] ever have a joint replacement or resurfacing?
EIJIAA Question Did [______/she] ever have a joint replacement or resurfacing in the last year before ______ died?"
EIMEDN Question How many such joints did [______/she] have replaced or resurfaced?
EIMEDB Question Which was the [third\second etc] joint [______/she] had replaced or resurfaced?
EIMEDC Question In what year was the [^ joint mentioned at EiMedB] replaced or resurfaced? INTERVIEWER:Specify the year.
EIMEDCA Question Was the [^ joint mentioned at EiMedB] replaced or resurfaced during [______/her] last year of life?
EIHIT Question Did [______ ELSA respondent's name] provide written instructions about the treatment or care [______/she] wanted to receive during the final days of [______/her] life, sometimes called a Living Will, Advance Decision or Advanced Directive?
EIHIL Question Did these instructions express a desire to limit care in certain situations?
EIHLA Question Did [______ ELSA respondent's name] (also) make any legal ar[rangements for a specific person or persons to make decisions about [______/her] care or medical treatment if [______/she] could not make those [______/herself]? This is sometimes called a Lasting Power of Attorney.
EIHLN Question Who had that authority, (that is, what was their relationship to [______ ELSA respondent's name] )? CODE all that apply.
EIEXPINT Question I'd now like to ask you some questions about any expenses which [______ ELSA respondent's name] incurred as a result of the medical care [______/she] received in the year before [______/she] 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. INTERVIEWER:Press and to continue.
EIEXPS Question Did [______ ELSA respondent's name] 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 Other than insurances did [______ ELSA respondent's name] receive any financial help to pay for any of these medical treatments?
EIFWHO Question Who else did [______ ELSA respondent's name] receive financial help from? CODE ALL THAT APPLY.
EIFWHOA Question INTERVIEWER:Record who [______ ELSA respondent's name] received financial help from.
EITOTLB Question Was it...... BRACKETS (250, 1000, 5000, 10000) [Bracket results are recorded in EiTol, EiTou, EiToe, EiTor]
EIFAMTB Question Was it...... BRACKETS (250, 1000, 5000, 10000) [Bracket results are recorded in EiFAl, EiFAu, EiFAe, EiFAr]
EIHPAY Question How were these costs financed? 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 [______ ELSA respondent's name] received. Now I would like to ask you about expenses which were associated with [______/her] funeral, or legal fees related to [______/her] death. INTERVIEWER:Press and to continue.
EIDCSTB Question Did [______ ELSA respondent's name] have an insurance policy specifically designed to cover [______/her] funeral expenses?
EIFUINS Question INTERVIEWER:if the insurance is not paid out yet, record the expected amount to be paid out. In total, how much did this insurance pay out?
EIDCSTA Question What was the total cost of the funeral expenses and legal fees[______ the insurance payment]?
EIFUNREL Question Who [______ paid for the funeral expenses (that is what is their relationship to [______ ELSA respondent's name])? 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 [______ ELSA respondent's name].
EITOTRES Question In total, how much did you pay towards [______ ELSA respondent's name]'s funeral expenses?
EITOTSPS Question In total, how much did the husband/wife pay towards [______ ELSA respondent's name]'s funeral expenses?
EITOTPRT Question In total, how much did the partner/cohabitee pay towards [______ ELSA respondent's name]'s funeral expenses?
EIFUNUM Question How many [[______ from EIFUNREL] paid towards the funeral expenses? INTERVIEWER:If same relationship, do not include respondent here.
EITOTREL Question In total, how much did the [third\second etc] [______ from EIFUNREL] pay towards the funeral expenses? INTERVIEWER:Enter amount in pounds.
EIWORINT Question Now I'd like to ask you some questions about [______ ELSA respondent's name]'s employment situation since we last spoke to [______/her].
EIWORKA Question Did [______ ELSA respondent's name] do any paid work in the time since we last interviewed [______/her] on [______ of deceased ELSA respondent's last interview].
EIWHNTM Question When was the last time [______ ELSA respondent's name] worked? INTERVIEWER:Enter month.
EIWHNTY Question (When was the last time [______ ELSA respondent's name] worked?) INTERVIEWER:Enter year.
EISTOP Question Had [______ ELSA respondent's name] stopped working before [______/her] death?
EIWHEN Question In what month and year did [______/she] stop working? INTERVIEWER:Enter month.
EIWHENY Question INTERVIEWER:Enter year.
EIWHY Question Why did [______/she] stop working? INTERVIEWER:Code all that apply.
EIWHYOTH Question What was the reason? INTERVIEWER:Write in.
EIPENM Question Was [______/she] a member of a private pension plan, including employer provided, personal, stakeholder, or any other scheme?
EIPENN Question How many pension funds did [______ ELSA respondent's name] have?
EIPTYPE Question What type of pension scheme was this [third\second etc] 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 [______/she] died, what happened to [______/her] [^ pension type from EiPType]? ...READ OUT... CODE ALL THAT APPLY.
EIPENO Question INTERVIEWER:Enter details.
EIPENWHO Question 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 [ and household/they] expect to start receiving these regular payments? INTERVIEWER:Enter month.
EIPENXPY Question INTERVIEWER:Enter year.
EIPENXPA Question How much do [ and household/they] expect to receive per month?
EIPENXPB Question Is it...... BRACKETS (250, 500, 1000, 2500)
EIPENXLM Question In what month and year do [ and household/they] expect to receive the lump sum? INTERVIEWER:Enter month.
EIPENXLY Question INTERVIEWER:Enter year.
EIPENXLA Question How much do [ and household/they] expect the lump sum to amount to?
EIPENXLB Question Is it...... BRACKETS (5000, 10000, 50000, 100000)
EIPENPD Question Thinking about the last regular payment [ and household/they] received, what period did this cover?
EIPENPA Question How much did [ and household/they] 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 [ and household/they] 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 [______ ELSA respondent's name]'s assets after [______/her] death.
EIASCK Question Can I just check, has [______ ELSA respondent's name]'s estate been distributed yet?"
EIWILLA Question Did [______ ELSA respondent's name] have a Will?
EIKIN Question Who was [______ ELSA respondent's name]'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 [______ ELSA respondent's name].
EIEXEC Question Are you the legal executor of the Will?
EIBEN Question Are you a beneficiary of the Will?
EIPROB Question Did/Does [______ ELSA respondent's name]'s Will need to go to probate?
EIWILLB Question Has [______/her] Will been through probate?
EIWILLPRO Question What is the total value of [______ ELSA respondent's name]'s assets?
EIHOME Question Did [______ ELSA respondent's name] own [______/her] main home or share of [______/her] main home when [______/she] died? By main home I mean the place where [______/she] lived most of the time (before they moved into an institution). INTERVIEWER:Other properties [______/she] may have owned will be covered later.
EIOSHARE Question What share of the house did [______ ELSA respondent's name] own?
EIOHMGAB Question Was it...... BRACKETS (2500, 5000, 15000, 50000) [Bracket results are recorded in EioHbl, EioHbu, EioHbe, EioHbr]
EIPRP Question Did [______ ELSA respondent's name] own any property, or share of any property, other than their main home when [______/she] died? (Exclude business property and other non-residential property, include holiday homes and timeshares.)
EIPRPN Question How many other properties did [______ ELSA respondent's name] own?
EISP Question Did [ and household/ their spouse/partner inherit the [first] home or [______ ELSA respondent's name]'s share of the home?
EISPOWN Question [______ you/ does their spouse/partner] currently own a share of the home?
EISPSH Question What share of the home [______ you/ does their spouse/partner] currently own? INTERVIEWER:Code how question will be answered
EISPP Question (What share of the home [______ you/does their spouse/partner] currently own?) INTERVIEWER:Give the answer as a percentage.
EISPF Question (What share of the home [______ you/does their spouse/partner] currently own?) INTERVIEWER:Give the answer as a fraction.
EISPA Question (What share of the home [______ you/does their spouse/partner] currently own?) INTERVIEWER:Give the answer as an amount.
EISPINH Question Did [ and household/their spouse/partner] inherit the home (or [______ ELSA respondent's name]'s share of the home) solely or jointly with some other people?
EISHP Question (What share of the home did [______ ELSA respondent's name] own?) INTERVIEWER:Give the answer as a percentage.
EISHF Question (What share of the home did [______ ELSA respondent's name] own?) INTERVIEWER:Give the answer as a fraction.
EISHA Question (What share of the home did [______ ELSA respondent's name] own?) INTERVIEWER:Give the answer as an amount.
EIHOWH Question [Who inherited this home/ deceased ELSA respondent's name's share] (that is, what is their relationship to [______ ELSA respondent's name])? 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 [______ of relative from EIHOWH] are you referring to?
EIHOLIV Question INTERVIEWER ASK OR CODE:Does this person live in this home at present?
EIHOLV Question Do any of these people currently live in that home?
EIHOLW Question Who lives in the house at present? CODE ALL THAT APPLY.
EISPLIVE Question INTERVIEWER ASK OR CODE:Does [______ ELSA respondent's name]'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 [______/ selling price] of that home?
EIHOAB Question Was it...... BRACKETS (50000, 75000, 125000, 500000) [Bracket results are recorded in EiHool1, EiHoou1, EiHooe1, EiHoor1]
EIHOMG Question Was there any outstanding mortgage on this home (before any insurance might have paid the outstanding balance)?
EIHOMGI Question Did [______ ELSA respondent's name] 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) [Bracket results are recorded in EiHobol1, EiHobou1, EiHoboe1, EiHobor1]
EIJOINT Question [Loop:Responses to EIJOINT are recorded in variables EIJOINT 2 as maximum number of other properties was 1 so only one loop] Did [______ ELSA respondent's name] own this home jointly with someone else?
EIOTHO Question Who else owned the house with [______ ELSA respondent's name] when [______/she] died? INTERVIEWER:CODE ALL THAT APPLY
EIOTHN Question How many [______ of relative from EIOTHO] are you referring to?
EISHARE Question What share of the house did [______ ELSA respondent's name] own?
EIOSHP Question (What share of the home did [______ ELSA respondent's name] own?) INTERVIEWER:Give the answer as a percentage.
EIOSHF Question (What share of the home did [______ ELSA respondent's name] own?) INTERVIEWER:Give the answer as a fraction.
EIOSHA Question (What share of the home did [______ ELSA respondent's name] own?) INTERVIEWER:Give the answer as an amount.
EIOIN Question Did only those with joint ownership inherit [______ ELSA respondent's name]'s share ofthe house?
EIOINW Question Who else inherited [______ ELSA respondent's name]'s share of the home? INTERVIEWER:DO NOT CODE JOINT OWNERS AGAIN
EIOINN Question How many [______ of relative from EIOINW] are you referring to?
EIOHWH Question Who inherited this home (that is, what is their relationship to [______ ELSA respondent's name]? 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.
EIOHWN Question How many [______ of relative from EioHwH] are you referring to?
EIOHLIV Question INTERVIEWER:ASK OR CODE:Does this person live in the home at present?
EIOHLV Question Do any of these people who now own the property currently live in that home?
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 [______/selling price] of that home?
EIOHAB Question Was it...... BRACKETS (50000, 75000, 125000, 500000) [Bracket results are recorded in EioHl2, EioHu2, EioHe2, EioHr2]
EIOHMG Question Was there any outstanding mortgage on this home (before any insurance might have paid the outstanding balance)?
EIOHMGI Question Did [______ ELSA respondent's name] 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 [______ the insurance policy pay out]?[range:1..9999997] EioHMgab. Was it...... BRACKETS (2500, 5000, 15000, 50000) [Bracket results are recorded in EioHl2, EioHu2, EioHe2, EioHr2]
EIPHY Question Did [______ ELSA respondent's name] 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) [Bracket results are recorded in EIphl, EIphu, EIphe, EIphr]
EIPHYWH Question 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 Excluding any housing, pensions, or businesses [______ ELSA respondent's name] had, who inherited the rest of [______/her] 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 [______/her] assets?
EIOTHSPS Question In total, how much did the husband/wife inherit from the rest of [______/her] assets?
EIOTHPRT Question In total, how much did the partner/cohabitee inherit from the rest of [______/her] assets?
EINUMREL Question How many [______ of relative from EIOTHAS] are you referring to? INTERVIEWER:If same relationship, do not include respondent here.
EIAMT Question [Loop:Responses to EIAMT are recorded in variables EIAMT401 to EIAMT800] In total, how much did the [third\second etc] [______ of relative from EIOTHAS] inherit [______ these]? INTERVIEWER:Enter amount in pounds.
EIAMPROB Question Excluding any housing, pensions, or businesses [______ ELSA respondent's name] had, what was the total value of these other assets?
EILI Question Did [______ ELSA respondent's name] have any life insurance policies which paid out on [______/her] death?
EILIWH Question 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 [ and household\the type of relative] receive from these life insurance policies.
EILIAB Question Was it...... BRACKETS (2000, 10000, 50000, 300000) [Bracket results are recorded in EiLIl1-24, EiLIu1-24, EiLIe1-24, EiLIr1-24]
EIENDA Question We have asked you many questions about numerous aspects of [______ ELSA respondent's name]'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 [______ ELSA respondent's name] in [______/her] last year of life? INTERVIEWER:If nothing to say, type None and press END.
Start of ES. Exit Survey
 

 
End of ES. Exit Survey