|
SA1A
|
 |
INTERVIEWER: INDICATE IF THE INFORMANT IS THE WIDOW(ER) OF THE DECEASED PERSON |
|
SA1B
|
|
INTERVIEWER: RECORD THE INFORMANT'S MARITAL STATUS |
|
SA2
|
 |
Approximately, how old was (NAME) upon passing away? |
|
SA3
|
|
INTERVIEWER: RECORD (NAME)'S SEX |
|
SA4
|
|
Did (NAME) die in a private house or in a hospital or institution? |
|
SA5
|
|
In what community did (NAME) pass away? |
|
SA6
|
|
What was the cause (NAME)'s of death? |
|
SA7
|
|
What was the primary sickness that caused the death of (NAME)? |
|
SA8
|
|
(Please remind me) When did (NAME) pass away? |
|
SA9
|
|
Not counting vacations and short visits, did (NAME) ever live in the U.S? |
|
SA10
|
|
In the last year of his/her life, not counting vacations or short visits, did (NAME) work or live in the U.S.? |
|
SA15
|
|
Was (NAME) married or in union at the moment of passing away? |
|
SA16
|
|
When he/she passed away, did (NAME) live in the same home as his/her spouse or partner? |
|
SA17
|
|
In what month and year did they cease to live in the same home? |
|
SA18A
|
|
Was (NAME) widowed when he/she passed away? |
|
SA18B
|
|
In what year did (NAME)'s spouse passed away? |
|
SA19
|
|
Did any of (NAME)'s child(ren) die? |
|
SA20
|
|
Did (NAME) took over caring for a sick family member? |
|
SA21
|
|
Was there a disaster (such as a hurricane, earthquake, tornado, flood, fire), which affected (NAME)'s house? |
|
SA22
|
|
Did (NAME) suffer an accident, was the victim of a crime, or some other event that affected his/her health or family circumstances? |
|
SA23
|
|
Did (NAME) had a loss (such as health, employment, or that of his/her children that affected his/her financial situation? |