REFUSED -7 KNOW -8 DON’T FENCEPOST PF2CG. Does {s/he} have difficulty going outside the home, for example to shop or visit a doctor’s office? (PFDFOUC) YES 1 NO 2 [GO TO PF3CG] REFUSED -7 [GO TO PF3CG] KNOW -8 [GO TO PF3CG] DON’T PF2BCG. Does {s/he} need the help of another person to perform this activity? (PFDFOUBC) YES 1 NO 2 REFUSED -7 KNOW -8 DON’T FENCEPOST PF3CG. Does {CARE RECIPIENT} have difficulty getting in or out of bed or a chair? (PFBEDC) YES 1 NO 2 [GO TO PF4CG] REFUSED -7 [GO TO PF4CG] KNOW -8 [GO TO PF4CG] DON’T PF3BCG. Does {s/he} need the help of another person to perform this activity? (PFBEDBC) YES 1 NO 2 REFUSED -7 KNOW -8 DON’T FENCEPOST PF4CG. Does {s/he} have difficulty when taking a bath or shower? (PFBATHC) YES 1
REFUSED -7 DON’T KNOW -8 FENCEPOST PF2CG. Does {s/he} have difficulty going outside the home, for example to shop or visit a doctor’s office? (PFDFOUC) YES 1 NO 2 [GO TO PF3CG] REFUSED -7 [GO TO PF3CG] DON’T KNOW -8 [GO TO PF3CG] PF2BCG. Does {s/he} need the help of another person to perform this activity? (PFDFOUBC) YES 1 NO 2 REFUSED -7 DON’T KNOW -8 FENCEPOST PF3CG. Does {CARE RECIPIENT} have difficulty getting in or out of bed or a chair? (PFBEDC) YES 1 NO 2 [GO TO PF4CG] REFUSED -7 [GO TO PF4CG] DON’T KNOW -8 [GO TO PF4CG] PF3BCG. Does {s/he} need the help of another person to perform this activity? (PFBEDBC) YES 1 NO 2 REFUSED -7 DON’T KNOW -8 FENCEPOST PF4CG. Does {s/he} have difficulty when taking a bath or shower? (PFBATHC) YES 1
12th_NSOAAP_Survey_Instrument_06.16.2017.docx