(),1

WCS
SURVEYS M? DISA8LE)PKPIW
Crmatlng
m
0v8rall ~
of mverity of disebihty
Jean Hartin erd David Elliot,
Camlses IMlisurveym
Office of P4ulmtim
1.
Intrahctim
The last natlcmal survey of dxesblllty in Great Brztam took place m
Su-icethem menY changes have occurrad ad the mformstmn from
1969
that survey could no longer give an accurate deecrlptlon of the
BY 1963 there was no up to date mfomstmn
current sltuatlcm
glvm.g en overall picture of people m Great Brltam with
dlsebllltzes and their cmcmstances, and mformtlon was rmuu+
to
help plan pollcles for benefIts end services for dlssbkl people
Thus u-i1983 discussions began between the Department of Health and
Social Security (DHSS) emd the OffIce of Populatmn Censuses and
Surveys (OFCS) about a programme of survey research to provtie the
nformatlon rqulred
DHSS commssmned
(a)
(b)
(c)
(d)
dlssbled
dlsablei
disabled
dlssbled
OFCS to carry out four sepsrats surveys of.
adults llVU
m prlvste households
children llVU
m private tiseholds
adults llvmg m comuiunalestablishments
children llvmg u-icommnmal estsbllsiments
The smveys of dlssbled adults end children llVW
m private
households took place m 1985, following a preimmsry
screerung
The survey of adults m
stage to ldentlfy sam les for these surveys
communal estebllshments took place m 1986 ano that of dlssblal
children m comunal estebllsiments m 1988
The surveys a- to provide c~rehenslve estmates of the prevalence
of dlssbzllty by age, degree of severity and type of dlssbxllty
In
eddltmn they w1ll provide other mformtmn
about the disabled, m
particular sbcut the fu-ienclaland social cmsquences of dusshllty
end the use of and need for tusalthand persrmal soczal servmes.
In otier to prom.de prevalence estmates by degree of severity of
dlssblllty, a defuntmn
end measure of severity of dlssblllty 1s
rqulrai, and a means of Identlfyr@ people nth dlssixlltles to be
This paper gives the defuntxas
being
u-mluded m the estmates
used cm the surveys ad provmdes a brief descrlptla of tk methcds
used to ldentlfy dlssbled pemle, but focuses msmlY cm the
development of a manure of severity of dlssixllty
Although the same prmclples have been adopted cm all the surveys,
the development work to prcduce an overall measure of severity was
undertaken prmar 1lY on the survey of dxssbled adults llvmg m
The methods used cm this survey have been
prlvete households
adapted altihtly to apply to adults llvuzz m comauuialestsbllslments
for whom not all the relevant u’if
ormatlon was avallsble Further
1
work is being carrimi out to extend the measures to diesbld
children, taking into account different stages of development Snd
different expectations about children’s behsviour. However, this
paper is confined to a the problems end methcds of developti a
measure of severity for adults.
It was agreed at the start of work on the survey that a
unidimeneional scale of overall disability was required, with a
discrete number of categories to which each parson in the survey
could be allocated according to the severity of their disability. In
addition to being used for prevalence estimates, the meseure of
severity is being uscrise an important explanatory vsxieble for
snalysing the rest of the information collected on the surveys about
the consequences of disability.
2.
CmcasQts MXI defimitims
Estimates of the prevalence of dieability derived from snY study
depend on the choice of concepts and the methcds used. These in turn
depend on the particular purposes and aims of the study in question.
This point is worth empheaieing becausa it means that estimates from
this study will not necessarily be comparable with those obtaind
from others using different concepts or methcds, and the methcds
developed for this study cannot be used for other purposes without
further development end validation.
An ~ually ixportsnt determinant of prevalence rates is the threshold
of severity chosen to decide whether or not someone should be
included in a particular study.
2.1
Disability es a cmtimuum
It is misleading to think of people as either diasbled or not
disabled. As soon as one tries to define ‘disabled’ in terms that
can be used cm a survey it becomes apparent that there is a wide
variety of possible definitions end large numbers of people could be
included or excluded dewnding on which was used. It is more helpful
to think of disability as a cantinuum ranging from very severe to
trivial dieabilities. The definition of disability for a particular
survey is determined by where on the continuum a threshold level is
set above which people are included in the survey estimates. This is
illustrate in Figure 1.
Figure 1 The cultilMlm of eievurityof disability
,
slight
Vsrg severe
t.hrmLld
t
<
4
‘dkabld
2
‘
>
Estmtes
of the overall prevalence of dlseblllty are baaed on the
number of people fwnd to have dlssbllztles above the threshold
level ~ this baels It makes no sense to say that a pertlculsr
survey under- or over-estunstes the true prevalence of dlsetmllty
(unless the methods used to ldentlfy people with du=bllltles were
umdequate ), since there 1s no true prenlence, prevalence depends
cm how dlsablllty has been defmd
end measured on the survey m
questlm
The threshold level chosen for a particular survey reflects declamns
about which pemle lt IS ~tendal should contr~bute to the survey
estmates
But JJIorder to aee the effect of setting the threshold
at a particular point, a measure of severity 1s needed to be able to
place people almg the contuvmm
The edvsntege of uati se low a
threshold as possible 1s that the effect of using a different hxgher
threshold can be studlecl,since mformatmn
1s avmllable about
The drsedvsntage IS that since there are
evewne
above that level
fewest people with the most severe dleabllltles, for a given number
of untervlews, there w1ll be a smaller proportlon of people with very
severe dlssknlltles compared to those with less severe d lssbllltlea
2.2
ICIIXlcrmceets d
defimiti-
A mor
problem m the general field of dlssblllty lles an the
confusmn over terrmology
Leglalatlon, admznlstratmn, Scedemlc
reseerch and evetiay speech allke use terms umonslstent ly, the
same terms are used to refer to dlfferent concepte and d lfferent
terms ue usd to refer to Identical concepts
Fortunately a way out
of the confusion 1s proposed m the Intematlonal Clesslflcatmn of
Impamnente Dlsabllltles and Hsndlcspa (ICIDH) This World Health
Organlsatlon clssslflcatmn prcduce=iby Phllllp Word prowdes
comprehensive def mlt ions of the man concepts m this area end lt ~s
these defm ltmns that have been edopted for this study
The ICIDH ldentlfles three dlfferant concepts es consequences of
dleesse end presents a classlflcatmn for each
TheY are defmad as
~t
‘AJ-Iy
loss or Sbnomellty of paychologlcal, phy=olmglcal or
enatormcal structure or functlcm ‘ Here we are deahng with perta or
systems of the bcdy that do not work
DMility
‘Any restrlctmn or lack (reeultmg from en qammmt)
of Sblllty to
perform an actlvlty ID the manner or wlthm the range crrmdered
normal for a lmmen being
Here we are telkmg abut th~s
people
cannot do
Herdicap
A dlaedvantage for a given mdlvtiual, reaultmg from an ~amment
or dlsatullty, that lnlts or prevents the fulfll.mentof a rOle
(depending on age, sex end aoclal end cultural factors) for that
mdlvldual ‘ This M m relatmn to a particular environment end
relatmnshlps with other people
3
4;
5
The ICIDH uses the term ‘disablement’to refer to all the
consequences of disease, ie it embraces all three concepts. It
includes a detailad clsesification for each of the three concepts,
designed to allow ceding from individual case records.
The relatimahip between the ccmcepte can be represented se:
DISSASE
>lnPAIiamlT
>DISAS~
>?MNDICAP
T
I
The following axamplas illustrate the relatimahip between the three
cmcepts :
InPAImmtr
DISABILITY
S4NDICAP
Visim
>SeJeimg
Xlrimtatirn
SkelelA
>Walkimg
>Mobility
Cmrdim-wiratory
>Welkimg
>M3bility
D*.
lgurmant
>S92ial imtsgratim
In the case of some impairments, such as visicm ad hearing, there is
a more or less one to one correspondence between tiairment end
disability if the impairment is sufficiently serious. However, it
should be notad that although a large proportion of the pcpulaticm
auffer from visual impairment, because of the availability of
adequate glasses or contact lenses to correct impaired vision, far
fewer people can be said to have a seeing disability. In other
csses, such as the two shown ebwe, different impairments can give
rise to the same disebility. Conversely, one impaimt
maY result
severe intellectual
im more thsn one disability; for e~le,
impairment might result in a variety of different dieabilities. The
lack of correepcmdence between disabilities and handicaps is even
more apparent than between impairments and disabilities, se handicaps
are affected by such things as differencem in the envirmmnent, the
availability of others to help end the roles en individual is
expected to fulfil. Sometimes an tiairment results im a imndicap
without any disability, as in the case of disfigurament ehown above.
It is important to keep these crmcepts clear because they are often
UMXI with different meanings. People frequently have rather
stereotyped viewa of what is meant by disability end who ‘the
disebld’ are, imagining perhaps a young pereon in a wheel chair or a
child with Down’s syndrome. Elderly pecple are not usually thought
of am being dissbld, but the above definition of disability means
thst it is the old who are moat likely to be disabld es the aging
6
4
process takes Its toll and restricts the actlvltles that the elderly
cen perform
As the survey results sl-mw,amcmgst the very elderly
dlsabzllty can be sad to be the norm
Another problem 1s that people tend to use all the dlsaixllty-related
concepts ulterchsngeebly or mconslstentIy, reflecting PSrtlY common
usage n particular sltuatmns
For example, evsryday speech refers
to people with ‘mental harhceps”. Accordm,g to the ICIDH
terminology, thuj should be ‘mental ~alrmmts’
because the terms
‘mental”
and
“sensory’
are
correctly
aPPlld to
‘Ptilcal’,
~auments
rather then to dlaabllltles A clesslflcatmn of types
of du+wbllltles w1ll therefore be m terms of actlvltles m which
performence 1s 1ultmi rather then the ~amments
or c~lamts
ceusmg the luntatmns
Yet another problem wzth classlflcstlons SPP11M5 to mdzvlduals on
surveys 1s that whichever concept 1s used, menY people will have more
then one mpamment/dlseblllty/handicap, and so cannot be asm.gned
unrquely to one category comprlsmg all those with a particular
type
For exle,
since multlple health problem become more CUMIOII
with edvancmg years, elderly people may well have phyalcal, mental
and sensory ~ammnts
causI.!_@
a Variety of draabllltles and
handicaps
After discussion with DHSS It was egreed that the mm
focus of the
survey should be on drssblllty, that 1s on what people can and cannot
do, without regaml to the cause of them dzsablllty
2.3
%verity
of dimdnlity
The ICIDH defines severity of dlsablllty se follcws
severity of dlsablllty reflects the degree to which an mdlvldual s
actIvlty performsnce IS restrlctmcl
This defznltlon lS being used on the survey. However, the severity
scale included m the ICIDH 1s ~tended to be applled to each
separate d lsablllty, effectlvely resultms m eeveral lundred
separate scales
It IS not intended es an overall measure of
severity TtEM the ICIDH does not define overall severity nor
provide a single scale of severity which integrates the varlcus forma
of dlsablllty, It does not provide a aultable besls fro assessing
the areas of dlssblllty crnstiered on the survey
2.4
Dimabilitim coved
by the shsiy
The study ah
to cover, as f= as possible, all the areas of
Dlsebllltles were classified
dlse.tnlltyincluded m the ICIDH
along the lines of the ICIDH, but with Sdlfferences where the
ICIDH was cmsxiered to be either too detailed or not detailed enough
for the purpose of thui study
6uestlms were then devmed to
It was
tientlfy people with a dlssblllty m each of the ereas
necessary to dectie on the form m which questmns should be asked,
end m particular whether to ask about what people can do or what
5
7
they do do, that is between what they are thcught capable of and
their actual performance. It was decided that the former was more
appropriate, cm the grounds that benefit sssesesent is mede m this
basis and the main focus of the study was on social security
interests.
Although it had been @red
that the survey would focus on
disability, it was not possible to ask questions about disabilities
in such a way as to ensure that pecple with the disabilities would
necessarily acknowledge having them. This WSE particularly a problem
with disabilities resulting from msntal end psychological probhms.
6ome of the screening questions therefore asked about impairments and
handicaps to attempt to identify such people. This had the
disadvantage of somsttiee identifying people who were not considered
disabled for the purposes of the surveY, but this was seen ss a
lesser problem than miesing people who should have beem included.
3.
Idantificatim of pex@e with dissbilitim
There is no comprehensive list of all disabled people in the country
from which a sample for the surveys could be drawn. In order to
identify semples of people with disabilities living in private
households for interview it was necessary to screen a large sample of
the general population. The basic methd was a series of screening
procduree which aimed to move successively towards the
identification of the group of interest, without excluding people
tisdvertently.
Initially a large sample of the general population (100,000
eddresses) was screensd to idsntify people with some form of
disability. This wan done by asking the occupiers of the address to
c-lete
a a~rt questionnaire which asked about problems with a
number of different daily activities. Anyone with eny of these
problems was potential y available for the next stage of the survey.
At the second stage interviewers epproachd all those aged under 60
and half of those aged 60 or over who had been screened in at the
first stage as having at least one problem. Disability is much more
common among older people end so almost twice es manY disabled people
aged 60 or over se mposd
to under 60 were identified. Interviewti
cmlY half of those aged 60 meant that roughly equal numbers of people
in the two age bands were interviewed, givimg scope for similar
detail of malyeis without incurring the extra ooste of interviewing
all those aged 60 or over. Remlte in this report have been weighted
to restore the two sge bends to their correct proportions.
In theory it would be possible to des~
a set of screening questicovering all types of dieebilitiee which identified people with
equivalent levels of severity re$iardlessof which disabilities they
might have and which COUld be answered accurately eo that all those
with a particular level of dieability were identified and ncme were
missed.
8
In prsctlce It was neither poselble to des~
a set of questlms that
ldentlfA
people at the same level of dxsmbzllty regardless of type,
nor could we ensure thet people always enswerd the screening
questions accurately
The screernng questmns were therefore des@wd
to screen ~ PeWle
at a somewhat lower level of eeverlty then reamed
eventually ~
order not to risk excluding anyone who rn.ghtbe of interest, and a
secord screenu
stage was usd at the stmrt of the MU-I mtermews
to check answers given at the first stage end to determne whether
the mdlvldual was Sufflclently disabled to be included on the
mrvey
Although this procedure reduces the risk of mlssmg people who m
fact should hmve been included as being muffIclently dlsebled, It
cannot enmdre that no-one 1s mlsseii
It IS always possible that some
people with dlsshlltles chose not to reveal them in answer to the
screening questIons end of course come d Id not respond to the
screenmg questlonnalre at al1
The first step m defnmg
a threshold level for this study lay m
the choice of screenquestions used at the mltlal stage, swce
onlY people who responded positlvelY to at least one question were
These questzons were chosen
included m later stages of the study
to include people with dlsahlltles that were llkely to have a
s~lflcmt
effect on the alnllty to carry out normal everyday
actlvltles The choice of questmns recmnres ~udgements to be made,
and we were gu Ided by the sort of questions that have commnly been
used m others studies of dlsstu1lty and by d Mcussmns end
conaultatIon mth experts m dlsah 1Ity research end organlsatlons
representmg d usebled people
Despite the use of a threshold level, lt 1s llkely that some people
who are receipt of services or use aids or appliances WI1l not have
Thm IS a cmsequence of the choice of
been included m the study
dlsablllty em the basis of the study
Some people with mpamnents
MSY ss a result of the use of azds or wphnces
have onlY a very
mmor level of dlsablllty and as such fall below the threshold
Clearly mlllmns of pecple with s~ht mpanments which mre
leve1
overcome by the use of glasses would not be cmstiered es dmebled,
but qually someone with a pacemaker that allowed them to carry cut
normal everway actlvltles without anY problems WWld not be
considered dls.abledfor the purposes of the survey
Slmllarly
someone with en mpamment which cmld be overcme by tehng reuulmr
mallcatlon end which dti not effect them everxiay actlvltles would
not be included m the survey
It was only possible to establlsh the level of severzty at whmh the
screenmg questlone were m fact operatW
mce a measure of severity
ccmmon to all typee of dlseh Ilty had bsen developed, which was not
had taken place
This meant that
pratuced until efter the mterwewe
some people were mtervlewed m ful1 who were subsequently excludei
from the defmltlon of disabled eventually used on the survey
7
‘91
F@re
2
Succeasim stages in ttm idemtificatim
with disabilities
of paaple
very severe
q
t
4
-----
,
,
----4
,
,
0
--
-----
____
-----
severity
,
----
----,
,
-—
-----—.
-----
-__
———
—-—----
___
___
-—
----
‘disl
_=_
--
——--
,
,
---
full interview. not ‘dissbld’
\
,
,
,
,
no positive answers to screening questiomawe
,
: /1
\
\
\
\
ii
ve#’g 1 ight
Figure 2 illustrates the successive screening stages used to identify
people along the disability centinuum. The total population is
represented es a triangle with respect to disability, since
relatively few people are very severely disabled, end the nuwbers
increase se one goes elcmg the continuum towards the minor
disabilities.
4.
‘ftksrlcsdfor
~te
of ssverim
For a variety of reasons it was considered necessary to devel~ s
measure of severity specifically for use cm the SUNSY rather than to
use any existing measures. The survey collected tiformation about
whether people could or could not perform meny different activities,
but did not provide anY means of combining this information into cme
overall measure. Statistical analysis cen be used to some extent to
summarise this information, but there are thrw problems it cannot
solve satisfsctorily:
8
10
d
~ti
the meverit9 of mecific
of d-llity
l.mitatime within an arms
In some areas of dlsatdxty the order of severity of particular
llmltatlcns 1s Obvlws
not being able to walk H clearly more
lurmtmg than only bang able to walk 50 yards
But m other
areas the order of severity 1s not clear
For example, lS not
being able to wash meself more hmltmg than not beable to
get out of bed without help? Even lf dlsebllltles can be Placed
m order of severity, the dlstsnce apart an terms of severity
cannot be determned by analyrns of the mtervlew data
b)
~imr
the mevmriti of di=bilities
in differ=t
~
The survey data provtie no ❑ eans of determnmg
the relatlve
For
severity of dls.ahlltles from different end unrelated areas
a=u?le, 1S It more dlsabl~
not to be able to walk or not to be
able to see, end by hcm xuch do these dlssbllltles differ?
c)
Ammessmg
t.lmmeverlty of cmbinsticme of dimabillties
The survey data also provide no means of decuimg on how
combinations of dlseimlltles should be treated
Should not being
able tn walk or see be conslderd to be a s~le
mum of the
separate d lse.b1Itles or should they be we@hted n some way to
allow for them uteractlon?
In order to compare different dlsebllltles and to comhne mformatmn
about them mto an overall me=re
we need a crltermn of overall
severlty
Since the survey itself does not provide one, there 1s no
satlsfacto~ alternative to some form of Judgement es the crltermn
of overall severity of dlsablllty This could have taken the form of
a research decrslon about how mf ormstmn about dlff erent
dlsabdltles should be comhned mto m overall measure, for axsmple,
than an overall ❑ easure could be obtauwi by SUPIY muumnng the
number of dlfferent actlvltIes an md Ivldual had dlfflculty with or
could not perform
This uwolves a Judgement both about how to
comb.ne the separate d lsebllltIes and that the result lS m fact
meeeurmg severlty
liehave eduptal a more sophisticated approach m which sesesaments
are usd both to achieve a consmsus about the meemng of overall
severity of dumbll lty and to determme how the mf ormatmn form the
eurvey about different dlsebllltles should ix combmed to give en
overal1 measure of severity This approach relles on the JUdgSMSfltS
of people ebcut the mearung of severity of dlsehllty.
However, the
procedures described below resulted m general agreement about whet
this 1s end about how the severity of individual dlsabllltles
contrdmtss to the overall measure
9
5.
?~
of mthxls
Usd
The methcxisUS* have been baaed on those usd in the USA to develop
a health status measure, the Sickness Impact Profile (1), extended
for uss in this ccuntry on the Lambeth Survey of Disability (2). AS
well es adapting this to our put icular research needs, however, we
have also intrmixed some eubstantial innovations.
The prrtluctionof a single overall nmeasure of severity of disability
for each person i.nterviewd on the survey involved five distinct
stages, three of which used subjective, compaxative judgments.
a)
Judgememt of the relative severity of epecific 1imitations within
a single area of disability
b)
Judgement of the relative severity of epecific limitations across
different areaa of disability
c)
Establishing a lower level of severity across all areas of
disability above which people would be defined ss disabld for
the surveys
d)
Judgments of the relative severity of combinations of specific
limitations
e)
Hcdelling how the judges assess different combinations of
limitations and applying the mcdel back to the survey respondents
Initially each stage was tried out on staff in OPCS and DHSS
connected with the surveys. Then we involved a range of
professionals with expertise in disability - doctors from different
specialities, phyeiothempists, occupational therapists,
psychologists. etc end people carrying out research in this area.
People with disabilities and those caring for them and people from
voluntary organisations concerned with disability were also involved.
Although the criterion of overall severity that we are using is bssad
on a consensus of assessments of a large number of people actti 55
“judges’ and is therefore aubjective, it is by no means arbitrary;
the judges were given careful instructions and a high level of
agreement in their assessments wee achieved.
Nevertheless, any approach bseed on the use of subjective judgments
se a criterion raises the problem of validation: howcanitbeshosn
that the measure devisd for the survey actually meeure
whet it is
meant to? There is no easy answer to this question, since
necessarily there is no objective criteriaa against which to validate
the measure.
Aa with many other measures of this kind validity is
established by sesing how the measure works in practice. Does it
have emectd
relationships with other variables? Do people placed
at higher points on the scale seem to be more severely disabled than
those at lower points? These kinds of questions will be enawertd
10
..
pertly through analysls of the survey data about people with
dlsebllltles end pmtly by other studies epeclflcallY des@md
uwest~ate the measure,
6.
Initial eelectim
of i-
for smuati
to
ersae of dtiility
The fu-st staze n cmnstruct~
a scale of overall severity of
dzsablllty =
to carry cut a ~tmsuderable amwnt of sultlvanate
statistical analyras to explore the relatmnehlps hatween the
orMmal
areas of dlssblllty coveral m the ~tervleumg order to
reduce them to a more manageable number which could be presented to
judges
ManY of the or~mal
dlsabllltles were inter-related ad
could be comhned
For example, problems with walking, clmtu.ng
steps and stairs, banding and balance eze all covered m the
locomotIon ares
Some of the or~mal
areas covered health problems
or mpalrments rather then dlsabllltles As such they could be
viewed as consequences of dleablllty end so It would not be valti to
include them m the mean severlty meesure
It was therefore decided
not to umlude mformatlon about them m the severity measures but to
exemne them separately
Below we Summarise the relationship between the orxmal
dleeimlzty
areas used IJI the mter’new and those for which sepaxate severity
measures were prcduced aa a result of the rating exercises, and show
the areas which were not mcludd
Three ereas of du%ablllty were
not included mltlally because the mfocmstmm collected n the
mtervlew dud not given suf flclently speclflc descriptions of the
dma!mlltles
These were dlsahlltles assoclatad with suffermg from
flts and convulsions, problems with eating, drmkmg
or dwestmns
and hevmg as scar, blemlsh or defornmty
In the cue of the flrst,
a scale of severity of problems was developed after the scales for
the other ten erees, for the second and thmd people were considered
to have a dlsklllty lf such problems seriously affected their
ablllty to lead a normal llfe, but no severity scales could be
developed as umufflclent mformatlon had been collected
All these
problems were relatively umcommrm and so we had had llttle
mformetmcn from pilot work on which to base mre detailed me=res
original Srees
Amae
m the ~
Ualkmg
Steps and stairs
Bending and stra~htenmg
Fall@
and balance
Reachand stretching
Holdw,
8TlWll18 and tUrI’IU
with Se&arste ~
I.ocmrlt lon
Seeu-@
Hearu_@
Control of bladder and bowele
Being understock/understmdu@ others
Self care & household ectlvltles
Social behavmur end intellectual
functlonulg
11
Reaching and stretching
Dexterlty
Seeing
Heam.ng
Centumnce
ccmmumcat lcm
Persrmal caxe
Behavlour
Intellectual functmnti
I*3,
Consciousness
Digestion
Disfigurement
Eating, drinking and digestion
Disfigurement and deformities
Anxiety and depression
Breathlessness, wheezing aod ccughing
Pain or irritation
The criteria for selecting the particular items (limitations) to be
used in each area were:
i)
The items had to have been included on the survey. All the
items used to filter people for the separate dissbility
sections in the questionnaire were included.
ii) We aimed to avoid selecting items that were highly correlated
with one another, since we could impute a severity rating for
any such items not includd in the exercises.
iii) Some areas includd questions which formed a natural scale.
In such cases we sometimes excluded some of these constituent
questions and inputed values for them from others on the scale.
iv) We needd to simplify the task for the judges. This msnt
had to avoid including too manY items in any one area,
particularly if those items involvd very small wording
changes.
v)
we
Certain questions usd in the survey deliberately EM
to be
over-inclusive end therefore used a rather general or vague
fOrm of Welds. These items were excluded.
Applying these criteria tot he selection process prcduced 134 items
which were tried out in a pilot first judgement exercise. A number
of other criteria were then applied to reduce this aet still further.
vi)
A few items that were rated very incmsistsnt ly by different
~~
were excluded at this stage (but were incorporated
vii ) Where a number of items were ratad similarly by judges, one or
more of these were removed and their values imputed later.
This finally reduced the number of items to 99 covering the 10 areas.
7.
Selectim of judges
The broad aim of these judgemsnt exercises was to attswt to identify
enY general consensus about the degree of limitation associated with
different disabilities. This meant recruiting a range of people to
act as judges, although we deliberately cmcentrated on people with
14
12
some special evolvement with the dlssbllzty field, rn the bssls that
they would have some knowkige or experience of the llkely degree of
lurntatum associated with dlfferent types of dnmbllltles
Imtmlly
each Judgement task was trmi out m staff frrn OFCS and
DHSS revolved with the survey
Later we recruited a range of
professmnals with epprcprlate expertuse - doctors, phymotheraelsts,
occupatumal theremsts and psychologmts, es w1ll es dependent
researchers working m the area
Finally we approached a number of
voluntary organlsatlcrisccmcemd
with dumblllt y end through them
recrultal disabled people and those camng for them to act a Judges
Altogether about 100 pemle were revolved m at least me of the
J@l~ent
axerclsse
8.
JulgeaIuItawithim areas of disability
All those acting as Judges were given the same detalld mstructlms
so that as far as poseable everyone was csrwmg
out the tasks m the
same way
It was partmulerly mportent that all the Judges
recognised that we were concerned with dussbllity rather than
handicap or mpalrment, end that they therefore shmld not think
about what m~ht cause the dlseblllty nor what sort of person m~ht
have the dlseblllty
They were asked to coneader the actlvlty not
SUWIY m Its 0~ r~ht, but also the mellcatmns that an mmbzlzty
to perform en actlvlty would have on smllar actlvltles TheY were
told to asmme that there would be no-one available to help with the
actlvlty
They were eskd
In all 45 Judges were revolved at the frost stage
to rate the Items m each area of dlseblllty ndependently on a scale
Each ezea was Judgd m lts
of severity of luntatlon from 1 to 11
The Judges were given en
own without reference to the other areas
11 point scale and a set of cards each descrlbmg an actlvlty that an
Examles m the
mdlvldual could not do or had difficulty with
locmotlon area were
‘Cannot walk 1/4 of a mile cm the level without stcc@uwJ or
severe d Iscomfort‘Occeslonallyneeds to hold on to somethmg to keep balance’
Cannot walk at all’
The Judges were flrst asked to reed all the cards m the packet to
gam a cowlete picture of the range of actlvltles nthm
that area
of dlseblllty
Next they were sskai to place the least lmltmg
actlvlty at point 1 on the scale and the most lmltm.g at point 11.
Finally they were asked to place the r@memmg
cards at posltxms
along the scale, so that the dlstsnce between the cards reflected
their cpmions of the relatlve differences m luntstlrns between the
actlvltles. Iiorethan one card could be placed at a scale point end
not wery point had to be used
Once the Judges had qletd
them
ratings for one set of cards they would move on to the next area of
dmimllty
end carry out the task m en ldentlcal WSY, but
mdep.mden tl y of
the previous
me
13
15;
The mesns and standard deviations of the ratings were calculated for
each limitation in each area of disability. The means allowed e=h
limitation to be given a score on a severity scale for each area.
From the standard deviations the reliability of the different items
could be assessed and a few items with very low reliability were
eliminated at this stsge. The were incorporated into the final
scales at the lowest point so that people with euoh disabilities
would not be excluded.
Three measure of sgre-t
between judges were calculate, enabling
us to measure the consensus smong judges and to identify and exclude
snY .W&!ements that were substsntially different from the majority
view in each individual area. We were also able to determtie whether
there was a consistent minority view or whether disagreements were
rsndomly distributed. The level of agreement among Judges was
generally very high and only between 3 end 6 judg-ts
were exclwdesl
from the different areas of disability.
This stage therefore resulted in 10 separate scales. Within each
area the mean ratings were used to determine the positions of each
item on each seals. But at this stage there was no means of
determining how the scales related to one snother.
9.
Julg..ts
betmen
disability areas
Once we had established the severity levels of disabilities within
different exess, the next step was to ccmpsre disabilities form the
different scales, ie across different areas of disbility.
The items rated on aversge the most limiting and the least limiting
b each of the ten areas from the first exercise were selected for
this second step. A total of 57 judges were asked to rate the
severity of these 20 items on a 15 point scale. As before the judges
were carefullY briefad. As well as all the points coverd
previously, they were asked to take into account bOth the differences
b severity between the most and leest severe limitations in each
area and the differences among the most and least severe limitations
for the different areas, using the 15 point equal interval scale.
Similu analysis of the results was carried out to measure agreement
between the judges. A stiilsx proportion of judgments were excluded
se at the first stage. Those that were excluded did not represent a
consistent minority view.
Frcm the mean ratings of the most and least severe limitations for
each area it was a simple matter to calculate where all the
intermediate limitaticms on each scale should be. Since the length
of the final scale is arbitrary, we chose to rescale so that the
least limitti of the final scale score 1 and the most limiting
scored 15 on the new common scale. However, problems with one of the
scales (intellectual functioning) led to ita being revised later.
The top score on this scale turned out to be higher than any of the
other scales and so the final scale had a msxti
score of 16.
Figure 1 illustrates the relative positions of all the different
16
14
lmltatlons m each area m the comon scale of severity. The
reference numbers correspmd to those for the Items MI the final
scales given at the end
10.
Setting
a carom
l-r
limt for disability acrma
all ~
Ch3ceall hmltatlcns had been placed on a comon scale of severity It
ws possible to estsbllsh a ccumon lower level or thresi-mldof
severity across all areas
Anyone with a dzsebll~ty above this level
would be defumd es d ls+ld
for the purposes of the survey, while
theme whose dusabllltles all fell below that level would not
The
questlcms used both at the ~ltlal screening stage and at the start
of the mtervlews had barn intended to operate such a threshold, but
m the absence of a means of compexti dzffermt d~ebllltles no
final defmltmn
of dlaekdlty for the survey was possible
In setting the common lower level several conslderatmns pertained
a)
We needed to avoid setting the threshold below the low values of
the d Ifferent area scales, otherwise there would be people
defuwd se disabled who were ountted from the survey
b)
tiewentcd to retain as much of the mtervlew data es possible
c)
In practIce the lme we drew to mark the threshold had to pass
through one Item one each of the separate scales, end so could
not be at exactly the same leve1 for each exea. Grantmi this, we
dld not went to make fme dlstmctmns
between limtatlons so
those that were rated es very nearlY equal were all either
included above the threshold or excludd below lt
d)
We wanted to avoid aettmg the threshold m such es way that a
very small change m that level would result m a very large
change ~ the number of people defined es dlseblad for the
purposes of the survey
Balsncmg all these factors and m comsultatlm with DHSS, we set the
The ideal scale value was set
threshold level as shown m F@re
1
at 4, but m practIce the next lower rated lmltatlrn below that
level wss chosm to defzne the actual thrsshold value for ssch area
Any tilvldual whose lmltatlrns wre all score belcw the threehold
level was not defu’wd es disabled for the Pumoaes of the survey
This reeultei m 5% of those who had hsd a full mtervurw bm.ng
excluded
11. ~inatiaaa
of dieabilitim
Haw.ng eetabllshed a cmmtm scale for the severity of the different
lmltatums meemured on the survey, the next task was to detemme
how people with different comhnatums of these luntatlona ahmuld
rate on the scale compared with people with JUSt one
15
We had already decirkd that within each disability area it was
reasonable to ccmsider only a person’s eingle most severe
limitation. However, we wented to avoid making prior a.a’eomPti~s
acroas areas. Similarly it would be wrong to assume without testing
that disabilities are simply additive.
It was not feasible to ask judges to rate every combination of
limitations that had been reportd on the survey, nor even the most
comon cmee; there were just too menY. Insteed we selected
combinations of up to four limitation in a purposive way to test
which features the judges were taking tito account in exriving st
judgement of severity. The limitaticms were first cleesifiei into
three broad banda of severity (appreciable, severe end very eavere),
and into three broad types (physical, mental end sensory problems).
‘Profiles’ comprising two, three end four limitetiona were selected
to represent various combinations of type end level of severity.
However, only -inations
of disabilities which actually occurred on
the survey were used. In all 64 profiles were selected, 44 with two,
22 with three end 18 with four disabilities.
80 judges took pert in this exercise, a larger number then at
previous stegea es we anticipated a wider divergence of views. In
addition to rating the selected profiles, the judgea were ssked to
rate two single limitations in order to provide a means of linking
the profile ratings to the previous scale for single ltiitations. As
before, a 15 point scale was used.
The same measures of agreement between judges were calculated. As
expected, there wee a greater divergence of viewe than at the
previous stages and 17 of the judgments were eliminated. However,
there wee little agreement among the 17; the did not represent a
consensus minority view.
G?. llodelafor disability profiles
Before atten@ing to mcdel the processes used by the judges to
determine appropriate severity scoree for combinations of
limitations, the scores for individual limitations were resealed end
rounded to the nearest 0.5 so that the lowest individual score use
0.5 end the hi.gheatwas 13.0. These are the final scores shown on
the scales at the end of the paper. The task was then to model
statistically how the judges made their ratings of severity. A
number of different models were tried. TheY were fitted using
leeet-equeres regression through the origin. The si@est
mcdel was
based on the SUM of severity scores for the disabilities in the
profile. More complex mcdels gave greater weight to the more severe
disabilities relative to the less severe. Iiodelawere tried which
varied the number of disabilities that were taken into ccmaideration
(2, 3 or 4) and which took into account which areas of disability the
limitations were frem.
18
16
.-.
.
The smplest mcdel which fitted the data well takes mto account the
three worst (le most lmltmg) dusabllltles, but does not take mto
account which areas they are frem, end wemhts thelr severity scores
as follows
worst + O 4 * (second worst) + O 3 * (thud worst)
This mcdel prcducd a correlatmns of 96 4X between the ratings
predmted by the model and the Judges actual ratings, a very god
flt
The mrdels whmh took mto account more then three dlsabllltles and
the areas that the dlsabllltles were from dti not produce sglflcsnt
mprovements m flt over this smple mfxlel Hcdels which merely
added up the severity scores without differential wetiht~
dld not
flt as well
The mcdel shown above had en error rate of 17A, where the error rate
IS the proportIon of proflles were the d Ifference between the
predIcted and actual severity score exceeds two
Slmce the profiles
were selected purposively rather thsn bemg a rendom sample of cases
from the survey, this does not tell us how manY mdlvlduals on the
survey would be clmaslfled dlfferently by the Judges end by the
mcde1
However, the proflles mcludad a h~her prcportlm of cwses
with three or more dlsabllltles end a greater dlverslty of
comtmat mns than was actuallY found so It 1s UnllkelY that the error
Moreover, there 1s no problem
rate would be aubstemtlally h~her
for mdlvlduals with only one dlsablllty - some 30% of all
mdlvlduals
13. The overall 9everity scale
To apply the ebove mcdel to a psrtlculer dlsebled adult m the survey
one finds then
h~hest three severity scores from the separate
areas of dlsablllty and adds them according to the formula shown
For people with only one or two dlsabllltles the remsmmg
dxmbllltles are set to zero
The overall severity measure thus
calculated 1s a cantmuous measure ranging fom O 5 to 21 4
For the purpose of provldmg estmates end analyamg the survey data,
severity scores need to be grouped M to a number of discrete
catagorles From the outset lt had bean envisaged that between 6 and
The advantage of chooeang the large
10 categories would be requmd
number M that when numbers Permt the full set can be used, or
arkmcant categories can be costmed to give 5, which 1s still
aufflclent for exammns
trends =SOC lated with severity
It 1s worth noting that since the hxhest score for a single
du?.stdlty 1s 13, people m severity categories 6, 9 and 10 must
necessarily have dlsabllltles n more than one area
But people with
multlple dusahlltles are not always fcund m the huihast severity
categorIes, It 1s posaable for scmneonewith three dlsebllztles with
low scores to be MI the lowest severity category
17
19’
The final 10 categories are as follows:
%verity
Weighted -ri*
ca~
10 (most severe)
9
:
6
5
4
3
L
1 (leest
severe)
soore
19-21.40
17- 18.S5
15 - 16.85
13- 14.85
11- 12.95
9- 10.95
78.95
56.95
3 - 4.95
0.52.95
Although the above scale has been usd for malyeis of the survey
results it has not yet been fully validatal. Tk essi.gnmantof
individuals on the survey to a severity category does not pose a
problem since it is determind by the rules above. However, es
mentiond above, there is no external criterion against which the
scale can be validated se a measure of severity of disability end so
our general approach is to see how well it performs in practice.
Analysis of the survey results will show the extent to which it is
correlated with other survey variables which might be expected to
relate to severity of dieability. Further research will be neoessery
to examine its performsme in other circumstances. It has been
designed for use in the survey context to provide population
measures. It woula need to be modified end validated for other uses,
notably for the assessment of individuals.
20
18
Figure
3
16
15
Judgesrallngs
ofseverlly
on a common scale
51
~
1
L1—
‘“’-r
PC1
14
C02
C03
DI
13
RSI
L2
11
RS4
RS5
~6
- ‘g
LIo– –
C07
Ccm
Ral>
;:;j!
@3
B4
:5 – —
14
C3
:s — —
s7— —
@s
1:
-
---Cll ,
CO1O
143
m ——
Col1i
- ------
Pcj
--
:
PC7+
PcsmJRSII4
D12.J--
C’7+
I
Cso
-tCTI
t
I
C$lo
1
CS1l
PCS– –
3
J
D2
DE
L12
i“
t
cm
09
D:o
L14+
13
S4 – —
:,3
FZ4
RS9
1
CS3
C2
Ccs
D7
L13+
H2
PC3
D5
F3S7
LII
L15~
I
cm
C03
*
03
17
- ~8
B1
t
t
04
f.%
c
g7
g
1
113–-
CS2
14
D3
L3
10 - L4
~
L5
9
(/29
LS
a
;5
2
Ht.
CS’T–
12
:3 – —
PC2
RS2
4~,
cl-
D2
12
5
S2
‘T
.---S2 ~-----
Slo --
L],
C4
‘jr
I,7
C5. .---i,
..---Hi
CS12
i+----
’05
112~
CS13
f
-------1-
CS14
4
G3
L1
Cannot walk at all
11 5
L2
Can only walk a fau steps without stopping or sevare discomfort /
Cannot walk up end dowm cme step
95
L3
Hes fallen 12 or more trees m
75
L4
Always needs to hold on to srmethmg to keep balance
70
L5
Cannot walk up and down a fl~ht
65
L6
Cannot walk 50 yards without stopping or severe dlscoafort
55
L7
Cannot bend dm.m far enough to tcuch knees end stratihten UP @am
45
La
Cannot bend down end pick somethm.g up from the flwr
strauhten up sgam
40
L9
Cannot walk 200 Yards wlthcut stoemn.g or swere d=mmfort
Can only walk up end dom a fhght of 12 stairs lf holds m
smd takes a rest / Often needs to hold on to eomethmg to
keep balsnce / Has fallen 3 or more tunes m the last yecu
L1O
Can only walk up snd down a fl~ht
(doesn t need a rest)
Lll
Cannot bend down to sweep up somethmg frm
stra~hten up again
L 12
Can only walk up and down a fl~ht
or one step et a tune
L13
Cannot walk 400 yards without stopping or severe dracmfort
the last year
of 12 stairs
and
/
of 12 etalrs If holds on
the floor end
of stairs lf goes StiSWSYS
30
25
20
15
05
’22
PSI
Cannot hold out either arm in front to shake hands
9.5
RS2
Cannot put either arm up to heed to put a hat on
9.0
RS3
Cennot put either hand behind back to put jacket on or tuck
shirt in
8.0
Rs4
Cannot raise either arm above heed to reach for something
7.0
R35
Hes difficulty holding either arm in front
with someone
6.5
RS6
Has difficulty putting either arm UP to heed to put a hat on
5.5
RS7
Has difficulty putting either hand
or tuck shirt in
behind back to put jacket on
4.5
RS8
Has difficulty raising either em
something
above head to reach for
3.5
RS9
Csnnot hold one arm out in front or up to heed (but can with
other arm)
R310
Cannot put one arm behind back to put on jscket or tuck shirt in
(but can with other arm) /
Haa difficulty putting one arm behind bsck to put jacket on or
tuck shirt in , or PUttiIW one arm out in front or up to hesd
(but no cliff
iculty with other arm)
23
to shake hands
2.5
1.0
10 5
D1
Cannot pick up end hold a umg of coffee with either hand
D2
Csnnot turn a tap or cmtrol
D3
Csnnot pick up and carry a pmt
a semge with either hand
M
Cannot pick up a small obJect such es a safety pm
hand
D5
Hes dlffmulty plckmg up end poumng frcm a full kettle or
serving focalfrom a pan using a spocm or ladle
65
D6
H= dlfflculty unscrewing the lld of a coffee jar or using a Pen
or pencil
55
D7
Cannot pick up and carm
40
D8
Hes difficulty wrmguIE! out hght weshmg
sclssors
D9
Can pick up end hold a mug of tea or coffee with one hand but not
with the other
20
D1O
Can turn a tap or control knob with cme hand but not with the
other / Cen squeeze the water from a sponge with me hand but
not the other
15
Dll
Can pick up a small obJect euch as a safety em with one hand kt
not with the other / Can pick up and carry a pmt of milk with one
hand but not the other / Has dlffaculty tying a bow m laces Or
strings
05
kmobs on a cooker with either hand
of milk or mqueeze tb
water frm
with either
a 51b beg of potatoes with either hand
or using a pair of
95
80
70
3.0
24
ml
Ce.nnOtfeed self without helP / Cannot go to and use the toilet
withcut help
X2
Cannot get into and at of bd
out of chair without help
m
Cannot wash hands and fsce without help/ Cannot dress and undress
without help
7.0
m
Cannot waeh all over without help
4.5
FC5
Has cliff
iculty feeding self / Has cliff
iculty getting to and using
the toilet
2.5
FC6
Hes difficulty getting in and out of bd
in and out of s chair
1.0
withrmt help/ Cannot get into and
/ Hse cliff
iculty getting
11.0
9.5
c
031
No voluntary control over bowels
11.5
U32
No voluntary control over bladder
10.5
U33
Loses control of bowels at least once every 24 hours
10.0
m
Loses control of bladder at least once every 24 hours
8.0
as
Loses control of bowels st least once a week
8.0
m6
Loses control of bowels at least twice a month
6.5
C137
Loses control of bladder at least once a week
5.5
me
Loses control of bowels at least once a month
5.0
C139
Loees control of bladder at leest twice a month / Loses control
of bowels occesicmally
4.0
mlo
Loses control of bladder at least once a month
2.5
C!Jll
Loses control of bladder occesionallyl Uses a device to control
bowels or bladder
1.0
25
1.
51
Cannot tell by the l~ht where the wndows
52
Cannot see the shapes of furniture m
S3
Cannot see well encugh to recogmse a frmnd
face
S4
12 0
are
11.0
a rota
If close to hls
, Cannot see well enough to reccgnlee a friend wtm IS en arms
length a=Y
10 0
80
S5
Cannot see well encugh to read a newspaper hesdlme
55
S6
Cm-mot see well enough to read a l~ge print book
5.0
S7
Cannot see well encmaghto recognlee a friend across a room
45
S8
Cannot see well encmgh to recognise a friend scross s road
15
59
Hss dlffmulty seeing to reed ordu_mrY newepwer Print
05
HI
Cannot
HZ
Cannot follow a TV programme with the volume tumei
H3
Hae dlffmulty
qu let room
H4
Cannot hem
H5
Cannot use the tel~hone
H6
Cannot follcw a TV progr-e
H7
Dlffmulty
room
H8
Dlfflculty follomng a ccmversatlm egauwt backgrand
hear sounds at all
heerr@
11 0
smeone
talking m
85
up
a lmud voice m
a
a doorbell, alarm clock or telephcme bell
80
55
40
at a volume others fmd
hearing somecme talking m
acceptable
a normal voice m
a quiet
no~e
20
15
0.5
&
Is koesible for people who IRIOWhti / her WS1l to tiers~
/ Finds it ixpoeible to uwderetsnd people wtm know him / her
well
12.0
C2
Is iqmseible for strangers to underspend/ Is very difficult
for people who know Mm/her w1l to underetend/ Finds it
impossible to ursieretandstrangers / Finds it very diffioult
to understand people wk know hidhar ~11
8.5
C3
Is very difficult for strangers to underspend/ Is quite cliff
icult
for people who know hti her wall to understand Finaleit
difficult to underspend strangers / Finaleit quite difficult
to understand people who know him/her well
5.5
C4
Is quite difficult for strangers to underspend/ Finds it quite
difficult to understand strangers
2.0
C5
Other people have Sdifficulty understanding him/her/ Hee some
difficulty understanding what other people say or what they mean
1.0
B1
Gets so upset thst hits other people or injures himherself
B2
Gets so upset that breaks or rips up things
7.5
B3
Feels the need to have scmeone present all the time
7.0
34
Finds relationships with members of the family wry
B5
Often has outborste of tenpsr at other pecple with very little
csuse
4.0
B6
Finds relationships with perple outside the family very cliff
ioult
2.5
B7
Sawtimes site for tira doing nothing
1.5
B8
Finds it difficult to stir him / herself to do things / Often
feels aggressive or hostile towards other people
0.5
cl
27
difficult
10.5
6.0
3everity
No of
11
13 0
11
Often forgets what was supposed to be
doing m the muddle of scmethti
12
12.0
10
Often losses track of what 1s being said
m the mlddle of a ccmversatzcm
13
10 5
9
Thoughts tend to be ruddled or slow
14
95
8
Often gets crmfusad about what t=e
of day It 1s
15
80
-1
Csnnot watch a half a hour TV progreme
all the way through and tell somecme
what 1s Wes about
16
7.0
6
Cannot remerber end pass on a message
correctly
17
60
5
Oftens forgets to turn things off such
se fmes, cookers or taps
18
45
4
Oftens forgets the name of pecple m
femlly or frumds seen regulsrly
19
35
3
Cannot reed a short article m
newspsper
110
20
2
Cannot write a short letter to scmeone
without help
Ill
1.0
1
Cannot count well enough to handle
the
mcmey
,28
Severity
~
Csl
12.5
13.8
CS2
11.5
12.8-13.0
CS3
10.5
11.6
CS4
10.0
10.6
CS5
9.0
9.8-10.0
CS6
6.0
6.6-9.0
CS7
7.0
7.0-8.0
CS6
6.0
6.8-7.0
CS9
5.0
5.8-6.0
Cslo
4.0
4.8-5.0
Csll
3.0
4.0
CS12
2.0
3.0
CS13
1.0
2.0
CS14
0.5
1.0
Hee fits:
Less than one year
Once a year but less then 4 times a year
4 times a year but less than once a month
Once a month but less than once a week
Once a week but less than every day
Every day
o
1
2
3
4
5
Only hes fits during the night
Only hee fits at the night or on awakening ;.6
Only has fits at the night, on awakening
5.8
or in the svening
8.8
Hes fita during the daytime
Always has a warning before a fit
Hae fits without warning
0
Loses consciou=ees during a fit
Does not lose consciousness
1
0
29
.-. ,
1
s
EDD1
P~
0.5
Suffers frcm problem with eating , drmkmg
or d~estlm
which severely sffects ehllty to lead a nomsl llfe
(Scare , blernshes ad deformitlss)
s
DF1
Suffers frcm a scsr , blamsh or deforrmty which severely
affects ablllty to lead a nomal llfe
0.5
30
%:a517
OPCS SURVEYS OF DISABLED PEOPLE IN GRSAT BRITAIN
1
Background
and timetable
The Office of Population Censuses and Sumeys
(OPCS) has been asked by the
Department of Health and Social Security (DHSS) to undertake a programme
of
research on disabled people m Great Britain
Three separate
surveys were
carried out during 1985 and 1986, and a fourth is planned for 1987
(a) disabled adults living in private households
(b) disabled children living in private households
(c) disabled adults living other than in private households
(in communal establishments)
(d) disabled children living in communal establishments
At present there is no up to &te information about the number
people in Great Britain and their circumstances and information
to help plan benefits and services for disabled people
of
is
disabled
required
The last national survey of the disabled took place in 1969
Since then
many changes have taken place and the lnformatmn
from that survey cannot
be considered to give an accurate picture of the situation
in 1985
Moreover, the 1969 suney
was of adults with physical
handicaps
and
impairments living in the commmnty
The current programme of research
IS
intended to cover both children and adults , people with either physical
or
mental disabilities and both those living in private
households
and In
communal establishments
The suneys
of disabled adults and children
living
In private households
communal
took place
In 1985 and the survey of disabled
adults
In
establishments took place m 1986
children
In
The survey of disabled
communal establishments is planned for 1987
‘he fieldwork period
for the
the
survey
of disabled
adults was July-November
1985 and that for
children’ s survey was October-November 1985
Coding, punching
and editing
1986 and
the data from the adulta and children’ s surveys took place during
early 1987
Reports on preliminary results will be prepared
for DHSS by
in communal
the end of 1987
Fieldwork for the survey of disabled
adults
It iS
establishments was carried out from September
to December
1986
planned to publish the full results of all the surveys during 1988 and 1989
in a series of reports covering different topics
2
Aims of the surveys
The main aims of the surveys of disabled
private households are to provide
i)
ii)
adulta
and
children
llvlng
In
comprehensive estmates of the prevalence of significant
disability by age, type of disability and degree of severity,
information about the financial and social consequences
of disability, in particular sources and levels of income
and the nature and levels of extra costs arising because
also the effect of disability on
of disability,
employment and mobility,
1
31’
iii)
some information about che use of and need for health and
personal social senices.
The survey of disabled children aims in addition:
iv)
v)
vi)
vii)
to monitor the implementation of the 1981 Education Act;
to assess
the effect of the child’s disability
family and the responsiveness of setvices;
to find out whether there are discontinuitiea
provision during adolescence;
on
the
in service
to obtain parents‘ views of how the services deal with
the early indications that their children have health
problems.
The main aim of the surveys of disabled people
living in communal
establishments is to provide
supplementary
estimates
of the extent
and
severity of disability provided by the household
surveys.
Thus , overall
estimates
of significant
disability
in the whole population
may
be
calculated by combining the results of the different
surveys,
suitably
weighted.
Subs idiary aims include providing information about the use of aids
appliances,
health
and social services and about
the management
financial affairs.
Apart from the main surveys other issues are being studied by
and re -interviewing some of those already Inteniewed.
Three
been undertaken:
a)
to
a Study of thirteen
transition to adulthood;
b)
a small number of the people caring for disabled people
interviewed in greater depth than on the main survey;
c)
the severely
detail.
visuslly
nineteen
disabled
are
year
olds
being
to
following
up
studies have
exsmine
assessed
are
in
their
being
greater
In order to study the expenditure patterns of disabled people in
greater detail a further study is being undertaken in conjunction with
the regular Family Expenditure Su?ney. For a year from July 1986 to
June 1987 members of household participating in the FES were
screened
for disability and those identified as disabled were asked the same
Social
questions about their disabilities as on the main survey.
analysis
of
comparative
Research Branch of DHSS will be undertaking
the finane ial circumstances of households with and without
a disabled
person.
2
32
and
of
3
Approach
to the assessment of disability
The 1969 su~ey was particularly concerned with the service needs of the
disabled
This was reflected
in the approach used
to identify
and
assess disability
By contrast,
the current research
is required
particularly for social security purposes, and this is reflected
in the
different approach taken
Further differences between
the tvo surveys
arise because there have been developments in the intervening
years
in
the way different aspects of disablement are conceptualised
which have
been taken into account in the current projects
Initially DHSS asked OPCS to design
a method of assessment
fOr the
survey based on the ‘loss of faculty’ approach used for the Industrial
Injuries and Uar Pens Ions schemes
For these schemes a medical
officer
identifies a loss of faculty attributable
to an industrial
injury Or
disease, service in the armed forces etc , assesses
the disabilities
resulting from the loss of faculty and finally arrives
at a figure of
percentage disablement on which a benefit is awarded
Definitions
of
the terms used are as follows
Lass of faculty
‘Any pathological condition or any loss (including a reduction)
normal physical
or mental
function
of some organ or part
body
including disfigurement ‘
Disability
‘Inability to do things or do them equally as well as
same age and sex whose physical and mental condition
arises from a 10ss of faculty ‘
of
of
the
the
a person
of the
is normal,
which
Disablement
‘The overall
effect of the relevant
ie the
disabilities,
inability to perform the normal activities of life - the loss of
strength and power to enjoy a normal life ‘
overall
health,
DHSS also asked OPCS to devise assessments
based on the International
OPCS
Classlf~catlon of Impairments, Disabilities and Handicaps (ICIDH)
have found the ICIDH useful as a conceptual
basis
for thinking
abOut
of
approaches to assessing the disabled and have adopted the teruunology
The
the ICIDH m describing the approach and coverage of the surveys
definitions of the ICIDH are therefore given below and the terms w1ll be
used in this way in the rest of this paper
Impairment
physiological
or
‘Anv
. 10S9 or abnormality Of DSVChOIOKiCal,
structure or function ‘‘-ihi9”ii simiisr to ‘iO&.5 of- faculty
above
anatomical
‘ def lned
Disability
to
‘Any restriction or lack (resulting from an impairment ) of ability
perform an activity in the manner or within the range cons Ldered normal
for a human being ‘
3
’33
Handicap
‘A disadvantage for a given individual - resulting from an impairment
or
disability , that limits or prevents the fulfillment of a role (depending
on age, sex and social and cultural factors) for that individual. ‘
The relationship between the different concepts
following examples:
IMPA1PJ4SNT
DISASILITY
I
I
VisiOn------------------>Seeing
is
illustrated
in
the
HANDICAP
I
------------------Orientation
Skeletal ---------------->Walking------------------Mobilfty
Disfigurement ---------- -----------------------asocial
integration
OPCS considered that assessments of loss of faculty or impairment were
not appropriate for uae on tha surveys for two main reasons.
Firstly,
disabled
people
themselves
snd
organisations
represent ing
their
interests generally find questions about disability
more relevant
than
questions about impairment.
The general reaction at the pilot stage was
that informants could not see the point of being asked questions
about
impairments that did not result in disability.
Also
such impairments
would not necessarily be mentioned
if they were not thought to be
relevant.
Secondly, assessment
of impairment would
require clinical
examinations, tests and judgements.
feasible
to
It was not considered
arrange for all subjects of the surveys to be medically
examined;
the
suneys required an approach which would be suitable for inteniewers
to
operate as part of a standard survey interview.
It was therefore decided that the surveys would
identify people with
‘disabilities’ as defined by the ICIDH.
Disabilities
were classified
into different
types along the lines of the ICIDH but with some
differences where the ICIDH was considered to be either too detailed
or
not detailed enough for the purposes of the surveys.
We have also
deviated from the ICIDH where it appears to be operating
on different
dimensions
The detailed information collected in the interview about the nature
and
to constructing
an
extent of disability ia being analysed with a view
overall measure of severity of disability.
First, scales of severity
Second,
the
for different areaa of disability have been developed.
severity of disabilities in different areas have been compared
so that
Finally we are
all disabilities can be placed on a common scale.
disabilities
contribute
to
establishing how combinations of different
overall severity of disability in order to achieve an overall measure
of
severity.
34
4
h
Design of the surveys
There is no comprehensive list of all disabled people
in the country
from which a sample for the surveys could be drawn
It was
therefore
necessary to screen a large sample of the general population
in order
to identify people with disabilities who were to be the eubj ects of the
surveys
l%e overall design of the sumeys
was therefore
first to
carry out the screening of all individuals living at a large
sample of
addresses and then to follow up and inte?rriew the disabled
Individuals
identified at those addresses
These
stages are described
in more
detail below
a) The screening sta.qe
The first stage of the surveys of disabled
adults and children
in
private households was to identify samples of disabled
people
for
inter. new
To achieve this a large sample of addresses of the general
population was screened using a short questionnaire
asking
about a
variety of difficulties
WI th everyday
activities
and some specific
health problems
Altogether 100,000 addresses were
screened
They
were selected from the Postcode Address File , which ia a list of all
addressea in Great Britain compiled by the Post Office
First,
a
sample of 500 postcode sectors was selected and then addresses
were
selected within the chosen sectors
The sample of addresses
form a
representative sample of all addresses
in Great Britain,
apart
from
large businesses and institutions
In 400 of the selected areas the screening questionnaires were
sent by
post to the occupier
of the address
Thue 80,000 addressea
were
screened by post
In the rema~ning
100 areas, comprising
20,000
sampled addresses , inteniewera
delivered the screening
questionnaires
personally
These areaa were predominantly in the inner cities where
response to postal questionnaires tends to be poor and often
there la
more than one household
living at an address
It is therefore
difficult to ensure that all the people living at an address
have been
screened without a personal approach
The success of the postal
acreermng method
dependa
on an adequate
to the quest ions
response rate and an acceptable quality of replies
OPCS has carried
out extensive
feasibility work
to ensure
these
criteria are met
At the pilot stage high response
to a postal
about
screermng method was achieved, but we were nevertheless concerned
can generally
be
Interviewers
the possibility of non-response bias
approach
expected to achieve higher levels of response than a postal
At the pilot stage interviewer follow-up of non-responding addresses
to
biaa with
a postal approach failed to reveal evidence of non-response
in
respect to disability, once allowance had been made for differences
the age distributions of the responding
and non-responding
addresses
stage one
However, as an additional check on non-responee at the main
in ten of addresses which failed to return a questionnaire
by post
after
letters were followed up by Inteniewers
who
two reminder
attempted to obtain a completed screening questionnaire
5
35
Of the 80,311 screening
questionnaires
sent out by post, 83% were
returned.
However, this figure includes those returned by the Post
Office or by other people because the address did not exist or was
vacant, or where the reply indicated that there were no permanent
residents at the address.
If these addressea
are excluded,
the
effect ive response rate from addresses estimated
to contain permanent
residenta was 82%.
‘Ibis figure also excludes
e small number of
questionnaire
which were retUMed with an explicit refusal to complete
the form.
Response to the follow-up of non-responding
addresaea
was also high:
after exclusion of non-residential addresses completed sift forms were
obtained from 80% of addresses, providing
a reasonable basis
for
studying non- response bias. Comparison of disability
ratea estimated
from the main postally screened sample and the sample of non-responding
sufficient
addresses
followed up by interviewers did not reveal
evidence of non-response biaa to justify rewe ight ing the estimates.
In the 100 inner city areas chosen to be screened by interviewers ,
which contained 19707 addresses,
screening
information was obtained
from 89% of addresses.
About 20% were found to be non-residential
addresses and some addresses contained more than one household.
The
response rate among households containing permanent residents was 87a.
Areas selected for screening by post were not expected to contain very
many addresaes with more than one household 1iving there. However,
the
questionnaire asked whether there were any other people
living at the
address who had not been included on the form.
If the original
form
filler indicated this was so, an interviewer was sent to check that the
sampled address did in fact comprise more than one household
and to
obtain completed screening questionnaires
from the other households.
In the areas which were contacted by interviewers
initially
the
interviewer could establish how many households there were and ensure
that each completed
a screening questionnaire.
In this way we
attempted to cover all permanant residents at the sampled addresses
The sampling frame used to select the addresses,
the Postcode Address
File, lists all addresses in the country with the exception of those
which receive a substantial amount of mail, at least 20 items a day on
average.
Thus the addresses of small businesses
and institutions
are
included. Addresses containing no permanent
residents ware asked to
IJe were therefore
left with a
indicate this and return the form.
number of small institutions containing varying numbers
of permanent
residents.
A mentioned above, surveys of disabled people living
in
communal establishments are being carriad out separately
and so any
institution with four or more permanent residents that was specifically
for the elderly, the disabled or for children waa not aaked to complete
However, other kinds of institutions
were
the screening questionnaire.
those
aaked to complete detaila about any permanent res identa, aa were
with thrae or fewer residents that were specifically
for the elderly,
the disabled or children.
In view of likely problems
establishing
the
interviewers
type of institution and the number of permanent residents,
were sent to contact all addressea of this type and to obtain completed
screening questionnaires if appropriate.
.
36
6
b) Identification
of disabled people
The screening questionnaire used to identify people
as disabled
who
would then be eligible for a follow-up
interview contained
quest Ions
about difficulties with everyday activities and some health
problems
The questionnaire was intended to be completed with respect to all the
people in a household, both adulta and children
The form- filler was
asked to give detaila of the aex, date of birth
and nature
of the
complaint or health problem of anyone in the household who had answered
that they had any of the difficulties or health problems asked about In
the screening questions
~is information
allowed ua to distinguish
60 and
children from adults and to divide adults into those aged under
to be
those aged 60 or over, gince only half of the latter group were
titewieved
Clearly it was nacessary
to include queationa
covering
as far as
possible all types of disabilities
The aims of the survey, moreover,
are such that DHSS’s ❑ajor interest is in people with moderata
to very
severe disabilities
alao important
to frame the
It W6S therefore
screening questions so that people whose problems lay above a minimum
‘sign~ficant’ level of severity of disability would answer positively,
in
but those with ❑ inor disabilities , whom we did not intend to include
the sample , would not
Our main concern was to avoid excluding
people
whom we would wlah to consider,
at least initially,
as sufficiently
disabled
On the other hand we dld not want to includa too many people
later turn out not to be considered
who would
as significantly
disabled, as this would waste resources
been
Our approach
to the assessment
of disability has
already
described
For the purposes
of this section
it is important
to
recognise that we have conceptual~sed
disability
along a contnuum,
from ‘none’ to ‘very severe’ , and have tried to identify
for inter. new
all those with more than a particular level of disability,
regardless
difficult
of the type of disability
this is extremely
In practice
since It implies that we can equate levels of severity
for different
types of disability and frame appropriate questions to identify
people
accordingly
During development
work we established
that for some
kinds of disability, notably mental
disabilities,
it was not always
the
to ask questions
directly
about
sufficient
or appropriate
included some questions
that ask about
disability, and so we have
Answers
to
health problems, handicaps, contact with services
etc
these questions are not intended to establish directly whether
someone
is to be considered disabled, but to identify people
for interview
so
about the disability
we
that we can then ask more detailed questions
are trying to identify
Because of the problems
of identifying
accurately
at the screening
screening
disabilities,
the
those people with significant
stage
those
questlonna.re
is somewhat
over-inclusive
with
respect
tO
To compensate
for
disabilities which are most difficult to identify
interview
is effectively
a second
this the first part of the main
further questions are asked about some disabilities
screening stage
are not considered
to
and on the basis of their answers some people
have a sigruficant level of disability and the interview
is terminated
at that point
7
37
Originally we aimed to achieve full interviews with 10,000 disabled
adulta and about 2000 disabled children.
The screening
stages were
designed to identify considerably more adults than this. However,
only
half of those aged 60 or over were salected for interview.
Moreover,
the gap of several months betwean
the postal
screening and the
interviews during which some people had died or entered an institution,
together with some non- response at the interview stage, were estimated
to bring the nuubers down to approximately those necessary
to achieve
the numbers of full interviews mentioned above.
5.
Interviews with disabled adults
Although in moat cases it was desirable for the disabled
adult to be
The interview was
interviewed in person, this was not always possible.
therefore conducted by proxy in a significant number of cases. In some
cases the disabled adult was too ill or frail to be interviewed.
If
the nature of the disability made communication
with an interviewer
difficult or impossible a proxy interview was generally preferable.
Since the time between the postal screening
stage and the intemiews
waa saveral months, some disabled adults had enterad an institution
permanently or had died; in these cases proxy
information
about the
nature and severity of disability prior to admission to the institution
or to death was be sought from someone able to provide it.
The main interview with disabled adults was in two parts covered by two
questionnaires.
The first asked questions
about the nature
of the
disabilities experienced by the subject of the interview.
The answers
to this part of the interview are being used to assess the type and
severity
of disability.
The
second
questionnaire
covers
the
circumstances
of tha disabled person
and
aims
to
assess
the
consequences of disability in a number of different areas.
a) The assessment
of disability questionnaire
This part of the interview has three aims:
to check the information provided on the screening questionnaire;
to ask further more detailed screening questions about some
disabilities;
to ask detailed questions about each disability identified in
order to aasess its severity.
In addition
this questionnaire
included some questions
about the
self-care
disabled person’s dependence on other people for help with
activities, which is not strictly part of the assessment of disability.
Some questions are also included about the people who provide this sort
of care for the disabled person.
some questions
were
Before the detailed questions about disabilities,
included to establish the nature of the complaints
giving rise tO
disabilities and how long they had baen present. The initial questions
about each disability establish whether the disability was sufficiently
snd
severe for the subject to be eligible for a full interview
therefore for more detailed questions to be asked. The further
8
.
38
questions about each area of disability provide
nature and level of severity of the disability
information
about
the
The questions on disabllicies were covered in the following sections
A
B
C
D
E
F
G
H
J
K
L
M
N
P
R
Walking
Steps and stairs
Bending and straightening
Falling and balance
Reaching and stretching
Holding, gripping and turrmng
Seeing (at a distance and reading)
Hearing
Noises in the head or ears
Control of bladder and bowels
Fits and convulsions
Communication (being understood and understanding others)
Social and mental behaviour
Other health problems which limlt daily activities
breathlessness, wheezing and coughing
difficulties with eating, drinking and digestion
severe pain or irritation
scars, blemishes or deformities
Dependence In self-care and household activities
b) The circumstances
of the disabled questionnaire
circumstances
of
Although concentrating particularly on the financial
other
of disablllty,
and the extra expenses
the disabled
person
The questionnaire
is
circumstances of the disabled
were covered
divided into the following sections
S
Health and social servicas contact with GP,hospitals and cllnics
home visits by haalth and social services
training and social activities
holidays and respite care
need for and reformation about services
T
Aids and adaptations use of and need for aids and adaptations
who provided and costs
U
Extra personal costs medicines
dressing and toilet goods
laundry
clothing and bedding
food
V
Mobility and transport mobility alone and with assistance
use of transport and transport problems
extra costs of transport
9
39
6.
V
Education and employment age finished education and qualifications
current employment status
current or previous occupation
earnings
if under retirement age, effect of disability on employment
spouse’s employment and earnings
X
Income
Y
Household finances payments from non-householders to householders
housing tenure
housing costs (mortgage, rent, rates)
fuel costs and extra costs
other extra expenses
Z
Financial situation debts and arrears
satisfaction with standard of living
possession of consumer durables
other standard of living indicators
what a windfall would be spent on
state benefits
information about benefita
income from other sources
savings
Interviews with the parents of disabled children
Whenever possible the child’ s mother was interviewed.
ThiS WaS both
becauae she is most likely to be familiar with the details of what
the
child can and cannot do, and also because
she is the parent most
frequently found at home during the day.
Information
about the
disabilities
of children who have died or
entered
institutions
permanently was not collected.
The interview about the disabled child is covered by three, rather
than
two, interview schedules.
The first concerns the nature of the child’s
disabilities.
It is intended to provide information comparable to that
and
obtained from adults but allows for the different daily experience
expectations of children.
The second is about senices and the effect
of tha disabled child on his or her family. It largely covers ground
survey.
The third deals with
the
relevant only to the children’s
circumstances of the child’s family and closely follows that used for
information
can be produced.
The
adults, so that again comparable
details are given below.
a) The assessment of disability quest ionnaire
The aims of tha questionnaire are identical with those of the adult
document (see page 8)
There are two versions because no single set of
years.
aged 0-15
for all children
questions
was appropriate
Accordingly, separate questionnaires
are used for children under 5
years and for children aged 5 - 15, but they are intended tO yield
comparable information.
.
40
10
All but one of the disabilities covered by the adult questionnaire
are
Included in that for children (the exception is noises in the head or
ears ) , and three others, particularly relevant to children
were added
The disabilities were each covered in a separate section as follows
Walking
Running
Steps and stairs
Bending, crouching and straightermng
Falling and balance
Sensitivity to cuts, bumps, bruises and infections
Fits and convulsions
Reaching and stretching
Holding, gripping and turning
Seeing
Hearing
Communication
Behaviour
Control of bladder and bowels
Pain or itching
Breathlessness or wheezing
Need for frequent or complicated treatment (which may
:
affect daily livlng)
R
Eating drinking and digestion
s
Scars, blemishes or deformities
T ,U Independence in dally self-care and other daily
activities
A
B
c
D
E
F
G
H
I
J
K
L
n
N
o
b) The response of services
The topics covered by sections of the questionnaire
are as follows
A
Discovery of the child’s health problem
The mother’s recollection of who first suspected the
child had a health problem and her v>ews of how the
services responded
B
Health and social sennces
Contact with GPs, hospitals and clinics (with emphasis
on the extent to which contacts with different outlets
are seen by the mother to be co-ordinated)
Home visits by health and social services
c
Education
Whether children have received statements (or in
Scotland, records) of their special educational needs
under the 1981 Education Act, and parent’s views of the
procedure
The type of schooling or pre-school provision received
by the child
The child’s participation in school activities, and
friendships
11
M
c)
D
The family
Effect of the child’s disability on family social life,
Effect on the parents’ health and relationships.
E
Respite care
The child’s experience of short term care.
The parents’ membership of voluntary organisations
self -help groups.
The circumstances
and
of families with disabled children
This questionnaire is almost the same as eecticnm T - Z of the second
questionnaire for adults (see page 9) , with the following except ions:
Aids and adaptations
- includes those particularly
children eg. special pushchairs or buggies.
relevant
to
Extra personal costs - takes account of those due to destructive
behaviour
eg. excess expenditure
on decorations,
furniture
and
fittings.
They also include extra costs of babysitting
and
childminding, but costs of medicines and prescriptions are axcluded.
Education and employment - these relate to the child’s parents
include questions about the effect of the child’s disability
on
or her parents’ employment.
Income - includes any income received by the
any other dependent child in the family.
7.
disabled
child
or
and
his
by
Interviews about adults in communal establishments
A sample of 570 residential
establishments
has been contacted
and
information collected from about 3500 residents
The establishments
comprise mainly aged person homes, Part 111 accommodation, nursing homes,
rest homes and homes or hostels for disabled or handicapped people.
The intetview is covered by one schedule.
It is a shortened
and
simplified version of those used for the survey of adults
1iving in the
community.
The main reason for the adaptations
is that a substantial
In such
proportion of tha interviews were carried
out by proxy.
circumstances less detailed
information
is available
(especially with
are
regard to financial circumstances) and explicit attitudinal questions
inappropriate.
Even when the residents themselves are interviewed many
are elderly and frail, or indeed very ill, and thus are easily tired or
distressed.
Jean Martin
Margaret Bone
Howard Meltzer
OPCS, Saptember 1987
.
42
12
fk.a577
SI I92
SllRVEY OF DISABLED ADULTS
Interviewer’s
Instructions
2s5%
Contents
1
%.oksround
2
bsi~
3
The main interviewer
4
Sifting
5
Followins
6
Sifting multi-households
7
Completion of the sift form and determining
who is disabled
=d
purpose
of the survey
m
sift sample
Scotland
up non-response
to the postal sift
and small mstitutlons
8
Serial nunbers at the sift stage
9
Who to interview at a sift call
7
.
10
11
tisngmg
12
Stnctu.re
lJ
Calls and outcomes and serial numbering
interviews with disabled adults
Interviews with disabled adults
.Jho to Interview
of the Interview
1~
Introduc x
15
PLnk schedde
16
Green schedule
17
Recall
18
Admmstratlon
the survey
for
10
II
.~
~.,
sheet
-,
43
S1192
1.
Survey of Disabled Adults
‘, INTERVIEWER’ S INSTIUJCTiONS
-..
,.
,#
Background and purpose
<,
$.
1.1
We have been asked by the Department of Health and Social Security to
The last national
carry out a survey of disabled peop,le in Gr~at Britain.
survey of the disabled took place in 1969. , Since then there have been many
changeg, for example in medmal knowledge and treatment, services and benef its,
which have affected the lives of disabled people.
The DHSS needs up-to-date
information on the rmrmber of disabled people, hmw.severely $hey are disabled,
This survey of disabled aa!~lts is one of a programne
and their circumstances.
of three surveys which will cover all types of disabled people. The other
surveys are of disabled children and disabled people living in inatltutions.
In
will be
all the surveys people with IWn Lal as well as physical disabilities
inclflded.
1.2
The main aims of the surke~ are .’
i.
to firm out how many disabled adults there are i~ Great Br~caln
living in the community rather thzn in Inscituclons, what type of
disablliies
they have and how severely disabled the> are,
ii.
to collect information about the financial and social circuw, ta?c%s
of disabled people, in particular their so~rces of income and extr .
expenses ar.islng as a result of disability,
111. to collect information about the use of and nee’ far health an~
social seri-ices amongst the disabled.
The survey IS caking pace in 500 areas 1: Great Britain.
A sam~le
:
1.3
100,OOO addresses taken frcm the Postcode Address File will be contacted
Occupants are asked to complete s short sift form about everyone llvln. .r :ne
address. This will enable ua co identify people with health problems or
disabilities who we wish to interview. We expect to approach a sample of ii,UdU
Some of these WI1l prove to have relatl<el:
adults for interview initially.
minor disabilities and so we hope to achieve full interviews with a samDle of
around 10,OOO disabled adults.
7
..
Design of the survey
In order to obtain a sample of disabled peoole for interview It IS
2.1
necessary to carry ouc a sift ~f a large sample of the ~eneral populat Lri.,
. ;.,:5
is being done by two methods. Firstly, in March we sent a postal quesclm-a.re
to a sample of BU,000 addresses taken from the E’AF. Answers to these
questionnaire
enabled us to Identify a sample of disabled adults who ‘-e w.sr tr
interview.
2.2
However,
the Inner city areas were not included in the postal sift, as rbe
problems of multi-haraehold addreeses and poor response make postal methods less
So in these areaa a different method is being used. Interviewers
suitable.
will be aaked to deliver the sift forma personally and if necesaarY help PeOPle
fill them in. In addition to the interviewer sift in the inner city areas,
interviewers in all other areas will be required to do some sift calls, as we
from the postal stape and checking that all
are following up non~esponae
haraeholds at multi-houeehmld addreeses have been sifted. Disabled ~ults
identified by the sift will then be interviewed; details of disabled children
identified will be returned to HQ to be followed up on the survey of disabled
children which starts in October.
’44
z
3.
The main interviewer sift sample
If you are working on the interviewer eift of addressee in inner city
3.1
● reae YOU will be iseuad with one ~ite
eift from per addrese with an addeee
label on it. YOU will ●leo have a liet of the addressee in your quota. You
should ettempt to obtain a completed eift form from eaeh hnusehold at each
address.
So you will have some spare white sift forms without labels to uee for
extra houselmlde at multi-hcasehnld addreases. For each household you sift you
should complete a calls and outcome sheet (dark pink). For all addreeses issued
as part of the interviewer eift with white forma ring 1 at 1. on the C and O.
●heet.
3.2
Call at the eelected addreesee end eatablieh whether there are any
permanent resident.
(A permanent reeident ie eomeone whose main residence this
ia. ) If there are none ring outcome code 01-03 aa appropriate and return the C
h O sheet with the sift form. Also enter the outcome code in the box on the
frant of the sift form.
If the addreee ie an institution to find out whether it caters specially
3.3
for elderly or disbled people, or is a prieon or a children house. Enter
details of the type of institution on the front of the sift form. If there are
4 or more permanent realdents at nne of these institutions ring outcome code U~
(large institution) on the C 6 0 sheet, entering the nutcome code in the box on
the front of the eif t form and return both tngether. If these institutions have
3 or fewer permanent reeidente they ehould be treated as ordinary addresaea and
ynu should obtain a completed eif t forma (or forma) covering all permanent
reeidents.
Likewiee other typee of institution should be sif ted as ordinary
If you are not
addreesee.
They may consist of several one person households.
sure whether to eif t a particular type of institution ring HQ for guidance.
3.4
At institutions that you are required to eift, and at all other addresses
containing permanent reeidents, contact one pereon per hcueehold to complete the
sift form. Make cure you identify all the households at multi-household
addreesea and eneure each completes a form. For refusals and non-contacts send
in a blank sift form with the appropriate outcome code entered on the front
page, together with a C and O sheet.
3.5
The eif t procedure ie summarised on the chart on page ~.
3
.
.
45
SUMMARY OF SIET PRWEDUW
w
b
Codes 01-03
or 12
+
=No
,
Yes
- COMPLETE
SIFT
FORM
4+ permanent
resldents~
Form
completed?
No
Q-
‘o+
1:1
Yes
Yes
&
‘O-EEl
+
Yes
1
c=
COF!lLETE
PINK FOIUY
@z=-l--No+
b
Yes
Code 09
REMENB’ER
TOENTER
THE OUTCOME CODE ON BOTH THE C&O SHEET ANo THE slFT Fow
46
4.
Sifting in Scotland
4.1
A problem can arise in Scotland regarding large tenement blocks which
appear on the pu merely with the number of the house and the street name.
TO avoid making unnecessary calls at these addresses, the valuation lists at the
Rating Office are used to sample one unit of the accommodation, where possible.
On the valuation lists, tenement blocks are listed as a number of rateable
units, each described separately as ‘house’ , ‘apartment house’, ‘service flat ‘
etc.
Example:
Address: 87 James Street
Entry on valuation list:
House
87 James Street
Gordon
Gr. ]
House
87 James Street
Kane
Gr.2
House
87 James Street
?fcKendrick
1/1
Service flat
87 James Street
Haydon
1/2
For each Scottish pre-sampled multi-household address you will be issued with a
blue pRE-SAYPLED ~JLTI-HOUSEHOLD SHEET FOR SELECTION OF HATEABLE UNIT(S ) and a
PRE-SAMPLED MULTI-HOUSEHOLD SELECTION SHEET.
4.2
Rateable unit selection procedure
When yo” have found the address at the Rating Office, enter the details as they
aPPear On the valuation liSt in the box on the front of the blue sheet for
selection of rateable units. Be sure to copy down the number or location of
each rateable unit so that you (or another interviewer on a follow-p)
ca~
subsequently identify the rateable unit(s) that will be selected.
On the back of the blue sheet there is a selection table for a range of numbers
corresponding to the number of rateable units you may have found. Against each
number in the range, is the number of the rateable !unit(s) at which you are to
Ring the number of the rateable unit selected - in the left-hand
interview.
column on the front of the blue Sheet.
YOU might find that the number of rateable units is too small for one to be
selected. In this case an instruction printed on the blue sheet will tell You:either
to visit the address and carry out the usual pre-sampled
(i)
multi-household procedure, ie list all the households at the address on
the white Pre-sampled Multi-Household Selection sheet provided for that
address and select the household(s) to be interviewed using the
selection table on the reverse
or
(ii) to carry out no interview at the address.
not visit the address at all.
In this case YOU need
Occasionally yo” may find that the selection table indicates that you should
Interview at any unit so
carry out interviews at two or rmre rateable units.
selected.
5
4.3
Special cases
a. Empty or ineligible units:
Any units that appear on the valuatlon
11st as vacant should be Included in your listing becauee they may have
become occupied since the valuation liet was compiled.
However, if a
unit is marked ‘derelict ‘, exclude it from your listing.
(Property with
no rateable value is often derelict, but you should check with the
officer at the Rating Office before excluding such property.
Units on the valuation list which are non-domestic
(eg shops, surgerlea, workshops)
or commercially rated
should be excluded from your listing.
It is clear that in some caees the unit selected will turn out in the
Treat them as you would any other empty
field to be empty or ineligible.
or ineligible accommodation - ie no interview is required.
Occasionally you may
b. Selected unit containa more than one household
find that the selected rateable unit contains more than one household .
In this case you should interview all households.
Returnlne Scottish selectlon sheets: .% pare of your admlnlstratlve
checklne-. You should record the outcome code from the pink calls and
ouccoms eheet Corthe selected household(s) in the right hand column on the
front of the blue Pre-sampled Yulti-household sheet for selection of
Rateable Units.
Please return all sheets attached to the Record(s) of Calls and Outcome
for that serial number ; even if no household has been selected.
5.
Following up non-response
to the postal sift
5.1
If your area tias part of the postal sift sample you will be given SC. ?
The
blank orange sift form with address labels on and a list of the addresses.
The
postal
sift
forms
were
sent
addresses did not return a postal sift form.
Ycm should attempt
out in March initially, and were followed by two reminders.
to identify households and obtain a completed sift form from each household as
described below.
5.2
In some cases you will have a yellow sift form matching one of the bank
orange forms. These addresses returned the yellow postal form buc dld noc
complete it adequately enough for us to determine whether anyone was elizible
1“ these cases mentify
households and find someone In eacn
for Interview.
household who can give the required information and ask them to comolete the
orange form. Return both the yellow and orange forms for the household,
In all these cases ring code 2
together with the calls and outcome sheet.
(following up non-rzsponse to postal sift) at 1. on the C60 sheet. you should
interview any disabled adult who is eligible for Interview according to the
cr~teria on the back of the C 6 0 sheet.
6
48
6.
Sifting extra households at suspected multi-household addresses and small
instruction.e
Some interviewers will be given a sample of completed yellow postal sift
IrImost cases
these are forms for addresses where Q23 was answered “’yes”,indicating that part
of the address ie separately occupied. At the addresa you should find out which
household the completed sift form refers to. Then identify any other households
not covered by the original sift form and try to obtain completed orange sift
6.1
forma and a list of addresaes to chetk for ulti-households.
form fr cm them. If there turns nut to be only one household give it household
number 04. If there is mere then one, give the original household number 01 and
numbar the other households from 02.
Ynu may also be given yellow forms relating to institutions which were
6.2
described at the bnttom front page of the sift. In mnst cases the form was not
completed. These institutions generally contain unrelated adults who should be
treated as separate household at the address. The ‘“households’”should be
identified and each asked to complete separate orange sift forms. It is
important that you include only permanent residents.
6.3
Those who are in the institution temporarily should not be included.
Return a completed orange form frnm each household and a C 6 0 sheet. Attach
the original yellow form to the first household.
7.
Completion of the sift form and determining who is disabled
7.1
The sift form does not take long to complete, so if possible you should
wait while it is filled in . If necessary you csn leave it and arrange to call
When the sift form has been filled in check before
back and collect it later.
ynu leave the household first that it is complete and unambiguous.
Then check
whether anyone in the household is disabled, as follows:- If any of the ‘Yes ‘ boxes to questions 4-11 are ticked the people tn whom
the ticks relate are counted as disabled. Details of these individuals
should be entered at 13.
- If there are no ‘yes’ ticks at 4-11 but something is mentioned at Q12 or ,?13
the person concerned will not normally be counted as dissbled. The n,SK
common complaint mentioned here are diabetes, high blood pressure,
hypotenaion, angina and other heart probleme, arthritis and only having one
lung which we are nnt interested in unless they cause the difficulties
covered at Q4-1 1. If, however, something mentioned at Q12 or Q13 conflicts
The main thing to remember
with earlier answers check with the informant.
is that we are interested in people whose complaints cause difficulties in
However, include snynne with a colostomy or ileostomy.
daily activities.
7.2
Accnrding to the number of people counted as disabled and their ages, ring
one of codes 08-10 on the Calls and Outcome sheet and enter this code on t?e
front of the sift form. A child is anyone who was under 16 on 1st June 1985.
7.3
If you have Idenr.ified any disabled children (outcome code 09 or 1~),
completed the pink sheet for the survey of disabled children. Attach this sheet
on to~ of the calls and outcome sheet and sift sheet fnr the address.
7.4
If there is norrresponae at a household for whatever reason fill in the
details required on the Calls and Outconke sheet and attach it to the sift form,
putting the outcome code in the bnx on the sift form.
7.5
So for each household you will have a Calls and Outcome sheet and sift
form, even if the sift form ia blank.
49
8
Serial numbers for the sift stage
The printed aerial numbers on the labels and address lists consists of S digits
for the area, followed by a slash and 3 digits for the address. The first two
digits of the area number are alvaya 00 and ghould be ignored. So when you
write serial numbers on any documents enter the last 3 digits of the area and
the 3 digits for the addregs. After you have finished sifting you will have
Single household addreases should be
identified households at each address.
numbered from 01 onwards. Make sure you add the household number co the ser~al
number on any labels you use as well as when you are asked to enter a serial
Put the household number on the printed labels attached to sift forms
number.
da well.
9.
Who to in Lerview at a S.lft call
9.1
You Jill not be interviewing any disabled
children on the survey but all
of those Identiflea will be followed up and interviewed later (in
October /Xa\ ember). You should m~tion
this at the sift call If appropriate.
Record any complete refusals to follcw-up on the pink form that you comple:e for
A child 1s defined as smsone who was
each house held with disabled children.
aged ~lnder 16 on ist June 1985, so check the date of birth of any sixteen year
olds care f~lly.
For all households wlch at least one disab Ied adult (outcome codes OS or
9.2
All those disabled adults
09) comple ce the back of the dark pink C 6 0 sheet.
Sub-sample those aged bO or over as
aged under s? are ellgible for interview.
follows
- List dl nous. h?ld members aged 16 or over in the orde! :hokx on the
C 6 P sleet, a?d enter their ages. Ring code 1 on lines :eLatlng to
any Jls~$Led ad~lt aged 60 or over.
If =t ends LI an odd fi..
-be.
- Looh A: :he address part of the serial number.
andchere 1s a disabled adult aged 60 or over on an —
odd nu,nberea 1=.
cI1?Y
are ell<lble for i~terview.
- Like.; se at addresses with the address part of the serlai number end~cg .?
an even ?umber , disabled adults aged 60 or over on even nunbered llnes are
ellglble for Interview.
In the last columm ring the person (if any) selected for Interview.
complete parts 10 to 11.
Then
9.3
Thus you w1ll only Interview one In two disabled adults aged 60 or over ,
However, You ,.~11
and you WI1l be u~llkely to interview two In one household.
have more t-vanone Interview in a household if there are two dlsejled peO.7:e
aged under 60, and also In some households where one person 1s under b~ and one
is 60 or over. Remember that even If no adult is selected for Interview there
could be a disabled child who we will follow up later.
8
50
10.
Arranging
interviews with disabled adulta
Adults identified from the postal sift
10.1
You will be issued with a list of detaila of the addreaa, sex and date of
There may be nmre than one at
birth of the disabled adult You are to interview.
the addreaa.
You till also have the corresponding completed yellow sift forms
from the postal stage. At the back of the form are detaila of disabled adults
at the address, at leaat one of which should correspond to the details on the
print-out.
YOU may not be required to interview all disabled adults at the
address.
If on the front of the form code 09 has been entered in the box there
will be a disabled child as well as the dieabled adult YOU are interviewing.
Make sure the family knows we will be coming back later to interview them about
the child.
10.2
Some of the postal forms did not give complete details of the disabled
people on the back page. If the date of birth was missing one of codes 13-15
will have been entered in the ronth box. Often it is not possible to tell
whether there is one or more than one disabled people in the household.
If ~niy
the code 1 (on the first line) in ringed and the month box is coded 13-15 check
If there
whether the ticks at ‘yes ‘ boxes refer to one or mre
than one person.
turns out to be mere thsn one person all disabled adults at that address are
eligible for interview. If there turns o“t to be a disabled child, fill fn a
pink form for the children’s survey.
10.3
Although you will generally know which person in the household is the
disabled adult who is the subject of the interview you will not know who filled
in the sif t form nor who the best person is with whom to conduct the interview.
When you make contact remined them of the postal sift form - the date stamped on
the front will tell you when it was received back in the CL:$:e.
Adults identified from inter.tiiewersifting
10.4
Since you will already have visited the household you will know who the
disabled adult is and whether the sift form was filled in by this persons or
somsone else.
11.
Who to interview
11.1
The disabled ad!llt selected for the survey is referred to throughout as
You should interview the subject in person if he/she is able to be
the SUBJECT.
If the subject is temporarily away or has a disability which makes
interviewed.
interviewing difficult or impossible you should interview an appropriate proxy.
A proxy interview is probably preferable if the subject haa a mental disaoiiic:,
You may
and may be necessary for people with speech or hearing problems .
interview the subjecc with soneane else present to help, or a proxy with t>e
subject present.
11.2
[f the disabled person has died or has gone into an institution
permanently try to interview a proxy using the pink schedule only. Record this
It is important that we find out as much as
as an abbreviated interview.
possible about the disabilities of such people because they are likely co be
amongst the most severely disabled.
9
.
51
12.
Structure of the interview
There are two interview schedules.
The pink schedule covers the subJect’s
disability and the green schedule covers all the other topics such as use of
services, financial and social cirmmstances,
employment.
The first part of the
interview consists of questions on the pink schedule which check the information
on the sift questionnaire and determine whether the subject has a disability
which is sufficiently severe for a full interview to be carried out. People
whose disabilities are only slight end their interview at this point and do not
go on to the rare detailed questions on the pink schedule nor to the green
schedule.
This means it is difficult to tell people how long their Interview
will last unless it is obvious that they are quite severely disabled. A short
interview which is terminated after the preliminary questions on
the pink schedule will probably take no more than half an hour. For someone
with a lot of different and quite severe disabilities the pink schedule may take
an hour. The green schedule should take about half an hour. However , all these
times depend on how easily people answer questions. You will obivoualy be
interviewing more people who are slow and who wander off the point than on an
ordinary survey and so the length of the interview will vary accordingly.
13.
Calls and outcome and serial numbering for interview wzth disabled adult
For each disabled adult eligible for interview you should complete one
13.1
blue calls and outcome sheet. Give each disabled adult an Indlvldual number,
starting from one. So at this stage the serial number consists of 3 dlglts for
area, 3 digits for address, 2 digits for household and one digit for individual.
On the C & O sheet code the type of sift which identified the disabled
13.2
The final outcome codes are defined as follows adult you are interviewing.
01
Full interview completed
both pink and
02
Short Interview completed.
pink schedule resulted in code 3 at R14
03
Eligible for full Interview
but only partially
completed
code 2 at R14 on the pink schedule, but
interview not fully completed
04/05 Abbreviated interview
(sub]ecc in an
institution permanently
or deceased
green schedule completed
code 1 at K14 on the pink scnedule
Code 11 should be used If the
13.3
Codes O6-10 are self-explanatory.
complalnt nu?ntloned on the postal sift form was temporary and the subgect has no
diaabllity. If there 1S any doubt about whether the subject Is ellglble fOr
interview conduct the first part of the Interview with the pink scqedule.
10
c,!
5,?
14.
Introducing the survey
a.
Introducing a sift call
14.1
Your introduction should be brief, mentioning the points in the covering
letter on the front of the sift form. Try to obtain a completed sift form
before mentioning that we want to interview anyone in depth so that there is no
bias in the completing nf the sift.
b.
Introducing an interview with a disabled adult
14.2
If you are interviewing somsone identified from the postal sift be
prepared to go river the points made in the covering letter to the sift, since
many people will have forgotten what it said. AlSO remember that they wet-s not
warned they would be contacted again. If necessary explain that we did not do
this because we are in fact only contacting a very smsll proportion nf those we
wrote to initially. It is important to emphasise that we will not pass
information to DHSS and that participation in the survey will have no effect on
benefit entitlements.
14.3
You may be asked questions about services or benefits for disabled
people. Most services are provided by Local Authority Social Services
departments, so people should be advised to contact them first. Benefits are
the responsibility of DHSS and so people should be advised to contact their
local DHSS office. If these cannot help you may suggest trying local voluntary
A Citizen’s Advice Bureau may be able to advise on entitlements
organisations.
and who to contact; other organisations such as Age Concern or organisations for
people ~ith specific disabilities or specifically for disabled people may also
be able to help.
11
.
53
15
Pink schedule
15.1
Before You start interviewing
‘lhansfer the serial number to the frent page. The area and address num oers
are on the address lzets end sift fomm.
If You ‘tave not already allocated
a household number at the sift. stage sni none has been added to the serla.1
number already, code 00 for the househo Id number.
‘7ach dl sabled adult In
the household eliglble for intem~lew shmld then be given an ~ndlvldual
number starting with 1.
The start and finish
times refer to this schedule only.
~snsfer
information from the sift form to the pink schedule followlng the
Instructions at Q4 (page 3). Once you nave done th~s yOII should not need
to refer to the sift fomo during the internew.
!7
,..
.-,
. .
FurPose of the uink schedule
?)
to check the lnfomnatlon on the sift quest~onna~re;
b)
to deteznune whether the sub;ect is sdfflclently
be ellglble for a full interwew;
c)
~f so, to collect details of each Type of disability
so that severity of disabil~ty can be assessed.
severely dlsablect to
the sub~ect has
The questions
?ousehold
box
Starting with the SUB,J=T (~e the disabled adult) enter detali. of ail
household members.
At MRITA1, ST VNJ5 note code 5 IS for people ,ho srs
cohabiting, regardless of their legal m~ltal
ste tus. Accept uticorma~.-.s
1
defuntlons
of full and psrt tune work, but for part time uorkers cods
according to whether they nomallv work 16 or more or less than 16 ho~-s
per week.
A benefit umt
consists of:
a married couple on their .,-n
a married couple or lone parent w~th the~r deuendent ch~ldren
(.e children aged under 16 or 16-18 smd ,n full tune educat,on)
one non-married
adult (19+ or 16-I8 and —
not m
Stsrtin& with the sub~ect’s benefit umt
urut the same number.
full time education j
.gIve s.11 people m
the SLTP :ene<Ii
Note: a benefit urmt IS not the same as a family umt on the GHS. m. 1s a
couple with a 17 yem old at school and a i 9 year old at work co!nprlse t do
Adopted or step cbldren,
If dependent, me mcludea
==e
benefit umts.
same umt a9 their adopt~ve or step parents, tit foster cnildren should be
,qIven a eeparate b$fictlt-t
number.
0,4
Before the mtex’mew
trsnsfer information frem the sift form accord=
to the
In a few cases the sift form WI1l not have
instructions at this question.
been completed fully, but either what infozmatlon there is on the fom or an
attaohed letter will have sugge9 ted that there is probably eomeone m the
household who IS disabled. Unless it is clear when yeu vlslt the address
that the person concerned is a ch~ld, you should start Intenlewmg
wztn
the VITk schpdule ?Td use +he aT.weTz to determ~ re wh?ther the su~.ec - ‘-s
[2
54
A few caaes may appesx to be ineligible from the answers on the sift for 3wi
have been included so that we can check whether the people at the addre:: are
in fact ineligible.
Most of these are people living in sheltered hoJsi-g ~.rho
.gr.ixyou
would expect to have been identified as disabled from the sift.
should interview with the pink 9chedule and use the sawers 50 determine winet.lner
a full interview applies.
we
M careful to read any letters or notes on the sift fom as you trsnsf er
Cases where =2 Sccom?zra.ing letter
information and make notes accordingly.
if
gave a refusal for the interview should have been removed in the office.
by chsnce you find one, please ring HQ.
Q~
The aim of this question is to identify the medical complaints causing the
disabilities that you will be asking aboat in the remainder of the interview,
On pages 14-16 is a list of complaints which are most Zil:ely to cause disabilities.
If the c Jmplaint mentioned is on the 1ist you can just .zrite the mme o? the
complaint. ”such as ~heart
complaint as given on the list. :Jote that some v-e
trouble’, ‘bad baok* and ~nervesq are also on the list. For anyt. hir,g
not on
the list deecribe the main symptoms so that it can be coded in the office,
We are not interested i.nall the subject!s complaints, only those that are
causing disabilities,
However, if this is not clea? at the beginning of the
interview include any doubtful complaints and delete an-y that are not related
to the subject !s disabilities a t the end of the pink scF?duls..
Q5(e)
Ye =e
mainly concerned with distinguishing codes l-~ from .everfthing else.
General instructions
for lettered sec tiom
A - P
Before the fnterview you will already have transferred ticks from the sift fon
to the boxes at the beginning of each section. The sections t%s:yhave the sane
general form. The first questions ) generally repeats a question from the
sift form. “fou then check agreement between the answer given in ?!,e intewier
witn the answer recorded on the sift font. If they do not agree probe to
establish whether ir:fact the subject has a clifficulty/problem ‘fldcode
accordingly. The S.nstier
given in the interview de temines
the continuity ?or
~~e ~st of the section.
In some sections the answers recorded at the check detenine vhe thm a letter
is to be ringed on the check f1ap on the back page. In other sections further
questions de+ennine this. The aim is to identify whe tker the subject has a
particular disability which is sevezc enough for us to ask for fmther details
and also to gu on to the greeen schedule.
Gnce a letter code has been ringed
for a particular section, the remaining questions de tennine the severity of
the disability{ covered by that section.
Degree of disability
In general we wsnt to bow what people can and carmo t do given the aid: or
means th2t someone with a complaint
applis-mes that they :Ionw-1ljjuse. ‘.I.is
or heaith problem smy, as a result of taking medicines or using aids, have no
resulting disability.
Thus come people ‘ho describe themselves as disa’oled mz~
not be counted as disabled according to the criteria being used for this survey,
Va.riations in disability
their difficulties vaq either from de.y to day or
over longer periods of time. k.; far as possible you sheuld ask them to think
~any
eubjects
will
say
that
r3
.
55
Codes for complaints causing disability
A
Complaints of bones, joints and mscles
1
2
3
&
5
6.
7
8.
9.
10.
11.
B
Rheumatoid arthritis
Osteo-arthritis
Arthritis - other or unspecified
Rheumatism
Osteoporosis
Ankylosing spondylitia
Cervical spondylitis
tluecular dystrophy and other muscle disorders
Slipped disc
Other bad back/back injury/lumbago
Other complalnt of bones or Joints (SPECIFY)
Complaints of brain and nerves (not mental Illness)
Stroke /hemlplegla
Parkinson’s (paralysis agltans)
3.
Multlple sclerosis (MS) (disseminated sclerosls)
4.
Cerebral palsy (spastic)
Paraplegia /quadriplegic /SpinZl inlurY
5.
Poliomyelitis (Polio)
6.
7.
Epilepsy (grand real, petit real)
Migraine
8.
Clizzinees/vertigo
9.
10. Spina biffda
11. Sciatica lneurltis
12. Head Injury
13. Other complal>t of brain or nervous system (SPCIFY )
(NB NOT ‘nervous illness’ )
1.
2.
c
Complaints of heart, blood vessels and circulaclon
1.
2.
3.
4.
5.
6.
7.
8.
D
Heart attack/coronarY thrombosis
Angina
Valve disease
‘Heart trouble’ unspecified/pains in chest
High blood pressure/hypertension
Disease of circulation /arteriosclerosis
Varicose veins
Other complaints of heart, blood vessels or circulation
Complaints
1.
2.
3.
4.
5.
6.
7.
8.
(SpECIF~ )
of lungs and breathln~
Chronic bronchitis
Emphysema
Asthma
Pneumoconlosis, byssinoals, asbestosis and other
industrial respiratory diseaseas
Lung cancer
Pulmonary tuberculosis (TB )
Breathing problems/bad chest - unspecified
Other respiratory compalints (SPECIFY)
lfl
56
E
Blood disorders
1.
2.
3.
4.
5.
F
Eye complaints
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
G
Meniere’s dusease
Otosclerosis
Conductive deafness
Nerve deafness
Noise induced deafness
Deafness of old age
Tinnitus/noises in the ear
Other ear complaints (SPECIFY )
Skin complaints
1.
2.
3.
4.
I
Cataract
Glaucoma
Macular degeneration
Detached/scarred retina
Congenital blindness
Caused by diabetes
Iritis
Retinitis pigmentosa
Blindness/poor eyesight DK cause
Other eye complaints (SPECIFY )
Ear complaints
1.
2.
3.
4.
5.
6.
7.
8.
H
Anaemi a
Leukaemia
Hemophilia
Hodgkin’s disease
Other blood disorders (SPECIFY)
Eczema
Psoriasis
Dermatitis
Other skin complaints (S~ECIFY )
Degistive and excretorv system complaints
1.
2.
3.
4.
5.
b.
7.
8.
9.
10.
11.
12.
I lees tomy
Colostomy
Hiatus hernia
Ulcer
Gall bladder problems
Kidney disease
Diabetes
Coeliac disease
colitis
Diver ticular disease
Cancer of the bladder /stOmach/bOw@l
Other digestive or excretory complaint (SpLCIFY )
15
.
57
J
Mental and psychological
1.
2.
3.
4.
5.
6.
7.
8.
K
complaints
Depression
Anxiety
Phobias
Schizophrenia
Other mental illness or unspecif led (incl. ‘nerves ‘)
Mental handicap/subnormality
Senility/senile dementia
Other mental or psychological complaint (SPECIFY)
Other complaints
1.
2.
3.
4.
5.
6.
Absence of loss of a limb
Deformity of a limb
Fracture of a limb
Delayed healing
Cancers /growths not already specified (incl. cancer Of glands )
(SPECIFY WHESE IT IS)
Other complains
(SPECIFy )
16
58
abomt a typical ~.
If tho difficulties sometimes completely absent,
ask them to think about a typical day when they me having cliff
iculties. ~
in doubt record what they cau do when the problems are worse rather than better.
CC4U0
laid
caauim
d.lfficul~
At the end of each eection ie a queetion asking whioh oomplaint(e) causes the
.ifsabili@ ccvered by the seotion. If cnly one complaint was recorded at Q5 you
oan code this without asking. You may sleo do this in sections such as sight
end heexing if it is obvious wh.fchcomplaint oaueee the problem. Otherwise
you shuuld check before coding and then ring the code nuber corresponding to
the number at t e top of the relevent columm at Q5 (p4-5).
A -Wtl~
If the subject c-
walk a certaim distance but is advised not tc, code the
he/she is advised tc walk.
A2
Stress ‘on your own’, but count people who need aids such as a stick to
this distance aa cede 1.
~
B Steps and stairs
If =swere
vary according to whether the subject is indoors or outdoore ask
about sta.f.rsindoors.
B3(a)
rZCmally
1 means
facing fo~s
end zsing slternate feet on alternate stairs.
qOne step at a time v means having both feet on one step before moving to t!!e
next step.
c Bending and
c1
Code
Ytie or demonst=te
if necessaq~.
straighteni~
‘yes * if either bending ~
strai&ten~
causes difficultjj.
E p.e~hing and stretching
Note that this section is about using @s.
standing or keeping bdence
If the subject has problems
ask about when he/she ie sitting.
If the subject has lost the use of a hand ask whether he/she was right or
E4
left handed before this happened.
F Hold@,
pippinq
and hmn~
A pint of milk in a bottle not a csxton.
FT
!L2.?&X
If the subject wears glasses ask the questions about circumstsnsee when tine
subject normelly wears them. If the subject has both reading smd distant e
glsaees ask about when he/she is weaV.ng the appropriate ones.
G3
People who describe themselves as blind may have a limited degree of sight,
so it is important tc aek this check question.
G1 6-17
Sight teste
‘#hencarrying out the sight teste it ie important that as far as possible
all subjects are tested under similsr conditions.
59
.17
The follow-
general rules apply:
i.
The letter chart should be held at eye-level
ii.
The letter chart should be held in such a position
the m=uman
amount of illumination
ill.
The subject should be asked to read out the letters on the cnart
iv.
When the sub~ect IS &lven the typeface card, ag=a~n rake sure ‘he
subject IS slttmg m such a posltlon that thz maxunum amount of
llluuunatlon falls on the card
v.
Use the piece of tape provided to measure 10 feet.
a coloured mark on It to ~ndlcate 34 feet.
that It &ts
The tape has
H .Hearmq
If the subJec t has a heamng ad the questions shoal i be asked about
c~rcumstsnces hen the heemng
ald ~s nonma.11Y ‘.,orn.
E h./E3
Note that there sre two different versions of the .-lrsi three questions,
depending on whlcb sift form was used. me IgoId, ~lft fom IS actuallf
orange coloured, and has the same questions as tnr vellot{ form. The white
sift fomn has an extra question on hearlag.
K COlltTol Of bowels arrd bladder
Note that people with bags , catheters etc. nay not hnve ticked the sift
question as they dontt actually lose control.
Ih ~ot include as ‘loses
control’ people who have to go to the to~let frequently out icm’ t In fact
have accidents.
L
Fhts and convdslons
~~
People may have fIts wnere they don’ t lose consciousness b~t are una~are
afterwards of what was hs,ppenlng c!urlng the fit. ‘bus they may wander off
and not know where they are when they recover.
L7
Some people are able to tell #hen they are about tc have a flt and are thus
able to take precauutlons agaHEt hurting themselves.
1,s
IStatus eplleptlcus$ ~s a medical emergency requlrlng Inmmedlate ~osp~tal
admlsslon.
Anyone suffering from this IS bound to ~mow , so If they are
not sure code ‘no’ .
M
Ml
U6
N
I
Conmumcation
The questaon covers both pro D1’ems due to ~peech bel rug dlf~lcult to u!!derstad
and where the conte~t of the speecn makes It dlfflcult to understma wh2t the
sub~ect means.
due bo th to hearing prOblems and
This covers d~fflcultles m under~tandng
for reasons such as poor conce~tratlon, low lntel? IBnce or other mental
problems.
SocLal snd mental behavlouz
In this section all SIX relevmt sift questions are checked first and If my
indicate difficulties or problems the whole of the rest of the eectlon applles.
Note that if none are poeitive the self completion at l{jO still appl~es.
Go
,
The section is intended to cover three main sorts of problems arising from
mental illness, mental handicap and senility. iIoJever,there is a lot of
overlap in the problems people experience and so all the questions are Zsked
of everyone.
N1l-16
This ~oup
NIT-29
I’hisgroup of questions covers nemory, corfxion,
with reading. ,miting and calculating.
N30
Self-cczplet ion
of que et ions covers mainly social behaviour.
concentration
and problems
This applies to all e:ccept pro~
interviews.
Tf the s:lbject cannot read the
re zti them out to hLn/her.
questiom
If the sutiject cannot .nderst.ad the
qu~stio~? or ?a’mot comp:ete tinemfor any other reasons please make a fiote
of the clrruns%nces.
Xake sure that subjects know what to io and chec!c
that they are completing
the ~estions
correctly.
P Otiierhealth ~ro?lms
Section P co..rersall other questions on the sift form that have not yet 5een
dealt with,
>e
test for wfi.etherthe subject goes on to a full interview
(if this k:: not a.lrea@ been determined bv earlier questions) s whether the
problems se-:e.=l~%Cf:ct the subject ?s abili~{ % lead a ncr-al life. :;ote
that ans...erz to +22 ia not ieternine -#hether a iull inter~ie.~ applies.
~ Indeaendemc e <n iai:-r ac:i..-ities
RI
W.
@
K5-6
<+1 Cl
Klo(g)
a 3
FQ4
.
61
16.
Green schedule
The schedule covers the consequences of heslth problems and disabilities for
vsrious sspects nf the subject’s life. A considerable amount of information
about the subject’s finsncial circumstance is required. This should be obtained
from whnever is best able to provide it. Questions about the subject’s spouse
should be asked directly of the spouse whenever possible.
Throughout this schedule where the words ‘health problem/disability ‘ occur you
may uae whatever term la acceptable to the subject co describe it, for example,
the name of a specific complaint or a general term like ‘“your disability”.
However, if the subject has several different disabilities make sure you are
referring to them all.
Note that if yo” have interviews with a husband and wife who are both disabled
and eligible for interview you will only need to obtain details of their
finances once. In sections Y and Z copy relevant factual Information from the
first interview onto the second person’s green schedule starting the second
interview.
Front page
The green and pink schedules will be punci-ed separately so make sure you
The start and finish times refer to this
complete all the details required.
schedule only.
w:
This IS meant to be blank.
S. Health and Social Services
S162
Exclude vlslts/stays which have no connection
problem/disability.
with
che health
S.7(c)
If the subject does not know the titlk of the person seen specify what
helshe does. A psychiatrist is a doctor and should be coded 01.
S3
This covers all visits for treatment, tests, checkups as an outpatient or
Some hospitals run educational or social clubs which should
day patient.
be included at S14, not here.
S4
At this and subsequent similar questions do not forget to ring the number
at the top of each column which applies.
S6
This is intended to cover the costs of private
treatment.
S8
There are a lot of questions in a similar form to this. For each person
Enter the
who applies, ring the number at the top of the column.
person’s code number from the card at (a) and vrlte the person’s name
(from the card) at (b) or describe what the person does. It is possible
to have two different people with the same code on the card. Note also
at filter questions that continuity directions are given If subsidiary
(Eg If code 2
questions apply, otherwise go on to the next COIU~.
aPPlieg at s~(d) go either to the next column if applicable or to S9.)
Note that there is no other answer code at this question.
and then specify at SY any other person or service
Ask S9 first
from either question.
20
62
Slo
Make sure you know which sorts of help and services are covered later in
the questionnaire
and therefore should not be included here.
Sll(a)
1Hes2th service personnel 1 covers anyone else working in the health
service such as an occupational therpiet, phyaiotherpiat, health visitor.
.$14
If subject is not cure what sort of place it ie, describe who goes there
and what they do there.
S16(b)
The codee are intended to distinguish ordinary holidays from vsrious
forme of respite care where a disabled person goes to give hie or her
family a break.
S22
It la important that the subject knows which register we mean. If they
are on the MSC register, which ia covered at W5, they will have a green
card.
T. Aide and Adaptations
T2(c)
(d)
We want the resin type of place they use the wheelchair in rather than
activities such as shopping. The exception is sport because some people
have special lightweight wheelchairs for sport.
DHSS runs a wheelchair service and provides the majority of wheelchairs.
Hospitals and social services departments somtimes provide them, usually
pn loan on a temporary basis.
T 7-19)
T26-28 )
This group of questions have the same format, each set covering a
different group of aids, appliances or adaptations.
Make sure you know
what is covered at each question so you don’t include thinss at an
earlier question which are covered later. Note that you may enter the
sa”me code for something that the subject has and something which he/she
thinks they would like if, for example, a new one or a different kind is
required.
T9
‘Pylon leg support’ (code 12) = a peg leg.
Note that elastic bandages and supports are covered at U5.
\
Tll
Thie question appliee to both those who are incontinent and those whose
continence is managed by the uae of bags etc.
T13-15
Include things used by the non-disabled which are required specifically
as an aid for the disabled, eg a typewriter for someone with
speech/hearing problems.
T17
Do not include adaptations
T22
Sheltered accommodation will consist of groups of flats or houses for
elderly or disabled people with a warden. Do not count arrangements
where the subject stays in his/her own home but can ring a warden or
other help if required.
T27(a)
Code what waa _
with the previcus accommodation
now have in the present accommodation.
63
to the’house which are covered at T26.
21
rather than what they
u.
Extra Pereona\
costs
U1
Dressings and bandagea can be obtained on prescription, as well aa
medicines.
U6
This la the firac of several questions which asks about extra coata. Try
to get the informsnt to estmste the extra cost arising because of the
health problem/diasbili ty, which would not have been incurred otherwise.
Accept estimates here and at similar questions , since we know informants
will find this difficult.
Ulo
A special diet means having to eat or avoid eat~ng particular foods, or
have to restrict calorie intake.
(b)
their Supplementary
This can include having to spend ❑ ore becauae subject can only get CO
more expensive shops as well as r-hecost special foods.
U12
v.
Soma people may get a special diet allowance with
Benef it.
Mobility and Transport
vl
By this stage in the interview it Aill generally be obvious which
4sk whatever questions are
mobility category is most likely to apply.
necessary to check subJect’s degree and mobility on hislher own.
V2
Use appropriate questions to determine sublect’s degree of moblllty with
assistance if somone is normally available to help. Note that at both
these question people in wheelchairs can be coded 5 If they usually go
out in their wheelchair, whereas somone with agraphobla might be coded
4.
V6
“Dial-a-ride ‘ schemes are run in some areas speciflcallv for disabled
people who ring a central polnc and arrange for transport for speclflc
journeys - llke a shared taxi. Voluntary organisations sometimes provide
transport to take people to speclflc places or events, usually that they
organise.
There are a number of different electrlc pavement
a common make.
vehicles.
Exclude
‘Batric-c’ 1s
help from the
V9 (a) )
Vll(a) )
Refers to help chat needs co be arranged.
conductor, guard or another passenger.
V13
The car does not have to be owned by the household
V15
An invalid car IS one that IS specially designed for disabled people, eg
the blue 3~heelers
member.
which are being phased out.
If a car has any adaptations at all co cope wlch disability code 4
applies.
(b)
Include only the extra cost of
of the car.
having an adapted
car, not the full cost
V17
The Disabled sticker (Orange Badge) is provided by Locsl Authorities and
allows parking in places where restrictions or payment normally apply.
Somone using a car on behalf of a disabled person may have one.
V19
Make sure the informant understand
the range of factors mentioned in the
preamble that mxy affect transport costs before asking the specific
question.
6$
27-
W. Education and Employment
W1 (a)
W2
Local authorities and voluntary Organiaationa run special schools for
children with a variaty of problems, physical, mental and behavioral.
Inc2ude attendance at achoola for the maladjusted and educationally
subnormal as well aa those for the physically disabled. Some ordinary
schools have spaclal classea or units for disabled children.
Code only the higheat qualification obtained. Most informants will know
which
this is, but if in doubt code more than one.
W3(a)(i)
Note that this ia slightly different from the standard GHS question
becauae of the inclusion of code 06. It is particularly likely that
people with disabilities will not actively seek work if they aee little
chance of finding a job.
W4
Co_nity
Industry Scheme
It provides jobs for
personally and socially disadvantaged young people who undertake work
It recruits 16-19 year olds for
projects of benefit to the comnnmity.
whom YTS places are inappropriate.
Run by the National Association of Youth Clubs.
Community Progr amme
Provides temporary amploymnt
for long-term unemployed adults on projects
of benefit to the community. Recruitment is restricted to people aged
18-24 who have been unemployed for over 6 months in the past Y months and
those over ?.4who have been unemployed for over 12 in.r.
tha in the past 15
months.
Training Opportunities Programme (TOPS)
It provides training for people
Run by the Manpower Services Commission.
who want to improve their job prospects by learning new or additional
skills. TOPS courses are open to people age 19 or over who have b sn
away from formal education for more than 2 years.
Voluntary Projects Programme
It aims to provide unemployed
Run by the Manpower Services Commission.
people with constructive activities which might develop their skills,
These projects can be taken
nrovicie
=.-. _—----rehabilitation or work ureuaration.
.
up by unemployed people without affecting their entitlement to benefit.
Youth Training Scheme
Mainly focuses on unemployed 16 year olds and provides a years integrated
In about two
programme of training, educacion and work experience.
thirds of schemes the young person works at an employers and receives a
minimum of 3 months training, which may be spent at a college
(Employer-baaed YTS ). In about a third of schemes the person spends most
of the year at a college, with some time gaining work experience with an
employer (College-based ~TS ).
W5
.
65
This register is kept by the Manpower Services Commission for employment
purposes.
Those on it have a green card. Do not confuse it with the
local authority register. Include only people with current Green Cards.
23
Wll (c)
Those in sheltered employment
are likely to be aware of this So cOde
‘don’t know’ aa ‘none of these’.
W12 (a)
People on these ache-s
these ‘.
W14
‘Live at your place of work’ includes residential
or pub, farmers etc.
wi5-18
Aak to see documents
w16
DO not deduct voluntary deductions such as SAYE, union dues etc.
w17-18
If informant
W19
This questions
W2&l(a)(i)
The main reason may be something other than the health
problem/disability.
w32
The Disablement Resecrleme”t Officer is based at the Job Centre and
advises disabled peoule about employment.
W35-43
See instructions
will know so code ‘don ‘t know’ as ‘none of
Jobs living over a shop
If possible
cannot give weekly estimate record ~hatever details you can.
iS abOut informants’ work at present.
for questiona w3-18.
X. Income
xl
The
Ask to see documents (order book, pension book) If Possible.
beneflcs paid should be listed on the book but you
not be able to
In this case enter fO.OIJ
separate the amounts for different benefits.
for the first beneflc and enter the full amounr under the second benefit
If a husband and wife
and mark with arrows which benefits are combined.
are paid ]olnt benefits record the full amount for the sub]ect and code
the partner’s amount as EO.00. If benefits are paid for periods of other
than one week calculate and code the weekly amount. Take care to check
whether the payment is for 4 weeks or a calender month.
The Severe Disablement Allowances replaced Non-Contributory Invalldlty
Pension and Ho”sewlfe ‘S Non-contributory Invalidity Pens Ion last
No\ember.
Constant Attendance Allowance is different from Attendance Allowance.
It
is an addition paid ~lth Induacrlal InJury Disablement benefit and War
These benefits may also include other additions
Disablement Pension.
such as Special Hardship Allowance, Unemployability supplement, Treatment
Allowance , Exceptionally
Severe Disablement Allowance.
Include In Supplementary Benefit all regular additions for special
requirements (eg heating, diet, laundry, clothing, domesclc help) but
exclude single paymsnts.
X2-3
Invalid Care Allowance IS paid to the person who 1s Caring for Sowone In
receipt of Attendance Allowance, but it is not paid to married women.
Recipients of ICA do not have to live in the same household as the person
they care for.
X6
People on these benef its will have received a Statement of Entitlement
giving their percentage aaseesment. Ask to see this if possible.
Xlo
This should include a21 regular income apart from benefita and the
earninge of people of working age, which have alreedy been covered. Do
not include payments from other people in the household. Regular
paymsnts from people outside the household (I) includee regular payments
of specific bills ae well ae cash paymenta.
Y. Household Financee
Y1
Make sure that you have coded the front page of the schedule and this
check correctly as the three groupa identified get different questions in
this section. The subject la a HOUSEHOLDER if either subject or spouse
Householders are divided according to whether there is one or
is HOH.
more than one benefit unit in the household.
Y2-3
We need to know in total how much the non-householder pays to the HOH,
what this covere, and what is provided without payment.
Y&5
Covers the reverse eituation: what the non-householder(s ) pay to the H(JH,
what this covers and whst is received without payment.
Y6
Ask questions as necessary
Y7-20
These questions cover varicms components of housing costs. Note that the
aim of these questions is to establish the net amount that the subject
(and spo.ee) is paying for housing, ~
a~housing
benefit, rebates
Thus if
etc. We do not want details of amnunte of benefits a:?drebatee.
all housing costs are met by DHSS/the local authority .:= do not need
details.
Y7-11”
Record details only of mortgage payment and any endowment policy which
Do not include insurance payments.
will pay off the mortgage.
Y20
This is aeked of everyone becauae people on housing benefit may still be
paying water or sewerage rates themselves.
Y21-24
These questions aim to cover the total annual cost of all fuels. Ask to
If informant cannot give details for the
see documents if possible.
whole year (for example because they have not lived at the address for a
year), obtain whatever details You can , recording amOunts, periOds and
dates.
Y25
Make sure informant has understood
question.
Y27
Be careful not to include anything that has been mentioned earlier in the
interview.
to establish the tenure category.
the preamble before asking the
Z. Financial situation
Z3
Only include payments
Z7
If iteme are owned jointly code ‘has ‘ if eubject has use of item.
item is not working code ‘hae’.
that are overdue.
25
67
If an
17.
Recall Sheet
At the end of the interview you should complete a grey recall sheet.
There
will definitely be some further interviews with some informants so it is
important that permission for recalls is obtained from as many people as
possible. Make sure you obtain the name of the person who gave permission, and
a telephone number if possible, as we may want to write or telephone first.
18.
Administration
Field dates .-
18.1
As indicated
Completed work should be dispatched
18.2
on the invitation.
twice a week co your regional office
Study Time
Tiresallowed is 4 hours
This includes 3 hours pre-briefing preparation
(study of the documents and the
instructions ) and about 1 hour after the briefing for:1.
Planning your quota
ii.
Revision of the documents
and the instructions
Checking Time
20 minutes per individual schedule.
5 minutes for copying the details from the sift
18.3
on to the schedule.
Claims
The survey number is 1192
The stage number Is 99
Study time (4 hours) to be claimed on the brief ins claim
~
time, for copying the details from the sift fOrms, (5 minutes Per
whole quota to be claimed o“ the first clam for fieldwork.
Checking time (20 minutes per schedule) to be clailned each week as and when
completed serial numbers are dispatched.
26
18.4
Order of documents
All documents for one household sbnuld be tagged together
Please tag the documants in the
following order:-
Sift call only
1.
2.
3.
4.
Children’s form (Pink) - if applicable
C & O sheet for sift (dark pink)
Yellow sift form - if applicable
White/orange sift form .
Interview only
1.
C 6 0 sheet(s) for l/V (blue)
2.
3.
Sift form
Pink schedule
4.
5.
Green schedule
Recall sheet (greY)
1
(One for each interview)
Repeat if two interviews
Sift call followed by interview
1.
Children’s
2.
c & O sheet for sift (dark pik)
3.
4,
5.
6.
7.
C & O sheet(s) for l/’J (blue)
Sift form
Pink schedule
Green schedule
Recall sheet (grey)
form (pink) - if applicable
(One for each interview)
1
Repeat if 2 interviews
For short or abbreviated interviews there will be no green schedule.
18.5
Whom to contact
Fnr queries concerning
:
Field procedures, technical points, exercises,
general problems with response
PAMILA CLAXTON
MAOGE BRAILSFO~
Allocation
ext 2200
ext 2200
of work, claims booking in - progress
Regional off ice
Research
Jean Martin
Lizanne Dowda
ext 2299
ext 2256
Dennis Lewis
ext 2358
Sampling
27
.
69
s1192
SURVEY OF DISABLED AC(JXM
Supplementary Instmct~Ons
1.
Postal Sample
H you are contacting an address where the uAndualls detals were not fdled u snd 13, 14 or 1S
was entered m the month box, the outcome code will
be 8 because we have assumed the person IS an adult.
If there tuxns out to be a &sabled chiLd f~ll m a
PM
cluldrenls sheet and return zt mth all documents
for that address.
2.
PUIICSchedule Intermew
As you go through the lettered sections the mfonnant
may mention a complant causJng ckfflcultxes wb.zch
you &d not hst at quest~on 5. If so, go back and
enrer It at quest~on 5 aud ask the subs~baxy questIons about lt.
3.
Both Schedules
Do not forget to r.mg the number at the top of any
column you complete m a gmd.
70
12.
Postal Sample
~~
‘fheperson/s to be interviewediare
the one/s listed on the address list not the
persons signed on the back of the yellow sift form.
—
only where there is inadequate information on the addrees list and either 13#
1S written on the back of the yellow eift form is it correct to~certi~
all
—
disabled adults at that addreea.
13.
or 15
Proxy Interviews (all quotas)
If a proxy interview is taken, becauae the informant is not well enough to be
interviewed, but la either present at the time or maybe around the house, the pink
schedule and the green schedule (if appropriate) should be used. Only when an
Informant
in an institution or haa died, will a proxy on the pink achadule ~,
be required.
14.
Pink Schedule
Sections A-P
Please ensure the correct interviewer check is used:That
with
la a
form
io if the answer given by the informant at the main question agreea
the /on the sift form codes 1 or 2 should be ringed. If there
disagreement in the answer given and the information on the sift
then the second check should be used ie codes 3 or 4.
15. When you fill in your allocation ,checkform pleaae make sure that you return
to the office all axtra eift forma where there is no addreaa on your list to match
the form. We would like these extra forma back aa soon aa poaaible.
General points
Moat of you will have received by now a list of errora that have been picked up on
the pre-checking of your firet schedules. There are a lot of clerical errors, and
data is being lost in same cases. Aa this is a heavily preceded schedule there
should be little error. Will you please make sure that time is spent on checking
the schedules for accuracy and completeness bafore sending them back to the offica.
I have had varying reports from intervi~ers
about the survey on, how diatreasing it
can be in some cases, but alao how cheering it can be where one aeee how people with
disabilities can and do cope, and moat of you in spite of difficulties with pressure
of other wnrk and mat eriala, are finding it an interesting and enjoyable survey. I
knew also that some of you are concerned about the slow progress being made due to
the length of the intervlewa, this is happening to not only you, but to all
Intervi-era.
Perhaps what IS reqtired O“ this survey more than any other 1S being abla to handle
and contr@ people - very difficult I know when they give you thair life history at
every queetion you ask! But some control la necessary otherwise informants tire
themaelvea, and also you the interviewer, as I am sure you have found out.
Nevertheless response rates seem encouraging at this point in time, ao keep up the
good work.
P A Claxton
Field Officer
14 August 1985
.
71
23
SUPPLENEtr2ARy INSTRUCTIONS FOR INTERVUkTERS. SURVEY OF DISABLED AOULTS
1.
PLEASE READ YOUR INSTRUCTIONS CAREFULLY
2.
When you are transferring ticks from the sift questionnaire co the pink
schedule - note that some people only tick ‘yes’ boxes and never bother to tick the
‘no’ box if they have no problem. This means that you may hsve bnth tick boxes
blank at the top of a lettered section. Ynu shnuld teke thie to mean chat the
answer wae no on the sift form (but dnn’t put e tick in the ‘no’ box).
3.
If the informsnt saye that they have nn complsinta at question 5, do not
intervl.ewthem. Use cnde 11 on the blue calla and outcnme sheet.
4.
If, when you ask ‘what complaint cauaea your difficulty? ‘ you come acrosa one
that hae not previously been mentioned, PLEASE put it in at question 5.
5.
When you aak ‘“whatcomplsint caueee ynur difficulty?” you muet code the
complaint number as givrn at the tnp of the grid on pagee 4 6 5. Some interviewers
are ringing 5 if the informsnt eaya “old age” - this la the code fnr old age at 5(e)
and nothing to do with complaint number.
6.
Do not code the complaint that the informant gives you.
description, the coding will be done in the office.
i’.
Just get the name or
Some intervi-era are not following the sign-posting prnperly:
w.
Section K
The subject msy loee control laaa
than once every 24 hnura. This
still counts aa ‘“noprnblem’”at 43.
Section N
The eubj ect may suffer from severe
depreaaion but if it does not affect
their daily activities no letter will
be ringed nn the check flap.
SectIon P
The eubject may euffer from eevere bouca
of breethlaasneas, wheezing or coughing but
you will only ring P if this affects their
ability to lead a normal life.
8.
At P22(e): if the subject ia retired and is over retirement age code 2. If
the aubject la retird but is under retirement aga end had tn retire early because
of a health problem, code 1.
Some intevl~ere are aeking the whole of section R when they dnn’t need to.
Remember thoee penple who don’t get help with personal self-care (thnse activities
on page 46) will m.iBamost of the rest of the questione in section R even If they
naed help with household activitiaa (those activities on page 47).
9.
10.
There ehould be a recall sheet for every pink schedule unless the subject is
desd or is~
institution.
11.
If the subject is dead or in an institution - code 1 at R14 even if it is a
short interview (no letters ringed on check flap).
“-z
/0
72
The SPSSX files have been created by the CPCS fran a SIR database.
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S8D12
S8D13
S8D14
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1. The variables S14AFflto S14AW, S17J1.fl
to S17AM6, S8PMl to SEAMS,
S9AMlto S9At6-expla.imd
on page 880 fthe OFCS &cuntmtation -t
Response Variables on adult Disability”. ‘1’bey
refer
re-i@Y
to @
mi*leS
S14AI to S14X5, S17AI to S17A6, SSM to
SEAS and S9Al to S9A5.
2. [email protected]
and W
have been brought Over frm
-18-
.
90
the pink sciwsdule.
-
Am
mm=
.. #AEA
.,
.... .,.
ADDREss
W4#J
ttm
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H*HoxD_n4D --
SERIAL
N-R
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OATS OF
,~ +
,;
FINISH
START
fis
p----
1
--
(1)
TYPE OF INTSRVIEW.
\
“
Wmm
.-
Full mtervlew .................7..
1
ShOrtutterwew,A
fu31.
2
for full, but mxunplete .
3
Abbreviated because in instltutwan .
4
Ellgtile
i
ehgible *
[
Abbreviated - deceased............
rdclNfis
I
(11) Wso WAS INI’SRV2ENED?
5
k
--.112
Sukgect..
Wt+ol
w
1
Both .....
G
.
(iii)WAS kXJSJ’RCTPPESENT
DURING
THS
INTERVIEW?
Yes
1
(IV) REASON FOR PROXY ,
t,
3
L
Sf%aam
-
all the t=
17 ‘
21
i%
-(iiI)-(v)
I
r1
.....
...rm
Wymq
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---..-&*d:::
“’*sent’d=e=ed
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Sub]ect confuse.dlmentallyincapable. .:’..
r
..
--
. .’
9’>- .
Sti]ect tklll .........................
3
Wr
Sukgect has speechfie.aringproblem...... 4
Sub3ect cannot speak Engl~sh............
5
~~r-.-.....-....-...
‘
$fb”
. .
(V)
PERSON NO. OF PROXY.
(FRCM HWSEHOLO
ti-
SOX DVERL?2W)
IF PROXY IS W
SPECIFY
PERSON N
IN HOUSEHOLD
RELATIONSHIP
%?mw
TO SUEUECT. ..........
w
p)A=qq
1!21-22
m’. ~
... ........
F
2
06
12
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12
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3
45
41 Xcu&cc #l
2.Susmer,s
mm 0%%!+
w
{
(cHEm wxTH SIIT mm
:;.
.23-*
3. (mDE FROM OBSmVATION
ET
ANO WITH AGE AT B ‘HOLO SOX)
IF sus.mm
SHCW cARD 1
15-XI
2q-3f6 ‘ii
27-28
IS SE2N m
IS
@cz9@1)
$=.
TO which of the groups listed on this
.,
card do you consider you belong?
zmhll~
white.................. ...m ol
-., ,
<.
.
-1’
L
-.
,
. .-,-
d
West Indmn/Guyanese. ...... 102
I
Indian ..................... 03
I
Pakistani ................. 04
. . .
I
05
I
06
....................
Bangladesh . ............. ..
.“>
.,
. .
I
‘5.
-,
Chinese
I
African ....................
I
Arab ...... ............ ...
0-~’lq
Mixed orlgln (SPECIFY)
07
08
@
Liqq
w
None of these ......... - .-
- (a)
w
1
.,
31-32
I
(a) How would vou describe the racial or
ethn:$,group to which You be long?
.’
u
I
92
-> fkcom@I tiGNCG AI
2
aslq-m=qi
3
1.
INSTRUCTIONS ?0 INTERVENER
(a) Before th= interview go thrcugh thi● schadula end tranefer al 1
ticks frcinthe sift form to the boxes at the beginning of each
section.
At this S-ge it doesn’ t matter if some ticks refer
to another person in the household.
(b) Frc.nthe back page of the sift form copy dmtails of the subject’s
health problems/disabilities to the lines balm. ~-Ig Wng are
If all that i8 written is ● list .Of-the
listed write NONS
answers given darlier on the sift ~form .s180 write ‘WNE. - ‘,
DISABILITIES/HEALTH PROBEHS
‘.
LISTSD ON SIFT FW=’ .\
‘.
-,.
..2
..
5.
.
.-..
.
CHECK/FIND OUI’ABC4iTCCY@LAI??TSCAUSIffi DIFFICULTIES AS FOLLCWS
~
-
According to the form that was filled in about your household, you
have some diff~culties with every&y activities, or suffer from a
long term health problem.
IF SPECIFIC CONYIAI~S
LISTED AT 4 (b)
The form says you suffer frm (CC44PIAIl?NAT 4 (b)) IS _&hat right? ~
you have any other long term ~laint
~ich affects YOUI ●veryday activities?
-lU
+ .,.
,.J,.
, .,..,
,..,.:,,!;
IF ‘KWS’ AT 4(b)
i.
Can you tel1 me what is wrong with you? co you have any other long
term cunplaint which affects your daily activities?
mm
ONE cmPIAIt?r PSS COUMN
Cm THE Nq.p-
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‘
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‘lF’”~Is
ON THE LIST IN YOUR INSTRIJ=TIf=JS
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. “ IF IT Is ~
ON ‘E-iE
LIST OR YCU CAN’T OSTAIN A KEDICAL NMD?.>DESCRIBE TBE NAIN
SYNPTONS SO IT CAN SE CODED IN TfO?,
OFFICE.
EXCLUDE CONPLAINTS wHICH SUSJECT W
DAILY AcTIVITIES.
LONGER HAS OR wHICH ~
,[~
NOT AFFE~
I
3
4-
!il
3
(a)
(b)
::
. .
... .
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1
(c) BDW old were you when
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A&@
IF RADIT=@MB
TS
CODE CO
1
I
Am
m+!’~q
n
II12-13
YsAAs
n
(d) For hcw ❑ any years
has it been as bad as it
““a’
‘resent’
%ws&b
LE.ssmAwl
YEAR=oo
w
,4.,
(e) What causad your
(CCHPIAI~) ?
CODE WI’lTiOLtT
As~=
IF OSVIOOS
PR@fPT
AS wSCESSARY
Born with it/bir&
injury..........-.:.
Accident ..............
Industrial disease. ...
.-
Illness (not 1 or 3) .,.:
*& -J$’~
old aae
..........~.’~..
1
4
—
5
.
.
.
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7
6
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/’
- .,
5
. .
$-..
. ..-
95
‘
RErlms ‘m Susmcf
“{
Ppsn 4 iii)
“Lkssx Core: ““”-
{
.
ciki?’s:. ~
.**%,
StS@m@S-D
b
,. .
●.<,
)..?.
.-*
~.,‘,
u
‘W, ....... .. . A. 1
‘qgi&i
S’KTION B
4’%7
SUBJECT WES
r
*M
IFww~ATw
AZ.
~
EAV?S DIFFI~L1’)
DNA Can’t walk (@e
3 at Al) ....
Al
Can you walk for a quarter of a mile on your
ovn without stopping and witkut s&.er< di~&fort?
I
-
Yes
‘.
No
$
What is the furthest yca ch walk on your mm
without stopping and without severe discomfort?
4
-.
SOyd~.
*-,
..
-,,
For how long can you walk on your own .
without stopping and without severe d~acakfort?
t13fi
Less than -5 minutes ..........?..
5, but less than 10 minutes .....
10, but less than 15 minutes ....
15, but less than 30 minutes ....
30minutesortmre
.............
. *..
1961
6
4
SECTIC4J B
3
RINA+AI
1
fit
wI
-
(a)
SEE A2
id
W12’fl
AIDS IF USED
A3 .
3
2
SiCTIC+J B
~
RING /k3
J&
*’
i4 .
.’
wa3k wra sl~ly or at th* sama paca
saabody els* of yam ●ge who is In good
health?
. ..
00 ym
●s
4
More slowly ....
Same pace ......
j \~
,.
i
~,d
~
2
b
A5 . How long can you remain standing without
A -- severe dimcom.fort?
.,&:+t+,#**
~:::W.3&w~>-9&
. p...&e&e..“‘“:+- +’
.,.
-..M. .::-...
&($ ..i
q.e+ mss than 5 BiQute.s.$<.
.....
“ :#e but.,,
$
.
5, but ~less thm “1O minutas .....
. . Less thaII 1 +r+ta
10, but less than 15 mhutes
.....
15. but legs than 30 ~ute~
..... I
d
9
IF CAN’T WALK AT ALL (COde 3 at AZ)
.-4
~,.ht>.~
-,:C~E WI_U3
A.SK3XG IF ~
.“ . ...
:+=-
nay I “just checi, can ya
stand at all?
.%,,....,
-LA6
Yes
No
A7.
what complant(s) causes your clifficulty
m walkmg/maXes It impossible for you b
+
2
P
1
walk?
2
3
4
kJLT!CO’9
5
wt-x.7
6
Wn
7
9
m
,
.
..
~--~”-, 1 e----
L
,-:.
,.-, ..
97
j. . ,.
Yom
FROU SIFT ?oNn 4(b)
[
mA:
81.
can’t walk (Code 3 at A2) .....
Do you have great difficulty walking
up or dmm stepc or stairs?
(a) INTtRvIsNsR CEEm
~
XF NBCESSASY -T
71ml%RS’msUB.TS2T
TICK
,- ~
SIFT FOW
“&
IF B1 AND SIFT FONM 4(b) AGNSS C~E:
SUBJXT
SAS DIFFICULTY ........
SUBJECT COBS tUT SAVS DIFFICULT!
IF B1 AND SIFT FOB144(b) ,DI=Q=
R02QiCILS DI.PFES124CE
AND~ CCXNf: &.y;;:;#
/4’
S~
cOS-SNM’ SAVE DIFFICOLT
.,-:,!.
‘.-’.
DNA: Can’t “walk (Coda 3 at A2i’ .s~~
f.-
:$flB2
IF CAN NALKATU
,
v.
Can you walk up and down one step
on your owm?
53.
In
B2
:
B3
:
Can you wa3.kup and dowm a flight
of 12 stairs on your own without
gtoppmg for a rest and without holding on?
)
(a) can I just check, do you wa3.kUP and
dowm steps or stairs in a normal reannex,
or dO YOU have to take one step at a
time o; go sideways or anythng like
133A
.
that?
Manages steps nO&ally .....
,&
. ‘.;.?.:
(
rmes not manage no-lly
‘..-
B4 .
~+=
If yOU hold a, cm yOU Walk uP ~d
down a flight of 12 *airs on ycur own - ‘
withOut stOpping fOr a rest7
-.
- ,*
,..,.
:....
yy?
WY
N
8
—
. .
.
98
e
.-
. ,9
.,
a
-(a)-(b)
(a) mu many stairs can you walk up on
your own (befora you need a rest)?
?+-31
,.,J
*
..
(b) Em ~Y
ymur wn
.
stairs ca{-~ou walk dcun“on
(kmforoyou need a rest)?
‘
‘#AIM
Ccxit4
I+lt:%
52-33
●
33
Walks up and dawn normally. .
3+
Dcaa not walk normal ly. .....
B7 .
tiat mplaint(s)
causes your difficulty
in walking up and down steps or stairs?
IF CAW’T WALK EWI’SR
wUMSSRS FRCM AV
WITE~
RIK cX3MPLAIWTWOS .
FROM Q5
35- %1
ASKIWG
B-ml
1
$mqa
67M3
m
“SC
.1...-,
99
la
.
a~-liiib
—-,
Y*9
BSNDINC AND STAAIGt’TFSNIt=
c.
17uNSFSR TICS PR~
SI~
w
FORM 4 (C)
am
DNA, Can’ t stand [Code
lb you have difficulty bending down and
straightening up again, even if you hold
on to aauething?
cl.
*. [a)
2 at A6)
Ye,
A.
L-L
NO
U?IsRvmlss
CsEcK
-,
CNECK IF NsCESSARY TEAT ANSNER ,ON SIFl!FORM
REFERS m 6uBJEcr.
.-k. i.,
.. :G
IF Cl AND SIFT ~RJ4 4(c) AGRES 03DE:
SUSJEC?fS=
,.*
*+.-.
-Cf
-,fi Cl AND S=
F&
4 (c) DISA~
D2FFSRENCS AND CODE:
“ !
,
+-,.
. 1,-,-.,1.
DI=I~~Y
00SS =
PROSE ~
C.%A
..........
EAVE DIFFICULTY.
:1
sECMON
SUSJSCf NASOI=I_Ty
...........
C2
-S
DIFPICUI.TY .
SSCI!IOND i
.-.~.-.
RING @6
EWE
DNA: can’t Stmld (Cnde 2 at A6)
I
IF CAN STAND
Can ynu bend down and sweep sanethlng up
with a dust pan and brush and straighten
up again, holding on if necessq?
%%i
G2
Yall
SSC1’IOND
No
t
447
C3 .
Can you bend dawn far enough to touch
your knees and straight= UP again.
holding on if necessary?
+5
C3
C4 . can you bend dum and pick sanething
Up frun the floor and ~~aighten uP
again, holding on if necess~?
C6 .
Can you kneel down and get back w
again, holding on if necessary?
Yes
.C4
No
.C5
Yes
*
C5.
NO
C5
Yes
NO
Nhat cc&plaint(s) causes your dlf ficulty
in bending and straighten%J?
.
100
D ‘
43
~
RE=NCIXJ3
C2
@a:@
-*. T
S&Em
C2 .
7‘
Sc
Yes
TICK FR@4 SIFT FOPJ44(d) m
NO
m
I-LJI-AI
D1.
from falls or have great
difficulty fn keeping your balance?
DO YCU 9Uff_r
Vf :
(a) IN1’SFXIHNZR CFECK
CSECS IF NDXSSARY
RRm
IJ)d~DBJscT
.
.
TsAT ANS~
~
ON S UT FUlN4
..
,.,.,
+ +
..’
3P-+.
~.
.& - .--L1 2.+%-J*,. +“ ..
IF D 1 AND SIFT d4-<4~&-AJ%SE
CCd :
,..
~.
4
SUE.JD2T SAS DIFFIcuLTY
....... ..
.
.
SUSJSCT 00SS NOT SAVE DIFFICULTY
2 .s~SSCTION
E
IF D1 AND SIFT FORJ4,4(d)DISAGRSE
Z;&F&*
,SVEJfrr
“sri3J%cT00SS
NOT SAVE Difficult
E
~v’i%$* 4&&iiALPr *
- ~,
.
.,
D2. ! In the pst ‘t&l&i’ ~nthe,
h Vyou ever lost your balance and fallen?
.1.
k“
.
.
1
2
-1
?
3
l-w
00 YOU need to hold on ta s-mrething
to help ycu keep your balance .....
-,
RUNNING
PFr14PT
)
.-.
allthe’timw
5!3-54
m
..........
quite often ...........
--
only occasionally ...W:>.
or not at all? ......:,.
.
.
D4 .
D3
f
(a) How WY
t~es have you fallen in
the past twelve months?
D3 .
57
RINGD9(a)
INTZPXIi?WERCHECK: i
~.
$4..
,
ELASEAD FAUS4 CAN’T-Sliilih
OR NHSDS TU EOLD-& .....
“‘
..-.—
-,. .. .
_.-,
k:.,’ ,
--..+ .. —.
—- --- .*=
, - ‘
;
..2
D5 . what” @ltint
(s) ci~~’~~
diffiml
..,, ?~~
~i”’.
,jti
.,
keeping your balance or having falls? =- ._
S-
-J
.,. -
. ,,, ~
.-
RING CONPIAINr NC6.
FRon Q5~
-
101
n1’7
= . ..
..
‘M
“-i!Kti’th
. .. . ..
. .
..
..+T2<
~
%iW$&ijij*?
@S:.3/3,w!mJo
R.
REKSIWS
Am OmmCEm
B1 .
Do you have difficulty using your arme
to rmch end stretch for things?
7 +S1, NO,
Ya
@.
(d
j‘-”r”--,
ItrERVIswEs a=
CIiD2K IF NXSSSUY
THAT ANSWSR CN SIFT FOSM
FUzFKwim SUMSCf
. .: *L-”
“z.,~$x.
, ,>. . .. , ~“:q.~c”,.
::,“;,~~
~f&xmD#
I
IF al AR9 SIFT msn 4 (e-)
EUKKCT
-E2
‘AS DIFFICULTY ..........
,@
-sECTIC51F
SUEJECT DOES NOT SAVE DIFFICULTY
c%
,.p
$$
*
IF El SND SIFT FOSJIm
#
q
-E2
L- z~$%’””:
~
s0SS ~
SAVE DIFFICULTY
-S=ICN
F
1#
-SK3WX4
F
-RING E-E 3
E3 .
SEW
CAsD 2
c~I ‘m
Left
Right
1
r
Using your &ST/L~
arm, how
difficult is it for you to .....
~
~
Please choose your answer from this ~
,. ~gq:.
card .
I
3
(i)
(ii)
+ -----
‘ .f
(iii)
(iv)
,,
(v)
.
1(k
12
13
hf t-handd?
w
Right-hanhd
,
2i
Uf t-handad
1
E5. What complaint(s) causes your difficulty
in reaching and scratching for things?
,
5
1.
MF%4
‘j
=
7
y*d*5j@A+ft*w
. ..r$g&$#llJ
;&
. ..
W
.
rz5 Mb
.
. .
I
13
103
g.
.
.
11
.
..
‘
.
..
-WC
UGlxm *5- kulw
@2
F.
HOLDING,
F1.
“m’’”
Do you have groat difficulty holding,
gripping or turnhg things?
GxUPPING AND IUPNLNG
Yas
“0”
“m
““
NO
‘(”ml
(~) I=+=K IF NSCESSARY THAT ANSNSR ON SIFT FORM
“FE’S
‘M SUSJ’B2T
IF F1 AND SIFT FORM 4(f) AGRES C~E:
,qJv
Fti
q%
SUEJECT EAS DIFFICULTY
@~
/“
00S.5 NOT SAVE DIFFICULTY
~
‘AS DIFl?ICULIY .;.....f~.
.
SU~
DOES tWT HAVZ DIFFICULTY
using
only, Can you .....
(i)
Pick up and carry a 5 3h bag
of potatoes?
(iL)
(iii)
iii
‘~
.,(.
~-,-q - .J
F2.
(Iv)
Turn a tap on and off? .........a..
Pick up a small object, such
as asafetypln~
...............M . ..
wnc+. y’sm
IF71%RV2EUSR fEE~ ,
(ii)
(iii)
(Iv)
F4.
@DE
ALL’Ix
Nol—Qm—
.
hand
Using
only,
(i)
31
.... ........ ....... .....
F*
F3 .
. ....... ..
......
...........
Right
I
Pick up and carfy a pint of milk
P ...
Pick up and hold a mug of
tea or coffee? .................ti..
w
D
I
G
2
~GF-F3
3
Left
lzP3=!3’
Squeeze out the water from a sponge?
w
FXUM E4 IF AL-,
ASKS66
Fty
Right-handed
1
d26
Left-handed
n
104
=IC?J
the control knobs on a cook”er?‘.
-
Are you right -handed?
.
1
14
M
I
w
IW
..’,
F5. 1‘m going to read Out SO= thti.qswhich involve holdinq,
gripping or turning and 1‘d like you to tell me how
difficult it is for YOU to do them (without using special gadgets)
SECW m
2
Please can you chmse
an answez from this card.
How difficult is it for you (or
would it be for you) to .....
,.-.,
*..
~m
. k<
i) Wring out 1ight”wash~g?
(eg a tea towel)
.
.
Not
Quite
Very
difficult
Impossible
dlfflcult diff~cult
at all
+7
ii) unscrew the lid Of a coffee~~>
Q
(iii) P$ck up and pouk from ● full
:.~t~t? ... .4 --.E*m*~>
(iV) Same focalfrom a pm using
a spoon or ladle?
44A
2
&3:’
2
es
c
(vi)Use a pair of scissors?
2
6s6
3
4s
43
W
54
5@
,
(v)Use a pen or pencil?
..
2
~
.L,
I
4
Nn3
51
4
Naj
I
52
I
(vii)Tle a bow in laces or String?
F57
53
C
.
I
F6 .
What complatit (s) causes your d~ffIculty in
holding , gr~pping or turning thngs?
1
2
RING COMPt#JNT NOS.
FROM Q5
3
4
fb+4L
MAX = 7
FbHz
fbws
6.
FbMk
7
F6U5
F6M6
Fbmv
15
%5
Sc
K9
[
105
(L
lh
L ‘t-d
,(h~
G1 .
Da you wear ghmees
or contact lenses?
q%
Yes - all the time .....
Yea - Somtimss
G2 .
........
m .....................
...
m you have difficulty recognistig a frimd
,.-;
across the road (wearing your glasses/lenses)?
,
--
(a)
!...
. .
.
Subject is blind
..
.
,.
..?
INTERVIPMER “~
,
,.
CBECK IF NSCSSSANY TEAT ANSNEN N
NEFEssm
1P G2 AND SIFT mNM
SIti PDNJI
4 (g) AGNSS CODS:
SUS.)D2TBAS DIFFICULTY .........
SUSJSCT DOSS NOT BAVZ DIPFICDLTY
1P G2 AND SIFT PORN 4 (g) DISAGRSS pNOSE ~
S2CDtKna DIPFSRENCS AND CODE:
SDBJSa
BM
$Zfi
DIPPICULTY .........
SUBJSCT DOSS NUT SAVE DIFFICULTY
t
M
G3
IF SUBJlX7 IS BLIND
DNA: Subject is not blind
can I just check, m a room during &ytims,
can you tell by the light where the wuviows are?
q3
G,.
Can you see the
in this room?
shapes
:
of the fumuture
..
NC
G5 .
CM YOU see well enough to recngnise
friend if you get closa to his face?
,-*
,
-Y4
Nc
G6.
can you see well enough to recognise a
friend who is an arm’s length away?
Y(
N<
G’.
Can you see well enough to recognise
a friend across a room?
Y,
N,
16
G
. . ..
-., .,
~xl”
Gs.
qf2-M6
——A.
.
..-
mq
T&w
(May 1 just check) can YOU see well ●nough to
recognisa a friond acrom tha road, if you
Yes
q?
G9 .
..
.
’11
;9
No
Even tbugh You COUICIII’
t x-Z=
the
parson, coqld YOU me a paraon standing
on tha othar side of the road (if you
wexa on the pavamsnt?
16
;11
,10 37
Yes
NO
, could yOU
G1O. If you ware etanding on the pa —t
see a car go by on the othar sida of the road?
.
Yea
.
,+,*.,.,
* .
W
..
-1,
-
18
No
.
Gil. OD YOU have difficiilty‘ieefid & %d
‘
print (wearing glasses/lenses) ?
ordinary
‘newspapr
““ ‘ L
G)
Yea
(a)
19
INTERVISUSR CHHX
CHBX. IF NECESSARY THAT ANSNES (X SIFT FORM
REFERS ‘P3SUBJHX
IF Gll AND SIFT FORN 4(h) AGSEH CCm3 :
SUSJSCI SAS DIFFICUL~
S~
IF Gll AND SIET FOPJ44(h) DIS~
OIFFSFSKE AND CODE:
G12 . I~VIEWSS
-a
.........
UNGG+G13
Ex3ESNOT SAVE DIFFICULTY
;12
PP.OBETO ASCCWILS
411A
+
S~
BAS DIFFICULTY i........
UNG G+
S~
tk3SS~
;12
SAVS DIFFICllL’3W
G13
CHECS
21
SUEJSCT HAS MY SEEItW DIPFICULTI (Code 2 or 4 at G2 (a)
.....!
and G1.l(a)
)
SOSJSCI!IiASDIFFICULTY SEEING AT A DISTAt+CE~~Y ...........
G13. Can you aee well enough b
a large print book?
H?-CTIONE
;~5 /
read
G
G14 . CM PU gee well enough to read
newspa~r headlines 7
1A
;,,<2
2
;14
1
;A
@+:
23
G15. may 1 just check+are you registered as .....
G$5...
1
bl~nd ...........
RUNNING
PRONPT
partially sighted ....... Pn 2
or are you not registered
aselther?
24
Nfi
3
..............
u
17
107(8
IQ
-,
.
.
QcMD
@
5t&Iok6 tfic@nFJ@
#J!.u
SIGBT TY5TS
G16
G16. DL5’3WKE VISICe4
OWA: Proxy inteniew
1-
...............
cannot t-11 by the light where
the windows are (Code 2 ●t G3) .
Subject’ a (dint.mce) glasses
not available .................
INSTPJETICWS ~
1 ,:.<>
IM’SRWEWSR :
-: ~ .+l,
,
[f subject normlly w-us glassee or contact lenses
they munt b-cwarn for the teat. If sUbjeCt hag
separate reading and distance glasses, distance
Check that the glasses are clean.
glasses mmt be mrn.
Sold the chert 10 feet frnm the subj=rt’s eyas. M&e aura
.Try to erranga fogh< . : &-#*z,
the chart is M1l ilhmirmted.
..
light tn fall on the chart. 14ea0ure 10 feet using the
tape provided.
(a)
can You see this chart?
Yes
~
ql@
(b)
Bow far down can you read thin chart?
Sutqect illiterate .........
*
Cannot read largest letter .
,
Subject can read all letters
correctly down to line:
$16$
RIWG APPROPRIATE
NUWSSR
,:
...,
(Read whole chart cO,;r:&t~Y..
Now can you read the next line down?
NeXt lme
C#6c
(ZBV) read ....
Next line not read ......
1.
108
18
03
&
—
,Sz’Y,< ‘
..
OSA :
I INSTRO~IONS
~:mh
sublect’s (reading) gl~=es
-
CD
not ~va~l~le
lYJ INTERVIEWER
34
‘1
or
If Subject normally wears qhsSe9 or contact
lenses
for readlnq,
or uses a magnifier or low vision aid, they qhould be ,used
fOr th13 test. Check that the glasses are clean.
Tr-l to arranqe ‘or
,Iakesure the test card IS well illuminated.
llqht to fall on the card from over the sub]ect’s shoulder.
(a) NAND &.$
OF TYPEFACE TO SUB.ECT
‘-’f
“ cti ‘you read-;~y of the words on this card?
.
I
.,3
b
---~
9-lj
~es
~
174 ;Iy
‘T
(b) Which 1s the smallest ormt
P
)9
, .,..
.
that you can read>
..
I
RING APPROPRIATE
NuX3ER y*, , -l-,,?
~ 1~~
--4
3a-33
~27g
GM
When dld you last have your sight tested?
Wlthnr the past year.q?%
.. ..... .
!
1 yr ago, but less th=m 2 ?rs.
3%
2 yrs aqo, but less than 5 yrs
5 yrs ago, but less than 10 yrs
19yrsag00r
more .....-.----;
Never had slqht test.......-.5
-’
.
G13 Because of your sight do You normally use
Yes
,any aids to help You get about?
qlq
,*,
~-@.;l
. i--i.
-,
.-.
+’Wf
(a) What rJds & you normally use? Guide dog .......... ........
—
MULTI rx)DGD
Same aid. ..................
PFQMPT AS NECESSARY
MAY ~ ~
white came .................
qlwtl
~iqwz
~~
qlq4M3
~lq4Mft-
“w
-
lliAT AYPLY
Or&nary
sti&
.... ...--.*-.
Another
perscm
to quid+ you.
o~era
G20 What mtnplalnt(s) causes you. &f flculW
‘(’) 35
w
In seeLn9’
36-3q
--”
fw!le
K7
(hllu
RING COAPLkTNT TOa .A
m h
FROM Q5
II
ONA.
White Sift form. . . . .
u
Yes
.——
TR4NSFER
NA1
‘1” “0”“m‘oM4(”
1
.. COHPLETE NEA’I
PAGE
No
IJLJ
KM.you wear a hearing ald at all?
,4
NA2. b you have dlf flculty hearng someone
talklng to you in a quiet rcom (with YOUI
. !’-
CNECX *F NECESSARY THAT ANSWER ON SIFT FORM
F.EFER5TO SUBJECT.
IF M2
AND SIFT FOPJ4 4(1) AGREE CODE:
SUBJECT SUBJECT ~Es
14mtl
DIFFICULTY ..........
NCT NAVE DIFFICULTY
IF Hi2 AND SIFT FORM 4 (1) DISAGFJSE PROBE TO
PJ3CONCIL’ DIFFERENCE ANO CODE .-
SUBJECT HAS DIFFICULTY ..........
.RINGl+-14 ~
SUBJECT C-3ESNOT HAVS DIFFICULTY
.RA3
Mm
Lb you have great dlffxulty followng a
conversatmn If there IS background nol se, for
example, ● TV, radio or children playlng
(wearing your hearing a~d)?
Yes
-,
wi3
- -,
.+. ,..
,-
.-,
-.
20
.
110
~’
---
52
-RINGH-9’s
-SECrION J
-“$.q!qlkq
;’=:
.
SS1. Do YOU vaar a hearing ●id at all?
53
‘“54
,.-”.- ~ .
*.:8
“
k“’‘
- --
.
3.-.. ,.
i-’
Da
#@
IF sS2 AND SIPT FOPM 4 (i) DIS-E
RB20NCILS DI FFssRics AND CoL&E:.
..
.. .
..
-<.
PROM
‘,,
.*
DIFFICULTY
- --- ---- ~“@’A
S~RAS
SUSJ~
.j~
TO
.. ..... .....
DOSS NOT SAVS DIFFICULTY
RS3< DO you have great difficulty following a
conversation if there is background noise, for
example, a N, radio or ch~ldren playing
(wearing your hearing aid)?
,,
*3
Yes
56
No
(a)
INI?5RVISNERCHSCS
CHECK IF NECESSARY TWIT ANEWSR ~
RSFERSTOSUSJU2T
SIFT IWRN
).
s.
!,-
IF SS3 AND SIFT 5?3s!4
4(1) AGRXS CUDE:.
)+~%+
“?
SUSJSCT EAS DIFFICULTY ...........
.RING*5
SU~
.SSCTION J
LxXS NOT SAVS DIFFICULTY
IF SR3 AND SIFT FORN 4(1) DISAGRIZS PROBS ~
. .
RIXXNCILE DIF
-E L
w
:~%E;&@WPB
~
r -.-”
.
,.
SUSJKT SAS DIETICULTY
,%.
,’
‘,%.“
/.
.! .-.
‘,
.!”
SUS.JU7f 00S, NOT SAVS DIFFIIVL=
,,2.
%
W
d. * $
,.
+, +x. “
,,
,.
~
.,.,
. ,&’~:, ,,
~ ..
:7
4
,#,
.J”--,.,
.
., w ,’.
*~
.-
21
SSCTION
J
.-
04.
m you have difficulty heartiq tit ● ~rm
.ay. to pu in a quiet room if ho SV*S
loudly to you?
l++
Y*m
+
No
o
MS.
-e
you totally deaf in your right ●U7
Yes
H5W+
H
n
.1. -
rem : mtally
dmaf h“ both ears
.,~..
.E1.
.,
k.
,-,.>
Little
or m
difficulty
mderat=
diffidty
Great
difficulty
Impossible
ix!
,
(iii)
(iv)
‘-l%
MAX
:7
tt$44L
WM7
,..
,“
al-
● -
f’—-
--
y----
NOISES IN T+lEHMO
7.
.-.
~-
.
ii; -+
s S&No
OR EARS
TRANSFER TICX FRC44SIFT FORM 4(j)
DO you Suffer SaVerely from noises in the
head or ears (such M rin9ing or buzzing)’
J1.
❑
!
5i
ID
Yes
,0
INTERVIEWER CHECK
(a)
CHECK IF NECESSARY THAT ANSWER CN SIFT lTIRM
REFERS TO SUBJU2T
-j
‘ ~’: ‘t,<
.~~~
~@ti
i
..”
,
%-”~,
IF J1 AND :IE+ SOW
;J
.
4-(j)AGRXE COOE.
Sfl
“
SUSJECX HAS DIFFICULTY ..........
SUSJECT LX3SSNOT HAVE DIFFICULTY
‘“‘IF J1 AND SIFT FORM 4 (]) OISAGREE PROBE TO
*M*
@Y
SU~
ODES KIT HAVE DIFFICULTY
SECTION K
S-ION
K
cause you severe distress
Ye!
NC
J3
What complant (s1 causes the noises m
your head or ears?
RING CONPLAINT NcE
S9’il
S3MZ
-.
m
-“:
.,..-. ,_. .-..
,-.
4 ,.
,.
!
.
. . ‘.
,
.
aM3
33M+
S9M5
~M 6
J3M7
I
li-17
9
-;
23
113
24
K
1‘d lika to ask next about any problems you MSY hsve .ith
ymr bladder or bcuels since these sorts of prcblemr arm
● ven If they don’t acs.ly to you.
very comm,
K1
‘(’) Mu
~
But first MSY Z check, do You use anY sort
of device to- mansge either- your bladder
Yes - bladder device
or your bwelGY
(a) What sort of device do you uss to
manage your bladder/hove 19?
/-
only
Ill
..Catbeter + bsg.
?-
K2
Yes
DO you ever lose control of your bladder?
m.
,
K2
Has no Voluntary
~h
Mf’LtG3
.
.
less than every 24 hours, but
at least once awssk. . . . . . . . . . .
+lW
*
,
-K3
control
d
(a) Do You lose control of your blsdder ....
at least once evexy 24 hours. ..
?!
(a)
~fi
.
1.ss thsn once, ● week, but .at a
least twice ammth. ......... .
W%
less thsn twice a month. but at
leaetoncs amnth .............
.. .
M
le~e thsn once a mmth. ....“.,’..
K3
INT~VIENER
CIZ?CK
.,+.
SWB.TSCT;- PROBLEN ZP :,X3,: <
. L--*--.r . ~l~-der -gsd
(~ ~“~ce”- (&de. 1 ,or .2-at-X3+*.%...*-.
..
r --(g*..;~
.
-.
.4
&
No voluntary control (Code 3 at U). --..-.-.--..-...-&.Ly,.’.
. .*.
Or loses control at least once m
.,.
,L pi
2,4hqs- (C@
%53
*
,
‘1 A~$i& =-%
“-
‘:>
<!%~tilem.
.%,...............>-. -.~”...*.-..-.....-...~-+ .-..
,,
*
~$;~ -.”’%@@*-~$%% - ?.
(a) CNECK IF NECSSSARY TNAT ANSNER ON SIFT POSH
PEFERS TO SUBJECT
.’
IF K3 ANO SIFT lT3F.W
5(e) AGREE CODE: ,_
s~
JUNG K _
*-;ABm.:&i??
-K4
sus.TDm 00ss Nor NAVE Pmsm
IF K3 AND SIFT FORM 5 (e) DIsAGSEE PROSE TO
SSCONCILE DIFFERENCE AND CODE:
SDBJSCT NASPROBLSN ..........
SUBJECT DOES IN3T NAVE PROBLSI
~ 13
FRING
4
h
i 1=4
.
24
..
.4— —
_.._.——
I
K~
K4
.
.. —-....
K*O
97 wl~-ti
-
-‘ ‘“
U@w
U4A: Wears device to mnaqe bowl n
(Code 2-3 at Kl) ............
00 you
● ver
lose control of your bowels?
Yea
kb
..
-(a)
w
15
Has no voluntary control
–KS
%,
.....
.
,s=
~,”- ?
36
,.
sod
,-”
IMAGED’
By DEV2CE (Codes
2:3
at ii)
NO W3LINTARY CONTROL (Code 3 at S.@ ......
-
OR LOSES CX34TRDLATBT=EA~
.G
(Codes 1-5 at K4(?I)
)
NO PROBLEM
(~)
}
,-
CHECK IF NECESSARY TBAT ANSNER ON SIFT FORN
mF’sRs To Susm
IF KS AND i%
FQRM 5(f) ~
SOBJECTBASPROBLSN
‘-’
,Y$3J
CODE:
SUBSSCT MSS
-,.
,..%
-RrNGK-w5
...........
-SSS K6
NOT NAVS PROBLEM
18
&INGK=
-sss K6
,..
b“iq
- SSCTI~
L
‘..
.
What complaint (s) causes your problem
.. .
with your bladder/bowels>
RING COMPLAIUT NOS
FROM Q5
K6Mt
4UUI
M4X
CO=
=
7
K6M2
24”26
k6M3
K6M4
/(6h5
~M~
—.
k6M7
25
n}
‘%
115
761
~
.,..,,,
-,ab<%~;-&~-
y-’~~--”m
“
‘“’
“-”
q\.,W,m
“:
F ITS AND CU4VULSIOM
L.
TRANSFSR TICK FROM SI~
FORM 6 (a)
Da 1
llava You had ●- fit or convulsion in tha past two years?
L1 .
Yes
L1
&g
1
NC
Zq
2
\
u
.
L2
H(
.,
L2
H(
L2. ‘ Abat how many fits or convulsions have you had
in the last 12 mnths~
,-.
I
.
. .
w%
J
I
.
L3 .
t
-.
When you have a fIt or convulsmn
lose consciousness kowpletely?
do you UsUai ly
II
Yes
L3
r
1
,W
,
L4 .
;
r-”””
when you have a fIt or convulsion do you ....
.o~
> !*-
Id
L4%: ‘-N
?Sm:w.:.
.
.
- ‘ . ,
-iNDIV20UAL ‘
. ...-.—
+ ~p’~d”~-e~wi* “&j
ects or do particu
movements? ......................E....
‘;1
1
6
.-,
-..4
.
,
l“M 2
33
~
ut4M3
Mnx = %-
I
32
.
Have illusion-s,dreams or hal lucmatippm?
,*
j,, .
5
!,
----
26
-.,— - —..
-
..
.—— — .
D
“.-..
L5.
. .
. ...
. ..
..
Row lonq does
. ... -,-
●
.- --~
--”-”-
——-—~----
fit or convulsion usually last?
Less than 5 minutes ...H . .....
5 tins, but lass than $ hour ..
PROUPT AS
NE&ESSARY
$ hour,
lass than 1 hour .. ...
1 hour,
but
lass
3h0ursormre
3 hours
...............
.,
Mulmcowb
.8
than
f
During thm night ..........
4i”*
J.
,.
:
Ye!
No
45
Solretim?s
L7
I
L8 .
00 you ever suffer from ‘status kpilepticus’?
L%
Ye
No
,..
%6
*
L9 .
What compla~nt (s) causes your fits or
conwulslons?
-),
...
RING CONYLAINT NOS
Q3DE ‘WIITiOUTASKING .>~x,a~’,,
‘ - ‘<.
: i “’i’%OBVI(XISLYEPILEPSY
FROM Q5
.
k-
.
*,
-
.k)LTl
.;-<,
.: &#j-z
C&>
-
‘I,->:*-
“
-/
~
L?M1
Lqh@
IJIM3
-LqM4
:::
Ul M7
’27
— .._
.
?’47-53
-%
Ml.
Do othar peopla have any difficulty understanding you?’
EKCLUDE
DIFFICULTIES
DUE TO POOR
ENGLISH
~4
..
l?:’
:
0
(a)
IWI’ERVIEWERCHSCK
CHECK IF NSCESSARY THAT ANEWER ~
REFERS TO SUBJSCT .
SIFT FORN
IF Ml AND SIFT FCIRM6(b) AGREE CODE:
M$ft -
SUB.TU2TRAE DIFFIcLILIY .......
d .
DOES NOT i RAVE DIFFICtf&~
.S~
>.
IF Ml AND SIFT FORN 6 (b) DIEAGREE PROBE TO RsCCNCILE
DIFFERENCE AND CODE,:
...
----
HAS DIFFICULTY .........
SUB~
.
.,
-e”
‘ ‘:.’-.~ “
“ ““ “-’!
&
-..:)*,:*%Z , ?*- CODE .FRC44 .Q135~VA’l’ICN~
,+;.7;
-’%
n2 . DG other .-KIlm
have
.
speech or understandtig what you mean?
IV
@.-
-
~.?,:.
:-
.!.
“’*
z..,
5k%$s@%?i@&.~~%:‘:..’“
Meaning ........... ,
M2’
Both. . . . . . . . .. . .. . . .
Subject cannot speak
-.
,
143. How difficult 1s it for people who know you
well to understand you. Is it:
SHU4 CARD 2
RUNNING
PRCt4P’f
(a)
h~
not diff~cult at all ....
quite difficult .........
- (a)
very difficult ..........
or impassible? ..........
U4
HOW diff~cult IS it for strangers
you . Is it:
m understand
u
.;
-J
. not difficult at all .......
SHC4i CARO 2
7
-J
IJ13A q
R~ING
PRO14F’T
Ite difficult ......::.
.+
verf dlffvcult
I-2
... .......
or impossible? ..........’?
J
~- .>~. .~y=. ...s&aki.ng)
do you use iny other
144. (Apart from
means of making yourself understood?
:--~+~
2.$
Mhi
X:
~~~-“%+aJ@$&
~
(b)
what
❑ eans
,do you use?
ll.
Signing ...........
COLE AIL
l.@)Ll-ia>~
lY-lATAPPLY
Finger spelling ...
Other gestures ....
Wrltlng ...........
Noises ............
‘tie’
.-.
“d’
w
-(a)
i3
,—
~g..-t
.
.. . .
!
.-
ns .
what c~laint(s)
-kos it. difficult
for
–.---your
otlmr peoph to unaarsrana
—
m~mum
‘iiDMQ5
NSM1
MULTtCObeb
MAX
●
7
I
-
M5MZ
MSM3
-M5p17
.-..
“e)
....-..
pl
.
-.
.-
,.
29
119
‘b
wonu
v>
--l
~--w
M~__l*r-
~bdMbft
TRANSFER
TICK FROM SIFT FORM
6 (C)
2
no 1
H6 .
Do you have any difficulty understanding what
other people say or what they mean?
EXCLUDE DIFFICULTIES DUE TO POOR ENGLISH
(a)
m
M6:s;
INTERVIEWER CHECK
CHECK IF NECESSARY THAT ANSWER ON SIFT FORM
REFERS TO SUBJSCT .
IF M6 AND SIFT FORM 6(c) AGRSE CODE:
‘SUBJECT HAS DIFFICULTY MA....
,
lINGtd-M7
SUBJECT CC)ESNOT HAVS DIFFICULTY
2
;ECTION N
IF M6 AND SIFT FORM 6 (C) DISAGREE PROBE TO RECONCILE
DIFFERENcE AND CODE :
.. ... ....
3
IING h4%7
SUBJSCT DOES NDT SAVS DIFFICULTY
4
;SCTIC44N
SUBJECT
H7 .
2s
RASDIFPICULIY
Are your difflcult~es in understanding
peep le manly due to a hearing problem?
MI&;
:)
2q
1
(al Can you lip read other people?
Yes - mast people
1
*
+
No ..............
._
[
M
Ma.
How d~fflcult IS It for you to understand
people you know well. Is It:
SEW
CAP.D 2
RUNN 2NG
PROMPT
M%
not d~fficult at all .....
1
quite difficult ..........
2
very dlfflcult ...........
3
4W
or impossible? ...........
-(a)
3~
49
[
[a) HOW d~fficult is It for you to
understand strangers. Is lt:
n9 .
M?ifi
SBow CARD 2
not d~fflcult at all .....
RUNNING
PROMPT
quite d~ff~cult ..........
Ve~ dlfflcult ...........
or mpossible? ...........
00 other people use other means of helping
you understand them, (apart from speaking) ~
--
M4’:
(a)
CODE ALL
TRAT APPLY
wti
120
=b
:;
33
What means do they use.
Mouchmg speech
Slqnmg .......
~qAMi
A4VLTtCRMb
32
MqM’11
Finger spel11n9
Other gestures
M94M3
3%-3q
;Tl#
MqAtl L
,/
30
!
721
I
UGC40
MO.
#t
cauTINueb
Nlmt c~laint (s) eakos it cliff
icult for
you to understand othr p.ople?
RING CQNPLAINT NOS
FRDN Q5
NubTIGMb
M@
h!nx=7
I@lm
MLfA3
H@ti4
!
#tL#M6
M$#M6
MiffM7
D]
I
.
I
..
I
“,’
I
‘
121
31
31-
.
.
. .
.
-
—r.
CsM3~:
FROM SI~
Steuo
71
FORM
6(d)
6(e)
6(f)
6(,)
I
6(,)
N1.
DCl
2
❑
❑
❑
1
•1 2
1 •1 2
1 •1 2
LILI
‘Lln
In the last twelva mnths have you seen a psychiatrist
or other specialist because of a mental, nenwms or
-tnmal
problem?
(a)
IF N1 AND SIFT FORN 7 AGREE CODE:
Ntp .....
PROBLEM ...
1
SUBJECT D313SNOT HAVE PROBLEN
2
SOBJECTHX
IF N1 AND SIFT FORM 7 DISAGREE PROBE TO RECONCILE
DIFFERENCE AND CODE :
Wli!
EuB-BASP
SUBJECT ~ES
N2.
D
........-
3
NOT E%VE PROBLSM
4
ROBLEN
Do you frequently get confused about what day
or tuoe It is, or where you are or who people are? mn
P
No
[a)
INTERVIEWER CESCK
CHECK IF N~ESSARY lTIATANSNER ON SIFT FORN
REFERS To SUBJECI’
IF N2 ANO SIFT FORM 6(d) AGRZB CODE:
SUB-SAS
I-J-J
2
I
N2R
PROBLEM .........
SUBJECT EK3ESNOT sAVE PROB&
~,,.
6 (b) DISAGREE PROBE TO ~ILE
IF N2 AND SIFT *
DIFFERENCE AND CODE :
~
1
2
{
SUBJECT HAS PROBLSN .........
3
SUBJSCT IX3ESNOT NAVE PROBLEN
[
4
32
I
N3 .
Do you suffer from severe depresslOn or anxlety~
N3
(a)
INTERVIEWER CHECK
cHECK IF NECESSARY
REFERS ‘KUSUBJECT
IF N3 AND SI~
~T AN= ONSIFT
::s
FORM
FORN 6(e) AGsSE CODE.
SUBJECT HAS PROBLEM
@fi
..
SUBJECT D3ES NOT HAVS PROt3LE:4
IF
—. N3 mD SIFT FORM 6 (e) DISAGREE PROBE ‘M RECONCILE
DIFFERENCE AND CODE
SUBJSCT RRS PROBLEN .........
SU6JWT
.
3
““
WJES NW
HAVE PROSLEM
Does your depression or anxiety affect
your dally act~v1t1es2
N4
,N5
‘e:
No
“5.
Do you hav,?clfflculty gettng
on w~th people>
1
(a)
N6 15
2
(a) Does th~s difficulty severely affect your
famly life, work or lelsure>
N6 .
a
INTERVIEWER CHECK
CHECK IF NECESSARY ~T
R5FERS TO SVBJECT
AWWER
ON SI~
@
FOF.M
I
IF N5/N5(a) ANC SIFT FORM 6(f) AG.SEEDCODE.
I
li.WDIFFICULTY .........
1
RING N*N7
SUSJSCT COES NOT SAWS DIFF ICW.TY
~
N~
~CT
IF N5/N5 (a) AND SIFT Fow 6 (f) D15AGF.5EpROBE m
RECONCILE DIFFERENCE WD CODE.
SUBJECT
S.%S
DIFFICULTY
SU5.7KT COES NW
N6
17
~1
3
.... .
RING N *N7
J
hAVS DIFFICULTY
[
1
N7
I
123
33
%fJIID
Q’3 cfwdTlw6D
?47. Do you I?ve a mental handicap or other
severe learning difficulties?
N7
(a)
I~nvI
SUER CHECK
CHSCK IF NECESSARY THAT AM~
REFERS TO SUBJSCT
:
1
it?
2
ON SIFT FORM
IF N7 AND SIFT FORN 6(g) AGREE CODE:
SUSJSCT
RAs DIFFICULTY
WEE
SUSJECT
N~
~W
.N7A..,
DIFFICULTY
1’
RING N +-N
2
NB
IF N7 AND SIFT FOW 6 (g) DISAGREE PROBE TU RSCONC ILS
DIFFERENCE mD CODE:
EASDIF??I~W
19
.........
SLIBJEcT D3ES NOT RAVE DIFFICULTY
N8 .
1
Ye
1
Nc
2
Do these problems affect your daily activities?
IW4
N9 .
INTERVIEWER CESCK
IF NECESSARY ~T
REFERS TU SUBWT
CHSCK
IF N8/N8(a) MD
AM~
N8
Nc
Ye
p10
w
4
ING N+N
:
Do you have a mental illness or suffer from
phobias, panics or other nems
disorders?
(a)
3
1
(a’z+
2
N9
2i
ON SIFT FORN
SIFT FORM 6(h) AGRSS CODE:
SUB~BAS
tiq ... ...
. ..
1
RING N+N1
NOT SAVS PROBLEM
2
N1O
PROBLEN
SUBJF.CT~ES
IF N8/N8 (a) AND SIFT FOPJ4 6 (h) DISAGREE PROBE TO
RECONCILE DIFFERENCE ~D CODE,
SD&7ECT BAE PROBLSM
SUBJ~
22
. ..... .. .
COES W’T BAVE
PROBLEM
3
RING N +Nl
4
;
N1O
N1O . IN7’ERVIENER CHXK
CODE N RAS BE~
CODE N W
Nd
.(NE PROBLEM/DIFP&LTY
RINGED FOR AT La
NOT BESN RINGED
-.-....”.-’.--..--&”...””fi.’&
)1
1
N11
2
N30
23
34
124
3<
7<
R-m
PY
. %.
.
-.
C9wlrwo
Nll. Do you find relationshipswith wrbars
---
, .
I
of
yOUr f-ily V@V difficult?
till
‘ie~
24
No
N12. Do you find relationships with people outsido
your family very difficult?
Yes
Nlz
N13. DO you often feel aggregsin
towards other people?
or hostile
f/13
‘.
(a)
25
No
Yet
No
DO ycu often have outburts of temp-rr
at other people, with l~ttle cause?
Iwu
YeI
No
N14 . Do yca ever get so upset that You ...
INDIVIDUAL
PROMPT
# ~+1
Break Or rip “p thing.? .....
2s
~l@
Injure yourself? ............
Zq
~4+3
Hit
ad
other people? ...........
N15. DO You feel that you need someone
with you all the time?
N
15
Ye
31
No
N16 . DO Ya fw
it
to & things?
diffi~lt
to ~t~
Y-self
N16
6
+ A
(a)
Ye
NO
:,32
DO.yd scnrtrtl.mes
~it fOX hours
doing nothing?
Ye
Null
35
Nc
33
v
!
m
~ ;---
~q
“-
““”-w-a’
‘
N17. 00 YCN 0ft9n forgot uiut you are supposed to
ba doing when YIRI are h the ❑iddle of
so~thing?
N18. DD you often loss track of what’s being said
in the ❑iddle of a conversation?
N19 . Do you often forget the names of people h
your family or friends that you see regularly?
3L
N20. Do you often get confused aknat *at
tti of day It is?
37
N21. Do you ever wander off without realisng?
Q
1
tm
2
3s
N22 . DO YCXI ever forget to turn things off such
as fires, cookers or taps?
1
2
G
(a)
Do ycm forget to turn things off ...
WA...
often .......
or only occasionally?
N23 . CAIYyou think clearly, or do ycur thaghts
tend to be mnxidled or slow?
N23
Thinks clearly ......
Muddled or slow .....
36
126
3J
_.
@udB *
GYwlwo
N24. can YOU watch a TV progrhour all the WaY tirOugh?
lasting abut
half an
N*
‘;;
I
i
(a) Could you tell someone else what
the programme was about?
N25. If a neighbour came to the dmr with
message for someone else could you
remeuber the message and pass it on
correctly?
)1
‘::
W@
%3
a
w
[
N26. Do yoq have any difficulty reading?
.
can*t read
w
●t
> - N27
all.. .
yes - has difficulty”
- (a) +5
No difficulty ......
-
(a) could you read a short article
m a newspaper?
fwt
Yea
+b
w
N27. Do you have difficulty writing?
*-
Can,t wr=te at all..
@q
NO difficulty ....-.
Could you write a short letter
someone witiout help?
to
NqA
4)
N28
1- (.) +7
- N28
yes - has difficulty
(a)
N27
‘:
i
%-8
N28. DO you have difficulty with sums and CalCulatf.Ons?
Ye:
~~
‘a) +7
- N29
N,
-.
(a) Can you count well enough to handle money?
Ye:
$
$/ti
N,
N29. What compla~nt (s) causes your dif fialties
w~th [REFER TO PROBL.E.N6
MFT4TIONED IN
RING COMPLAINT Nos
SECTION N]
L
A
2
5+
1
2
3
FROM Q5
4
HqM$
tiLqMz
5
6
NZW3
fJ2q#pl-
/dzqflts
37
51-57
7
D
9
dilq Mb
rwn7
127
3$/
Having health problems or being disabled sometims gets people
down . I bmuld like YOU to complete a short questionnaire about
how you are feeltig now or in the last few days.
1‘d lfie you to read ●ach sentence and decide which of the
headings appl iea to ycu and then ring the number underneath.
For example, if the sentence definitely applies to you rtig
number 1. If it only scmetimes applies to you ring number 2
and so on.
Please try and answar all the guestions.
have any difficulty. —
.
~ ~
-‘
L-t M kIUIU$f yOU
.,_
..
-.
Sis? #C\ .’3.3.
FOLO BCBEDULE WITS WEKT PAGE UPPESMO.5TAW-DSAWE mINFOS14AWr.
IW COSRB2TLY.
CSECK DISCSEETL Y TSAT IT IS BEIWG FIILED
.,
A
IWFO~
AWBWF.RED.
BAB FINISiSD =K
WBSN
TBAT ALL ITEMS SAVE BEEW
WSEN THS SELF-COMPLEl’1~ IS COMPLETE GO TO SF.CTI~ P.
...
..
.
,
,<. >
38
— 128
3q
—
SELF-CONPLETICW QUESTKXNAIRS
N30.
1.
F
2.
(,<
i.....”
.
YES ,
DEFINITSLY
+-.. ‘
I wake early thsn sleep badly for
the reet of the night ........
N*%..
G.
I get very frightened or panic
feelings for no reaaon at all ..N3#%...
YES ,
SONETINES
........
..*.. ”3 -....--.4
........3
. .. . . ..t’/3#... <l . . .. . . ...2 ..~..
3.....-.-4>
I feel miaersble and- -d
4.
I hsve loit interest in things .“”w...
5.
I get palpitations or a ssnsation of
~ buttsrfliee in my s~ch
ox chest *.Q
.........2
NO,
NOT AT ALL
..MT3
3.
~l
2
No,
NCJTNUCB
<’
.........2
m..
......... 2 ...
3 ....”...9
.. -3 .......~
6.
I avoid other people these days ..~6.
7.
I still
8.
I feel scared or frightened .....N*..
C
......... 2 .,A..
9.
I feel life is not -rth
fi
......... z ...NQ-- 3 --....-.9%6
enjoy
teethings
Iusedto
<1
@$7..
~...
l~ving .ti~~..
10. I feel odd and different frcm
other psople ...................
..
9?
11. I am restless and can’t keep still
12. I smmore
*
......
..UA..
2 ..~..
3 . . . . . . ..3%3
s
. . . . ----
4>L9
3........315
1 ......... 2 ...m..
3 .......
1 ......... 2 ..A..
3 ........>4
~
irritable than usual ..~~
~.~
T’
13. I feel self-conscious and embarra
.........2
g.~..
.........2
.....
...IW3..3 .......~~q
2 ..A..
3 ........92@
14. I feel less attractive
than I ussd
to .... .... .. .... ... .......... .. ..qhw
. .......-2
15. I feel that psople “sxe avoiding M
these days ......................Nyf6<
-.@-..
3--..-..-321
.......... 2 ..ti.:. 3 ........~m
39
%8
.
1
Do you suffar from severe bouts of breathlessness,
wheeztig or c~gh~g?
Yes
NO
?1
1
z
::)
9
u
(a) Does this limit your &ily
activities?
Yes
m~+
..
P2!
-.~-.--
-.
5, .,*..
2NTERVISWER CHD2’K
CSECK IF =SSSARY
THAT ANRSFSRS m SUBJ—5ZT
ON SIFT FORM
1
9
J
“.
.. ‘P3
,
es
SU5JSCT 00SS NOT SAVE P~BLEt4
P3 . Does breathlessness, wiIeeZiI19or cmghfig severelY,
affect your ability to lead a normal life?
P4 .
q
‘
what complaint (s) causes
wheezing or cOugh~g?
.-
.j
40
130
A-
-
4/
i
“-,
.
.-..
.,.,
&.
2’
0
,
Z%:
.
.
.
,.
.
.
.
.
.
,,
,
.&l
..
;.
.— ---
-
-“’
,,
fl,
r
“&};i;m
“
PAIN AND IPR2TATICN
‘s=
Ph.
Do ya
M
MS
WfkJI , .,,
‘1=“w ‘lm‘w 5(’)1.211Jl
suffer from severs pein or irritation?
Pain ...........
?l~
Irritation .....
Neither . ......
(a) DCOS the Pain/irritation limit your
dsily activities?
. Ye8
,,
.—
....- * ..%
P12.
.
,-
INTPRVISWER CBECK
CEECK IF NECESSARY TEAT ANSWSR ON SIFT FOPJ4
REFERS 1-Osos.3m
IP P1l/Pll(a) AND S2FT msm 5(C) AGRJIE CODE:
“’fti
‘
.....--,,,:
.
..
-- . .“,&-tir
SUSJ’ECTRAS~~:...
. ,.
,..
,,-!
..-r: ~.! - f< P?**
sUEJSrT DOES k- BAvs PRoBLm
2P P1l/Pll (a) AND SIPT PORN 5(c) DISAGRES PROBE ‘IO
P.EC(NCILEDIPP’~E
AiJD“C-*Ez
----- . .
s~
EE&Li24’=.m
-!
p
‘b
P13+& .?
, .,j -*
. $.
P19
2
,’, - .%>klb *g
.,
P13
SUBJD2T DOE-SNOT RAVE PROBL~
.
I
,,
l!!
4
P 19
i
i
1
P13. 00 you ever take pairJcillers/medicties
for the irritatlon~~
M
I
(a) Do you take them .....
every &y
!%%
?l*
........-.
.=7.’.
several ttis
a wesk ..’
or less often than tit
,,:.
#
,,..-- .
d
‘i.
P14. Do YCU suffer from pain/irritation all
the time or are there tlmss when yuu
,,,,;;,tLy&
are free of it?
... ~~i~s~.
sometimes free of it
‘D’
‘ii+
Plsg
2
(a)
39
-.
,.
I
42
132
43
/1~
q -;
—.
.iz
-,
Pis. whan th Pddhi-tion
YOU dasc?tia it
wld
i,
●s
●▼
its
,
wrstr
✟✠
✎✎✎✎✎
❑ild .............
disccafOtiiIl~
RUNNING
PR@lP’T
. ..!
39
diatr0SSiI19 .....
terrible ........
or axcnlCiatiIlg?
P16 . BOW Oftti is i~~;#f
.
--..; 7 ~ t , .,-,:-+,-”w-t~w’~’-
as tit?
All th~ t~
-’ --’-”At ~aa,t -e
y’k
...........
. &y ....
P18. what complaint(e) causes your pain/ irrimtiOn?
RING C@lPLAI17T NOS.
FRon Q5
..
t2-
f :8A1
klLT
ICON>
w+%
:7
?39 M~
fwM3
Fc
E
.:
,-.<
43
, 133
*..
.
w
Yea
TRANSFES TICK PRCM SIFT FOP.M5 (d)
NO
❑l
P19. Do ycaJhave a scar, blemish or deformity
which limits your daily activities?
?l’I
(a) ~SRVISUES
‘es
m
M
CSSCK
CH=
IF NSCILSSASYTNAT ANSNER ON SIFT FORM
REFsRs’msuBJscT
~
.,
i’1’9
‘AND SIET FT3PN5(d) AGREE CODE:
SUB.TD2TRlL5 PSOBLEN .fl~~
P20
SUB.JD2T DOES NUT RAVE PROSLEM
2F P19 AND SIFT FORM S(d) DISAGREE P-E
RICONCILE DIFPERENCE AND CCIDE:
P22
5d
~
P20
,
P22 -
‘?$L
+-u-’~ tQ#&+.
P29.~&*
,fia‘,&/bl~’h/&frjdty
eeverely
affect far ability tn lead a normal life?
,’, .,,.,;.
.,..
@#
Yes
No
P21. Nhat (ccmplant)
deformity?
caused ymr
scar/blemish/
RING CONPLAIhT N“S .
FRO14Q5
FmM1.
p*2
I’2$M3
Pzlwk
tZlM5
F’ZIM6
,.,.. **J,
‘]
.
b--
,’(’
,,
..- .-
. ., -.
44
134
._
L&s
ANDCC9ENNETREROR NUf ‘ml! SANY OISAC31SSMQ4T
NM
SACSPR09=,
~
R=~v=
,s
ANm
2NrSPSfIsN:
ANSNSR CN
SIFT FORNI
Y*S
8.
Yea
No
(m) In the last twelve mnths hava ycu attended
a day cantre, taken sheltered work or 1 ived
in tieltered housing because of a heelth
Da
problem
,,
w-~yry
attended
~yo-r
“
‘.--’n&D’-
2
or disability?
p~
, ,,
.~(~
;
,,., .
a special school”’~~use
Of a long
“ term health problem or disability?
...:*
*5
“.- ,
N
-—
.,
Are ycu lbited in the typ or amunt of
paid work ycu c8n & because of a health
pr~lem or disability?
.
=..
>..
..... . ,
--D Ll(e)
)
No
l.,.+!
.I
.
I
-,+.,.
I
‘4T,
.-.-
.
.Zy{,
(“
-
63
1MA2
-J
“.’ L1 ❑ (f)
“-3
“
-
Do Y- have IanY ‘other difficult~es with &Il$ *
activities becauee. of a &nability or lon9 ... y +-7 term health prdl~~ tha$ ~ycm haven’t
:.-1
, ,*;A
~e;
‘2
mentioned yet?
,.-
,..
-
P22F’
4P3A—
“E
L.
P23 .
-----
~
W
Recaab
li-
..
... .
s?-
.
“L
45
135
46
r
— .—
m
w-$
1
.
R3
%
..<>-.
.MNG
2
3
(a) CXD2K AMtisM
i.e.
L*.
&
12
2-20,
-30
al, 31 -S@
Ctx.a ql)
AT RI (b) MD
CODE:
“.-A;
SOMi7 SELP PROVIDED BY AN INPOBMAL =PSR
- (A relative, friend or neighbour) ...........
ALL NELP PROVIDSO BY VDLUtJIXRY OR FORMAL
SERJICSS ...................................NO~PP~VID~O.W..
R-_R3
RING R+(a)
o
1
2
3
~f.at. ~t~ ................
we t.Jfij
57
60,02-50
~q
HOUSEHOLD ACTIVITIES
ISHC44CARD
IF YES (COde 1)
2,
.-l
4
(D) who helps YOUT
a
u
IF NO-ONE ~TER
00 IN BOX
Q:w
R3 .
How difficult 1S it fOK
you to:
:~~
g::~
. --
anyone to
help you
Yes
NO
wake a CUD of
prepare a snack?
prepare a hot
meal?
w
1%
wash up and dry
dishes?
wash up and dry
Usea
use a vacuum
cleaner to clean
the floor?
*
do the household
Shopping?
vacuum cleaner
to clean the floor?
~
~ 1~. Do the household
shoppng on your own?
13.
R%l@
u-
w
1A
AS.:’
“r -
+
:A:&
‘R4.-”C_ANSWERS
AT R3(a) m
*k;,*. . $.
“
CODE SUWNARY :
.
.. ,~
J..
is :.4*
~.~
;,&
&
Z-20/
e33
al, 3~-’3o
( w
?*)
(b)
.-
-
‘
“
,;:+..--+
‘
NO SELP NESOED (No code 1 at R3 (a))“’:.-.
. ~ #.F
- .“S7.ZJ -“’ ..<
‘
~
SOME SELP PROVIDED BY AN INFOW4AL FIS&P611
,
(A relatlve, friend or neighbC#I>)’~~w
...
T+
ALL HSLP PRG41~ED BY VOLWARY
OR FOiW
3
.. . ........
SERVICES
NO HELP PROVIDSDOo&
.W .•k.~~. .... f...
4
137 U$2
-.
r
IF HELP WSSIMl)WITB SELP~
R5.
(Code 3 at R2)
tR4A.NO help needed
RsDti
(Code 1-2 at R2)
.. .. .
YOU’ve told me that there are some personal things that
ycu need halp with. I’d lLke to ask you first ha much
help ycu need during the night. Can YOU tell me which
of these descriptions fits you best?
U5
I need no help at night, or very little
help ..............................”.-.’
CCOE
FIRST
~T
APPLIES
..
-. :.:..
,,I ~caslonally need help during tie
+ m4gh4
-~+ ..4.
j
for more than just r.few minutes .......
I
help most nights at least once fo!
than justa few minutes ...........
need
mre
.*.
. , .+J& 4-...
...
. .
.,
R6 .
I need no help during the day, or very
little help ............................
CDLE
FIRST
XiAT
APPLIES
!J
‘1
I need help from scrneoneelse Once Or
twice a &y, bt they don’t need to be
there all the time .....................
During mst of the &y I need help with
things like getting to the toilet,
getting in and out of bed, but 1‘m
alright on my ovn for an hour or so ....
1 need a lot of hel~ ‘&r attention fr-~someone else throughout the day ..,.,.,.
...
R7 .
IF CODW
2-4 AT R5 ~
R7
R6
ii
of the past six writhe?
-R9
{’.
.. .. ‘-.
.’
48
138
(mM
*
l~tk
R8 .
K~
%2
>=w*
W>
Although you don’t need (much) help with personal
things Like washing, dresslnq or going to the toilet,
do you need someone to be with you most of the time
to avoid dangers either to YCU or to other people for example falling or Leaving gas taps on~
U8
(a]-(b)
12
R9
Yes
No
(a) Do you need someone to be dlth you
. ..
.
Rw?....
----
‘-- ‘-”-”just
during the day .
RUNNING
just <urlng the .Lght ...... ... .
PiOM”~
or ciuruwgboth the day and nlght~
i3
2
+3
—
—
.,
-..
*‘i
- --~’----’:’
“’~}”;
$;:”-”
“--r
-
.&i,
.,*$,
J
..,:’
-.,
-‘-
“1
.
-.,.
139
49
—
50
—-””
-IL==&/
. .
-s--:+.
IF ANY EUP
.
. ..
=s
,. ●C
WITH S~LF~
F@.
. . . .
!,
,,
IS PRCWIt4tDBY AN INFOP.ML HELPER (~
1 ~t
(a )
Uqlhln
.0
: ’14
DNA. No informal help . . .
INTERVENER
CHE?2KOR ASK IF ND2ESSARY
ml
HOW manY d~fferent ~NFORWiL HELPERS] relat~ves/
friends/neighurs
altogether have you ❑ ent~oned
who help You with personal daily act~v~cles>
NO
b
~, ,l,mw~~pE=
~ -q
r.
FOR SACH INFORHAL HELPSR RING NU,MEERAT TOP OF COLUP44
AND COMPLETE R1O-R12 FOR EACH
“m<w%-3
. -“’
~
~~
41
,
*.q
ti*>*t’
ikm
I@two
R1O . IF SELPER LIVES IN HOUSEi+OLD~E37
FRW EI’IKXDEOx (a)-(g) are DNA
‘&Y
~ ,.:
PERSCS4NO.
,
‘.&
.4
pmR
xmTs
OL&IDE
%‘ E=
W-#
.
~TIO+LSFfI
&E
:TO SUBJSZ2TAND fXX4PLETE (a)-(g)
-E
,-
>%
OR ASK:
(a) SEX OF EELPER: “; ‘
-
(b) AGE OF SELPSX ,
ESTIMATE IF DK EXACTLY
Rq@
(c) MARITIAL STATUS OF HELPER:
YEAF
Uarrle
Single
W~dowe<
*
$?#
Dlv/Se)
!
1,
(d) ~=ING
I
STATUS OF SELPSR :
Full-tune
Part- tme
..
,
..
‘~
FTEd
....
Not workln<
(e) Does
RUNNING
PROMPT
~P~
~
live
*1, b;;~~”,
wlth~
~e$t
dmr
-
a few umnutes walk or drlv~
or further away?.... .. .. ..... .....
.
(f]
How often does [@LPm]
ccme ti’help or $ +’
look after yGU?
More than once RYC
a a ......
once
,.
. .a*
:-----a !-’ --:,.*%*>
-.
.-.
.
Every other ‘&,yT,r.
..........
2-3 tmes.awe.sk ..........
Once a week ...............
Less often than once a wed
(g) How many hours a week does ~ELPE~
spend
helping or looking after you or being there
in case you need help?
~q
HOURS
LESS TMAN 1 tlOUR = 00’
I
140
51
.7
.
PUNCS
NUNS!-
o
q-id
01
o
o
02
li-iz
03” L3”1*
04
o
- . .. .
~
is-lb
,L.
. ..
.-
,7
.,
,
@-is
,
. ..
- -.
m IU3
H’
~Z%?
..
convulsions
~KL
L
10 21-X
o
,
>.
‘1
I
I
I\
.
141S2
9
T“
Rti
Stii.1? SELPER IS IN E’K)LD
R4A:Helper not ~n h’hold+R12
7
Abut ha =ch of the &j- dOeS ~P~]
spend helping you or looking after you
or being there h came you need help?
A1l day end at night ......
All &y
v
A few hours a daY .........
.. .
Less than a few hcur~ a day
,
-.
~
time ..............
4;_
.
R13. IF MORE T13ANm
5PER
m:
R-A
1
One helper only ...
Of the people you have mentioned,
which one s!xnds the most ttie
helping or lmki.ng after ycu?
R.INGCODE 1 IN CtiRCOLONNtiY
*D
(lGlo#5
1
...
o
i3
- -,
ANY OF CODSS A-R RINGW , B~
—
/–
of
&13
i
1
R:
o
SUBJECT DSAD/IN INSTI’lWTI~
AsBREvIaTEDmERvIEw
‘
I(N
...........
1
X*ANY OF CODES A-R RINGED, SOBJD2T L3VSS AT ADDRZ.SS
ELIGIBLE FOR FULL INTERVIEW .....
2
NONE OF CODES A-R RINGED -S~RTIFWERVIENoNLY
3
1
I
,
bq$%u
*
w
*
..... ..........
%
l~t-
-—
‘f
CLOSE ~VIl
s
Go Toclwm
SCKEDULE
Asm.mmm
~gmm
8+A&N
u
&k
51
I
?wW
53
ttiLf.
-6
lAnr’udi6u
.
- .,
M:.
-. . . ..
J.U.-=- -,
-
rt-=7-
.“
>,...*,,.
c, .,i’x~
d.,,...-.. .-.--t-..
.. ... ... .. .
,
.
RSV2SED
SURVEY OF DISABLSD MXJLTS
s1192
Wlfzls
22s
(GREEN SCHEDULE)
%.2577
mmWEWEN’S
Nms,
q
,,
!
<
[“
.s, ”
F“uml
f.. ‘,,
i
CSECX HOUSEHOLD BOX:
(a)
.
EOES SUBJECT H?+vsA SPOUSE IN THS HOUSEHOLD
Yes ....
[
sfwAsK
No .....
tio N&
j
A
(b)
IS THERS ANYONE ELSE IN A OIFFEPSNT BENEFIT
UNIT FROM SUBJECT (AND SPOUSE) LIVING IN THE
H’HOLD7
Q
1
No .....
i
4
P 4U6W
Yes ....
b
ro&-.
2
3
0
, *<&*1“
/
/
*
.,
.,-
‘\
- (i)
‘
Iy
“
1
P-1
~i
‘J
2
Yes. ..X ---
(1) Is SUBJECT OR SPOUSE HOH?
17
s.
SEALTS AND SOCIAL SSFWICSS
S1 .
Row often
have you seen your fsmily doctor or GP
in the psst year in rr.meet.ion
with your health
probl~disability?
M/#@
=97
NUMSSR OF TIFtSS
INCLUDP,SESING A PAR’ltiER
OR 1.0CU14
sj.
EXCLUDE VISITS WHSN txXXOR tKfi?SSEN
~
JUST !M CO~
(f)
Never,
(a)
8-1
S2
PRESCRIPTION
00 you generally visit the surgery or does the
&c&r
_
and see you at home?
Slfl
Visits surgery ......
~ctor
Daring the psst twelve months, have you
been in hospital as an in-patient for
. . treat=fmt or tests u connection with
your Ip+a2thproblem/dlasbility?
,!
visits home. .
S2 .
.
S2
@
(a)
Yes ....
.(:)-
No .....
S.3.11
sw many separats
n
stsya
have you hsd
bosp~tal In the past ~elve manths?
.
S2Q
NUMSER OF STAYS
~K]#fi=?9
.
(c)
.
12-13
IL-IS
/6-17
-.
(b;) dtdd
=
- (c)
WIsn you were IIIhospital, which of the
PeOPle lzsted on this card &d you see?
- --- - - —
--
SRCW CARO S2/S4
Cmsultsmt
.! J__
or other doctor ............
.f’luqtxmco
Radlologlst ..........................
U4% = 10
Phyaiotherapl$t.......................
occupat~onal Therap2st
52c
/’
(OT)...........
Spsech Therapzat ......................
COOE
A1.L
THAT
Eesring Therapist or Technlclan. ......
~ticnno roculist . ........... .......
APPLY
Chiropodist ...........................
Dletlclan .............................
Ml
s2c#q7
s2cti3
s Xr’lq.
Psychologist ..........................
Psychotherapist .......................
osteopath or Chuopractor.
............
Hcmeopath, Acupuncture St, Ref lexologlsl
s 2CIY5
Artlflclal lmk#appliance
s xc m
s 2cn7
s 2C vs-
fitter. .....
Health V1s~tor ........................
Hospital Social Worker. ................
Nurse .................................
S 2-C I’M
Other (SPECIFY).......................
3
_.-—
_.—
.,
19-37
.
II
S3 .
(Awrt from seeing your own &ctor/whan you stayed
in hospital) have you been tm ● hospital or clinic
or anywhere ●lse in the psst yesr for treatmsnt or
dw5aIPs for your health prohl~disbility?
Yes ....
S3
Al+. . . . . .
2
INUODE VISITS TO EC6PITALS , DAY N9SPITAZ.S,
CLINICS , PRJXATE~Ns~TI~
~
.
EW!2JJDE A’3TEM3AMCE AT DAYCZWI’REOR SHEL’I’SREO
uXXSHOP
(a)
0
1
.
(a)
,~8 38
.
ibw -y
different places hsve you hsen for S3 e
treatment or cherkugu in the past year?
tie
Uns
:-
~, M-
40
A
FUR SACH PLACE ATTSNDED RING WI
S4 .
S74RT
acc04D
27
R 77@/p?Jo
Now
my
~
times have
you
)-(d)
No.
3
heed
to this (BOSPITAL/CLINIC)
in
the pact year?
S4 d
~ER
t-lo
OP T=
I
When you go there are you
nomlly
there ......
for an hour or two ....
ROIDJiNG
Pm-
II
for half a day. $.~.. .
or the whole day?. ....
1
1
2
2
3
3
(c) tich of these people do yOl
u5ua21y see at ttms
-‘(t2c5PITAUcLxN1C)
7
SSON CARD S2/S4
consultant or other doctor. .....
01
01
01
01
Rerllolcqis
02
02
02
02
. ........... ....
03
03
03
03
0ccupsti0na2 Therapist (OT)....
04
04
04
Speech fierapiat ...............
05
05
05
05
Naariag ‘Ihcraplstor Technician..
06
06
06
06
Opticisn orocutist
...........
07
07
07
07
Chiropodist ....................
08
08
08
08
Dietitian ......................
09
09
09
09
Psycholuqlst ...................
10
10
10
10
Psychotherapist ................
11
11
11
11
Osteopsth or C2nropractor ......
12
12
12
12
Fkmeupath. Acupuncturist,
Reflexologlst ................-,
WI
13
13
13
13
14
14
14
14
Eealth V1sitir ................
15
15
15
15
Hospital Social Worker ........
16
16
16
16
Nurse .........................
17
17
11
17
18
18
1s
t..............----
Physmtherap=t
Artiflmal
\
f G%
12-3[
-----
-
2.urb/appllancefztter.
Other (SPSCIPY)
. ..............
(2%0L>
IT
&
.04/--
..
14;
/-
CONT.VJUL Rfcall)
S5.
lb W-l QI
DO your visi~ to the (HOEPITAL/CLINIC) nOHDallY
cost you anything in traveling expenses?
S5
Yes ........
tIIA/
NO ........
(a) How much have theSe journeys cost you
in the last year?
S6 .
2
;’ 41
EP
, 55A
EN’ITX ANOUNT
(
INCLUDE COSTS OF 5HJPER IF
SAS
TO BE AcCCMFANIED
—
o
1
s
DK/NQ
SSAVK
I
DO you have to pay anything towards the
cost of your treatment apart frcm any
charges for prescriptions?
Yes .......
S6
00r
iit..m
I
tifi/No ........
0
1
a)
2
,750
1
(a) EICWmuch have YOU paid ~warde the
cost of your treatment in the last
year?
FNrERANcmm
S6 fi
I
(
es
S6AD K
DK(UQ
I
Ii)_
m.
You have any other expenses such as
paying for fcod and drinks when
you go to tie (HOSPITAL/CLI~C) ?
S7
Yes .......
AM] No . . . . . . .
o
1
-(a)&(b)
2
-s8 59
(a) How much has it cost You in the last
year?
s71q
ENTER AMODtW
)
60-66
67
(b) What does this amount cover. ......
Food and drink ......
PlUL1,D<D
Mnx =3
Other (SPECIFY)......
6%-70
S76M1
S76PIZ
S76M3
*
6VD
S~q WCE
03_
COLS
146
7 ? .Sozol
5
— ——. .——
——. .—_.—
...———
.——
—.
—._.—
--
S8
Here is a list of some of the people who come to the home
to treat people with health problems or disabilities.
Have any of these people visited you in the past year?
SEW
CARD S8
Ss
CARD S8
I
01
013tr1ctnurse
Ilurslng
auxiliary(egbath attendant)
02
Co~~unxty psychiatric nurse
03
05
Co~nun]ty nental handicap nurse
Health“Is]tor
06
Othercomm.nltynurse(hat doesshe do?) 04
Phys~otherap~st
07
Occupational
therapist
08
09
Chiropodist
IF YsS?OANY
AND CCHPLETE
RIWNOKBERAT
TOP CF COLUMN
(a)- (d) FOR FACE PERSON ~0 CVMSS
\—
%2
3
I
5
9’3,
(b]NAME
I
OF PSRSON
IF COOE 06 DESCRIBE WHAT
THE NURSE M)ES
(c)How often does the
..come >
S8C
Every day or nearly..
(:l-l;c;
-
2 or 3 times a week.
P~~od
Once a week
Vlsmw)
Less
. .
than once a week
o
1
1
1 127
2
2/12
3
1
“3253
4
4 /s
1
1
2
2
3
3
4
54
5,47:
\
T
,2
ti/
m
YEs
(i) Em ❑uch do You pay
per week?
No
lo~
l-(i)
2
1- (i)
235
1-(11
2
2
EP
EPEP
13-17
1- (i:
,,
EP
92
z
9
*
139
I
9
9
\
/
58
147
.- -. ,,
-i
S9 .
E@rc is a list of servicas which can halp people with health
problems and disabilities and their families
tbVe YOU had
~Y of the= services in the past year?
SEC$’ICARD S9
CARO
S9
Local
authority
Healson uhrels
Laundry aervkce
Incontlnmce
Might stttlng
servlct
aervlc.e
Mobility/technical
officer
Social uorker
Voluntary
uorker
Vlsltlng
Private
service
dme~tlc
Private
nurslno
Othsr
10
hone help
help
helo
Sq
Yes
~
11
12
13
16
for the bllnd 15
16
17
18
19
20
INo
pl-
1
(a)-(a)
2
s10
T,
?
21
L%ScRi8E)
(pLfAs[
I
IPYESTO
AND
~-#
ANY RING NVMBS.RAT 10P OF COLUNLN
CU4PLZTE
(d - (d FOR SACE SERVICE
6)
3
Q
32
ao-2f
q9
/,0
9-
I
(b) NANS/DESCRIPTION O?
SEAVICS
f
;
j
i
j
(-=.
d
ac-
“i
(c) Em often does the
come?
Sqc
. .
Every
day or nearl
3
2 or 3 times a wec
@o-
Once aweek
WVlca
1
1
II
~
2
3
3
. .. .
Less than once a
week
1/
, ....
\
(d)
.&k4
pay
-Wng
I&~
fortha.
4
-&
~e.
. .... ?
!
:2
1 (i
l-(i)
2
2
IF YSS
(i) Ecu much do YOU paY
per week?
EP
El
sq~i
IR
APKxJ2?I
1I
I
&iDD~
IF ~dA
~~~c
UGFDH
Ffi~ $#DE
/8 9
9
11
(e) H- many hours a week
do you have a home help
for?
Sqtz
HOIJFU
/9-21
IF VARIES GIVE AVSRAGE
1
5-q
148
7
/’
-.
Slo
Ssw
CARDs se Am
S9 AGAIN
Is there any sort of help frcm the people or services
listed on these cards which you are not gatting
at present, but which you think you need?
Yes
a)
!
10
S12
(a) Nhat sort of help or 8ervice do you need?
EsCLUDE F2NANC2AL,.SEIP, ID3= WITS BEM?FITS , ~
CODE NO.
FRmcARDssoRsf
.$‘6~ . ~1~
ARE COVERBD
AIDS , APP~
\ LAY3ZR
1
OS DESCRIBE SBIaP NSEDSD :
nl(Alxwo
S1.onuz
@
//-
2Z
sioh M2
sfohM3
SlohM4
s~on~
S11
Eave you asked
s!l~f46
for &ii= hmlp/service?
Yes
●) z
S12
Nho did You ask?
(a)
Doctor, nurse or othex hselth service
personnel
... ... .. .. .... .. ...
Social serviceslsocial worker .......
t’lw.-xrcaba
nR8 =4
Citizen’s Advice Bureau .............
DIiSS/Social Security ................
24-31
Disability advisory sen?ice/assoc. ...
Other professionals (priest, teacher,
solicitor etc. ) .............
Other (SPECIFY) .....................
S~M%
3A5AMZ
512
Eave you been offered any help or service
which you have turned dcmn?
(a) Nhat help/sexwice did you turn dmtn?
~
Com
CARD S8 OR
OR SPECIFY
~UL7~~d
IYnx
DKIN~
s13
=3
33-38
=Yq
Did you turn it darn bscause you dld
not want or need the help, or for
sane
other reason?
Du3n’t want/need help
Sc
Other reason (SPECIFY)
39-4/
Ssfq$
S$3M2
Sfi
m
60
149
8
. ..
(
1
WORD
COf’JqwaG
16 SGQLWJCC
OZ
s14. DO you regularly go anywhere for training or social
●ctiviths,
such - to the place ZAstad cm this card?
sscu CASm S14
ICARO S14
Day Centr*
kdult Tralnlng
SA4
I
ti~ jNo
1
Centre
Club for the dl$-bled
Other SOC1al club
2
EXCLUDE NORMAL
3
FULL TIKS EDUCATION
6
Adult aducatl.an
centre
Other(PLf AS[ DESCRIBE)
6
(a)
Acq
WDE
2
S15
42
coLouN
# NO
3
*
S3?2SS
(al-(e)
I
TO ANY RIY?GNUMSSRA T!20POF
AND COYQLE2S (a)-(e) FoR SACS PUCS
4ecoeh
m
1
5
WYES
SmUq
Yes
0
s
f4n=9
FR3.FFOl CARD S14
*
(b) Description
Cou
~- z = ao
~
)
~~
3-7:
~~.
(c) Is this.
... specially for people
with distiilitfes,or can other
people go there?
+G
/0
For the disabled ,. . .
For othera ..........
1
N@
2
o
1
1
2
2
(d) How oftan do you usually
go to the
.... ... ?
s~
Every day or nearly ..
(PLIXYCI.I
20r3timee
1 -D
P6 R ACTKK77 ~
aweek.
.
...
Once a week .
)
Lass than once a weak
)
(e) Em lon9 & yOu u~ally
~~
stay there?
lor2
hours .... ...
Ealf aday.
C?JD *WU
S15.
ao
.
. ..
kbst of the day .. .
frrm the club you have just mentioned) are
(Apart
you (or the person lwking after you) in touch with
cowlu~
&.~~~
any (other) organisation for people with health problems
or disabilities, or their families?
Sls
I&~Q
02
43
Yea
fiS+\No
1
(a)
2
S 16
ml
6
.
150
s
s16. curing the past year have You hen
away on holiday?
Yes
c
1
G2
‘(a)
2
(a) Apart frcm holidays, in the past ye=
have
YCm been to stAv suoawhere else for a break
or convalescence
(or
to give the P9rson looking
after you a break) ?
464
EXCLUDE ‘IREA~
Yes
IN HOSPITAL COVSRBD AT S2
(b) IF YES ‘M SIlliSR s16 OR s16(a)
tie INo
. ●e
DNA . NO ?0 KifS----X
(b)
. S18
.
Nhat sort of place (s) did you 9tay at?
Ordinary holiday acccrunodation
(hotel, villa, caravan, StB) ....
mm
With fad ly or friends ..........
AIL
Eospital ........................
‘IllATAPPLY
Nursing hana
U
14~UCJXXD
r-lwx
.. .. .... ....... . ... .
Convalescent home ................
=4-
SA6 Bl%l
wba M2
au
Eostel for disabled .............
Loca 1 Authority hcme ............
BP13
Eme
slam+
run by disabled organisation
Private fad ly ..................
Other (SPECIFY) ...... ..........
how many times have YOU
517. In the past year,
hen m- stay- wxnewhere else for four ~ghts
or
longer? -
$37
END S6Qu4.AJ~
oa
COL.S 79
-~
.
zni~AM : Wj
NUIQ!SROF TIICZS
02
FOR FACE STAY OF 4+ NI~S
RING NIMSSR
AT TOP OF COLDNN AND CCM.PLSTS (a) - (c)
None
?2
9-10
(b) Wm
paid for this holiday/
break?
Self /spouse .9A? ~
Mc
H 4X
:3
:~
42-U
-(a)-(c)
+7
4
I
1’
1
1
11-1~
3
2
2
3
3
Voluntary organisation
4
4
4
Other
5
5
5
Friends/rela~$~~
social serv1&$7@@
APPLY
(SPECIFY)
1
.
TSAT
,
\
/
-s19
%
Didn’ t cost anything
6
6
(c) How long did you etay there?
LN00FD”7C
10
62-
NR/
:=?9
151
s18. Is the reanon you have not hsd a holiday
because YOU did not w~t One Or for
acme othar reason?
(SPECIFY)
DidnntwSnt
mDE
ALL
lMAT APPLY
S$I?MA
Financial ream-
sllru2
liealth/disability ................
agm
e u Lmm
tvnx= b
tO gO ............ ..
3
................
%-//
(SPECIFY)
..................
mar
s@”t*
s19. Enw often do you hsve a visitor or have
wmaone call tn ses you?
Never
.. .. .... . .. .. . . .. ..... . ... .
Everyday
... .. . . . . . .. . ... .. .. . ..
s~e.ral timss a week ............
hcee~~
.....................
Every 2 Vsaks ...................
PRU4PT AS
Once a-ti
....................
NscEssARY
~cein3mxAtIe
................
Less often ......................
s20 .
would yOU like people to Visit
you (mre often 1 or n0t7
1
1
Ye:
s 20
2
lJfljNo
S21. DC YC41 think tb.atyour hsslth pr&laQ/
disability mekes it difficult for you
to tie frie.ds?
Saa
(a)
Why 1S thiS?
01
Mnbility prnbleMs/cm” t get out
~DE ALL
173AT APPLY
~catiom
difficultiaa
(speech, hesring) ..............
Sub ject’e personal ity/attitude. ...
02
03
.......,..
04
Can’ t da aams things as
...
previ.msly ................. .
w
05
other [SPSCIFY) ..................
06
Other psople’s attitudas
~ [
,
I
152
sUMS.
:~:
::
~WIM
2
s-
63
--------
.-—
--
S22. All local ●mhoritias
kaap ● ragiator of
handicapped
pecple so that they C.UY provide
samices
for the handicapped people in the
Are you on your laal
axaa.
regimter?
authority
OF DISASLSD
NE. ‘IHIS IS N3T THS REOI~
PsOPLE KSPT BY lTISMSC F~ SMPLOYME~
PURPCSEC
Yes
m
SZ2
23
25
:a)
DK
(a) Had you heard of the local authority
rsgister of handicapped people?
s 224
(b)
Yes
D)
no
23
26
Are you not registered because you
don’ t consider yourself to be handicapped
or for s-e other reason?
Not handicapped ...........
fiULzCt2wD
nay
s=OPl
.3
I
Oth-
reason (SPECIFY) ....
S.ZZ6MZ
M3
SU6
Nfi
S23. If you wanted to find out about services
available to help people with health problm
or disabilities, or for their fmilies how ~ld
YOU find Out?
IF SAYS W3WLD Asx EELPSR,
EELPER WJOLD FIND OUT
s23
S ~
M%
~ Z
s13/q3
sa3?f4
ASKBW
SZ3M
s22M6
Ductor, nuree or ocher health service personnel. ....
I.acalauthority social services/social
wrkex
. .... .
Advice Bureau .............................
CODE
citizens
ALL
lHAT
APPLY
Lmss, sc.cial security ..............................
Disability association/adviso~
ssrViCe. ...........
Other prof esaiOnals (priest,90Mci~r.
Relative, friends or ne19hbOUH
tsach=
etc -.
30-4/
. .. .. . ... . . . .. .... ..
POst off ice .......................................
Library ...........................................
Other
(~~~),
..................................
ALL
Czu
7+%0
:203
“153
,
-.
T1.
INTERVI=R
C~CK
- ASK
IF NECESSARY
CODE:
~
7f
(CODE1
Subject has a wheelchair ............
~IcH
Sub3ect does not have a wheelchal ~ M
IF HAS ONE
IF NOT USED)
1
T2
R
2
SEE T,
m
T2 .
1‘d 1to ask you a bit about Wheelchairs.
How many wheelchairs do You have, lncludlng
any YOU don’ t use at present?
NW45ER OF WINS
hfH&i@o
f3
4
1
1
2
2
/01
1
1
2
2
2
1
1-
2
2
3d
3
sport . ...........
4
4
Other
5}
5
3
(Ws)cti
1RCC_
...
a hand-prope1led ?
wwLcw!id
You control/propel tlus wheelchair
yourself or does sOm=one else contrOl
)
(b) ~
push It for YOU7
T213
Self -controlled/propelled
PRIORITY
TO cODE 1
Somsone else cOntrOls/
pushes It ....... ........
(c) What do You ma~nly use th~s
wheelcbalr for~
Indoor use only.
CODE ALL
Outdoors In garden
THAT APPLY
Outdoors m street
fzuwd
nam~
y2~
rlnx =5
k
3
EL&HAIR RING NU14RER
m
ASK (a)- (d)
~eLa 3--I . Seqwo
coLs~. z:23
u
(a) IS *S
Wheelchair,
powerd.?z.??
w
~
U8S
o
24
2
1
k
/Q
0
2
(sPECI~) ...
A1’i’#
Not used ..........
6 -(L
(d)
6 -(i
IF NOT USED
(1)
Why
don’ t you use ths
-f--2cI
wheelchan?
Don’t need to. .
161
1
1
Other (SPECIFY)
2
2
2
(d) Nho provided th~s wheelchalr~
Self/spouse. ..........
1
Friend/relatlve. .....
~ (e)
}
DOSS ..................
7=
Health/social
Voluntary
Other
(e)
154
*stm.
organlsatlon
(sPECIFY) ......
Tz-t&
.rgAnom05
How much dld tlms wheelchair cost?
(1) Huh. many
was
—.
services
#*n”.
years
bought?
It
*
7U.A..
*1
1
(e)
}
3
4
4
4
5
5
5
6
6
m-b/9”22
23-,24
1,
(e)
z
3
/7 3
ago
DK/N~=f#w
e..
<4
1
-—
I
.. . . .
E
T3 .
I? SAS ANY PR2VATtLY ~
(Code 1 or 2 at T2 (d))
WLELCRMR
T31wA
DNA :
?40
private wheelchair.......
o
1
;EE T4 f
—
uhy did you buy a wheelchair privately?
//-1+
3
DdUA
T4 .
I? DOES NUT SAVE A DSSS WRBEWBMR
ringed at T2 (d))
(Code 3 ~
—
rf#A
DNA :
Has
XX
ALL WHSE.1433AIRUSERS
T2C
Is
DSSS uheelcbair
(Code
T5 .
=7
.6
. . . . . . . .
About hw mny hours a day on average
do you spend in a wheelchair?
-.
..
3 at T2(d) )
*
dl
W~
DNA: \ Wheelchair nOt used. .......
.
T5
20
~5Dfffi
Wheelchair not used everyday. ....
T6.
Have you had any problems with your
wheelchair(s) in the past SIX months?
T&
Yes .......
No
{
Fro . . .
(a)
,,
23
(a) What problems have you had?
rlKL~c,ofxD
2.!4-2’i
,
p’l?vt=4
155 66
‘i
I
aw-lllwe
CGCV?.D
DNA. subject
Iv.
m
.WQUCMCIE
9.2
has nO walking
a
(cde 2 or 4 at Al (a)
(PIWX SCIiED~ PAGS 6)
diffialt~
3
you use any aids to walking or getting about (apart fraa
wheelchairs)
such as those listed on this card?
77
SHOW CARD T7
30
Yes
1
(a)
NO)
2
T8
D
IF YES RIWG wUWSER AT TOP OF COLUFD4 AWD
CC44PL5T’E (a)
- (e)
3
4
6
5
%7
Description
(c) who provided the.. ...?
(WC”
Self{partner ............
a K6GORD
RR
,
Friend/relative. 5J.~. ..
SzD)
Eealth/scdal
)
serviCes. -
1 1 1 1 1
(d]
(d)
3 II
(d)
(d)
(d)
3
3
3
3
voluntary org ...........
4
4
4
4
4
Other (SPECIFY).......-.
5
5
5
5
5
1-(e)
1- (e)
1- (e)
1- (e)
l-(e)
2
2
2
2
2
EP
Ep
EP
EP
EP
I
T
L
I
IF CODED 1 OR 2 AT(c)
(d) Did you buy it in
the last year? ~TD
\z
Yes
Mn
/NO
IF YW
How much tid It cost?
(e)
13 !7
1
9
9
this card which you think would help you get about
but that you dcm’ t have at the moment?
‘f%
9/S
9
9
Yes
.
D?SmB)3
In
1
4a)
S
31
1-
AID
/
MD
I,,,,
.
,7
I
Description-
I
M
Halklng
rlu
.
52
frame/tripod/zlm.er
L-@2000
I
156rmx=5
No
dns-
1
67
T9. 00 you have anY 8W9ic*l
aidn or supports
anything else listed cm thi9 card?
01
or
1
Yes
SHW
Tq
CAPD T9
A/q/NO
‘a)
TIO
2
IF YES RItK NUNEER AT TOP OF COLLFINAND
CONPLETE (a)-(e)
1
I
6
4
3
~
42
7
NJ
c
Description
. .
N310 provxded
A
\
the. ...?
1
.SeM/prtner.Z7C...
(d) 1
(d)
1 1 1
1
(d)
(d)
1
1
(d)
21
3
21
2
2
2
3
3
3
3
org .......
4
4
4
t
4
DOSS ................
5
5
5
5
5
Other
6
6
6
6
6
1 - (e)
1 -(e)
1
2
2
2
2
2
fp
!2p
fp
Ep
!2p
Lc
I
I
I
Fr~erd/relatlve.
Health/scxlal
. ....
servlcf
Voluntary
(SpEc13-f)......
IF COtiED 1 OR 2 AT (C)
(d) Did yOU buy It n
the last year>
T9D
IF YES
(e) HOW much
ad
Yes
uq -No
/
It
cost>
1 (e]
3
1 -(e)
z 12
2
!2
fp
(.
%
x
1-
9
9
&
9
-(e)
9
1
1
-(e)
-(e)
x
9’
9
>
~
TIO. Me there anY SUrglCal ~&
or SUI )SUdI as
those llstad on this card w311c21you think wauld
help you but that you don ‘t have at the moment?
Surgical
corset
Surgicalcollar
Otherbraceor support
Artlflcla]
leg
Artlflcial
arn
Artiftclal
Joint
Artlf]clal
Pacemaker
●ye
Pylon
03
04
05
06
01
08
09
f
lC
leg support
1!
li
●ld or support
Other surgical
,. ----. . . .. .. . .
,,
fi~o~
22
ol
E
Ye9 I
rJh/No
ARD T9
Splints
SCQUCti
710
(a) IF YES ENTER AID NO. FRCM4 CARD AND
DESCRIBE AID
5urg1cal Footuear (tg built-up shoe) 01
02
Calipers
COA)~NUJZ
DescrlptiOn:
~
11 ~
\u
2
CO U-iTAJUC
DNA
<K04i3
2Z
S&XACr./CE
02
Sub]ect has no continence problems (code 2 at U2 and u4)
(PINK SCHEDULS PAGES~-25)
T1l. DO you use any incontinence aids or any of the
devices such as those llsted on this card?
-/-52
SHOW CARD Tll
II
,,,
M f#m
IF YES RING NU24BER AT TOP OP COLUMN AND
CCMPLZTE (a)-(e)
3
=26
Ou
(b)
y
-
T13
1
(a)
2
T12
5
~
~
1
(d: 1
5+
6
7
o
S-7
5S#@
WCH
‘o.
‘?’%P
Description
‘x”
4
3
(c)
z
Who provided the....?
self/parher.?w.
0)
.,
1
Friend/relatlve.. ...
2
Health/social setilcc
Voluntary Oq.
Other
... ..
(SPECIFY ).. .. ..
IF CODED 1 OR z AT
1
(d
(d
1
T 1
(d] 1
(d
2
21
21
2
3
3
3
3
3
3
4 1)
4
4
4
4
4
5
5
5
5
5
5
1 -[e)
1 -(e;
1 -(e]
1 -(e
1 -(e)
1 -(e
2
2
2
2
2
2
EP
!?p
fp
QP
Ep
I
I
L
I
L
2
(c)–
(d) D1d you buy It In
the last year?
~~
1 1
(d)
Yes
Nfi~
w
/2
IF YES
(e) HOW much did it cost?
fp
T23C
I
E
17
9 [E!
s
.
those
9
9
9
9
-
LMted on this card wkch you think would help
you but that you don *t have at the _ent?
(a) IF YES ~TER AID NO. FRCN CARD
AND DESC3UBE AID.
Ileal100P
Cathcte,
:leosto,
y/colostomy
bag
Bag for .r, ne
Incontinence pant.
Inc.ant, nenct pads
Rubber sheet f.attress
COV,.
other protective
bedd, ng
O,
Other a,dsl~kethese
(PLEAsE OESCRIB[)
9
q-l a
Yes
~j
NO
1,, \
‘1
t
!4
2
“)55
T13
5665
04
02
03
04
05
06
01
08
1
No
1
I’ms
I
6.W7V
&l&
e~cc)~ ~
DNA .
&
&QuCsJc5
Sukqect
has
no
dlfflale]
sight
(Cede 1 at Gil)
(PINK SCHEDUIZ PAGE 17) ...
as
T13. Ou you use any vlslon aids such
those llsted on this card>
66
Yes
Nflj NO
IF YES R3NG NLIMBsRAT TOP OF COL13PIN
AND
0314FLETS (a)-(e)
n
T15
T13
SHIX CARD T13
ST4 H
3
riil-
1
(a)
2
T14
‘-
u
-
15N0
a?
&
FRC41~
COLS
I-z -a (a) AIO ND.
= 27
~:q:
GU
3-7
(b) Descrlptlon
7?:
= S*UQ
(C) WIIoprovided the. ...?
/
Self/partir
(Pund)
Riand/ralative
1
ww&
!?.
1
(d) 1
(d) 1
.....
2
2
3
. . . . .. .
Other (SPECIFY) .....
T 1 1 1 1 1.
1
(d) 1
2
2
2
2
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
1 -(e) 1 -(e) 1 - (e)
1 - (e)
1 -(e)
1 -(e)
2
2
2
2
2
2
fp
fp
fp
Ep
fp
Ep
13 /7
x
I
Health/Social SeI=Iice
Am)
Pu
T13
II
Voluntary
IF
CODED 1
org
(d)
(d)
OR 2 AT (C)
/2
(d) Did jTw buy it 13P
the last year?
Yes
A@l 1 No
IF YES
(e) How much did it cost?
713E
.2
~“~
~~
a7
ri3m
13
I
x
9
x
9
9
x
9
yfx &n’ t have
at
.X5
9
L
ere any vision aas S“
thoee listed on
thiu card which you thiti would help you but that
the
o:
67
mxhsnt ?
Yes
%%
#f)/N.
(a) IF YES ENTER AID NO. FRCi4 CAIVJ AND
DESCP.ISEAID.
‘CARD 113
Guide dog
Sonic ad
Mh~te cnna
I
(d)
1
1
(a)
2
T15
6B77
x!
=
“
,
Description:
;;
rtu~G=Q@
03
Hq)(
Ordznary stlch
Ragn, fylng glzss
04
05
Lou vlslon ●]d
EraIll*qu~pm. nt
U?,t~ng frame (eg for cheques)
Frame for telephone
Ttlk, ng book ■achln#/cassette
~ecorder
A.d~bla/tactile
mtasurlng device
Other vltlon
ud (pLfAu OISCRIBI)
06
-fi4RM1
.5
9
TW
.
1
a
.
1
rw
07
08
09
,
L-
10
MelV~S
11
12
t
~l+wz
COti
18
79-80
•AJ~
z ~
SCQU6~
d
~C~Jj
ax
70
159.
i
I-T
-R-
zQUC8,@Z
o!J
RcCOQD
~z
IF SUBJECT IS SEEN AND CLEAFU,Y HAS
OR
CJ3u
3-2.
>2
3-7 :~~~o
COL.S
NO fS24F.lNG
SPSSCH DIFFIcULTIES COOE 2 AT T15 AND T16 NITHOUT ASKI14Z
II
T15. DO you use any ads for hearing or speech dlfflcultles
such as those llstedon this card?
ris
SH~
Yea
CAFU3T15
1
Qt-
IF YES RING tRIWJERAT TOP JF COLUM?4AND
3
8
2
full/m
*dR#o
(a)
4
T16
6
5
“(03DE FR134
“am’
Oescrlptmn
Who prov~ded the...?
1 T T 1 1 1
Self/partner f15G.
1
(d) 1
3Wiend/relative .....
2
2
[email protected] Semict
3
voluntary
4
Other
Org .......
(SPECIFY) .....,.
IF CODED 1 OR 2 AT
L
5
5
1
(d)
1
(d) 1
(d]
2
2
2
2
3
3
3
3
3
4
4
4
4
4
5
5
5
5
5
1 -[e)
1 -[e)
1 -(e)
1 -(e)
1
(d)
(c)
(d) D1d you buy Lt m
the last year?
l’)5D
II
(d)
12
‘e’
fS4/NO
1 -(e)
1
-(e)
2
2
2
2
2
2
Ep
ep
fp
fp
fp
Ep
IF YEs
(e) HOW much d~d It cost?
7 ISG
I
(
,13 17
I
I
9 !%
z
9
L
I
9
z
9
9
such as those llsted on t i card wluch w
think
would help you but that you don,t have at the mxbmt?
I
Yes
T16
.
I
I
t
I
(a) IF YSS SNTER AID NO. FAND DESCRIBE AID
?earlng ald
Adaptor for telephcme
Adaptor for tv
Adtptor for radio
F1. sh, ng l~ght for telephone
Flash~ng I,ght for dooc
Fltshing ●lar. clock
Po]nter board
Iypeurlter
Otherspeeth/hearing aids
(pLfA5[ oucmr )
_
Descr~ptaon.
CARDn5
A2D
NO.+
~
-t
3
o~
1
(a)
2
T17
‘i
l@-lq
01
02
03
06
05
06
07
08
09
do
19
~
Ufilk
-,
9
LLqs-
--/1
l_Cohluuuf
I
f26c0/20
XL
02
Sequ.exf
T17. 00 you use any pieces of special furniture or dally
Livxng aids such as those llsted on this card?
SHIM CARD T17
Yes
-fI 7
NQ } No
IF YES RING MJKBER AT TOP OF COL.LMNAND
C@3PLETE (a) - (e)
RECORD
s3neA
pdo
aq
,
82
(a)
2
T18
5
–/0
q
Cou
3‘=2“
7 = saNo
‘u
‘)
““
4
3
w
1
2!0
6
-
-1
1
.
79
‘0” ‘m”%-’
(b) Descrlptlon
+
9
c1
(C) NhO provvded the. ....?
(P-3+
*COLZD
*if/partner
I
Pa
.~~~~. .
1 1 1 1 J 1
1
(d) 1
Friend/relative ...... 2
2
->
‘“d* ’sOcial ‘“mice
;a
Voluntary org ........
4
‘f
OLher (SPECIFY)
. . . . ..
IF CODED 1 OR 2 AT (c)
(d) Did yOU bllyIt
the last year?
X’P
5
1
(d) 1
2
2
2
3
3
3
3,
4
4
4
4
4
5
5
5
5
5
1 -(e)
1 -(e)
1 -(e)
1 -(e)
1 - (e) 1 -(e)
2
2
2
2
2
2
Ep
fp
fp
fp
1
(d) 1
2
2
3
3
4
5
F
1
(d)
@No
(e)
1
2
IF YES
I
z
9
Scq
I
9
LKsJcc o
furniture
—
7/8
NO
(a) IF YES SNTSR AID NO. FRU
DESCRIBE AID
CARD AND
CARD117
Cridlc for bedclothe$
Orthop,edl C ,,tt, e,,
R,ppl, ,attre,,
Sheep,k, m .attrt,,
Oth,. ,pe~la]
bed ~v beddlr ~9
(pLEAS[ OESCRISI[)
Commode
San,-ch,~p
Toilet hoi,t
Oth. r a~ds to toxlatttng
(pLf A5E 0sSCRIE4)
Bath ho]st
#on-sl\p .*t
12
13
14
Other aids to b~thlng
(pL[As[ DISCRIBE)
15
B,th seat
J
[Ilv,
ro”.
ental
controls
(Cg Possum)
07 Spec, al cha, r
08 Other $Pec, al furmlture or
09
~ldi(pLf
As[DfSCRIBE)
la
11
ML4UZW06D
finx
.
9
or
Yes
01
02
03
04
05
0s
.
L
9
=-
daily llving-aids such as-those on this card
which YOU t.hnk would helD vou ht that vou
don’t Zhve at the -nt?-
E,d h.a,,
t
Bed polesand ladder$
(d)
I
fP
e
(d)
12
Yes
a
II
(d)
*O
20
16
17
1.9
7-WM4
/NO
,
I*
&
?~g
m YOU use any small aids or gadgets such
as those llsted On this card?
i
I
SHW
Yes
TM
CAFU2T19
1
h81No
‘a) w
T20
2
P1
L
{-
I
{
4a<7
1
1
IF YES RING NUMBER AT TOP OF COLUMN AND
COMPLETE (a) - (e)
COQ
<15co@
(a) AID NO
MAIQ@
~Q
(CODE FRCM CARD)
7
6
5
&
~
1
(d] 1
(d)1
2
2
3
3
//
(@,/~~
]
!
1 ,~f.cal@
~
1 1 1
1 1
Self/partner.........
1
(d) 1
Friend/relatlve. .... .
2
2
2
3
3
3
2
1
3
4
4
4
4
4
4
5
5
5
5
5
5
12
1 -(e)
1 -(e)
1 -(e)
1 -(e)
1 -(e)
1 - (e)
2
2
2
2
2
2
fp
Ep
fp
EP
Ep
Ep
L
IL
I
I
II
Health/SOclal Services
!:;,Voluntaw
Org. .......
(d)
(d)
1
(d)
4
Other (.5PECIFY)
.......
IF CODED 1 OR 2 AT (C)
(d) Did YOU buy it in f140
the last year?
Yes
Nfl I No
IF YES
(e) How much ad
it ~~t?
(
-l-w
t3 I
z
9)8
; Go
Q ucAIrE
T2
9
9
9
9
o
&h as
those
#
llsted on this card which YO” th~nA would help you
but that
you don’t have at the nument~
I
9
!
7=
Yes
~fi / No
I
(a) IF km EmER AID NO F20x4 CAFUI
AND DESCRIBE AID
~
4
CARD119
.
i
Special
crockery
cutlery
Special .tens,ls
,
p*tat O peeler)
01
s+
02
(eg t,n
opener,
IaP’t,,f
lcr/s
PtC,altaps
i
Special door ha. dl, ~
I P,ck UP a,d (,$ ,H,lp, ng Hand, )
Dressing .,ds
Elcctrlc toothbrush
Gadget to SU..C, help
Oth$ 5.. ] I a,:, and gadget,
(PLW
OESC:IBE)
I
.
,
*..
.,
lDG
03
04
05
06
07
08
09
10
4t-
63
WI
T21. How many years
have
yrx
Ilved
at
addresg?
this
-rZ
DK/N6
1
8-q
c ~~
T22. (May I Iust check) are you living in sheltered accommodation?
(WARM14 UJ PRE41sES OR ON mm)
Yea
722
Al$)jw
T23.
2F SUWECT
LIVES WITH AOOLTS ~N3R
2
THAN S~S42
DNA. No one in h’hold is 16 or owz
apart fraa subject and sp-mse
Lk.esyour health problem/dlsabil~ty mean that
you need to llve with relatlves or ecmeone
else who can help or look ●fter ya?
Y*4
‘T24.Nay I just check, d~d ycm move here because of
health problem/dlsabll lty?
Tq
MI
(a) What was It about your prev~ous
wh~ch meant you had to move?
1
3
1
2
+Jo
YOU
1
10
1
)
Ye:
1
.(a)
~
2
-T25
\.
/
1~
accommodation
Couldn’t manage steps/stairs....
CODE ALL
THAT NPLY
tlU LTCODu
nmi
=5
Problcanswith ne~gtiurhood
(e.g.hills, access to shops,
transpxt) ....................
02
Couldn’t manage to lcgk after
hcnuse/garden
..................
03
Couldn *t look after self alone. .
04
Other
05-
(spscxrr). ...... ..........
r=4AM 1
72A+lw:
J3- 22
J
4
~~;
T25. Ooes your present house/flat have any
disadvantages which make It fifflcult for
you to manage with your health problem/
dlsablllty?
9
725
(a) what disadvantages does It have?
n14LllCO@
<ti4m
Ttififl
MB=lr
=s
p&:;
1
-(a)
2
-T26
I
—
z
1-J
Ma
=
)
+-33
m9’15
74
22
163_
— II
T26 . DOM your present accomcdation hava any adAptaticuIsbecause
as those listed on
of your health prcblem/dis&bility Sthis card?
Yes
-6
SNa ~
T26
1
IF YBS RING NUNRER AT TOP OF COL~
CMFLBTB (a)-(c)
Afn/Alo
A2AD
3
(b?ItnA1.+1
1
1
5elf/partner786~..
+2W
Friend/relative .....
Pa
Eealtb service
social
services
“~~Tl&j
VOluntAZY
)
org
......
.....
-
E-
@3mzLJ
/
5
~
~
JUM6
@
-1
8
(SPECIFY)
T27. IF ANY ADAPTATI~S
COU1
2
4
musing dept .......
Adaptations already
there .... ..........
Other
2
3
.......
D)
2
(*)34
T28
a=
1
1
27
2}}
2
3
3
4
4
2:
1
2
1}
T27
1
27
1
3
3
4
4
2
3
4
2
7
1
27
5
6
5
5
5
5
6
6
6
6
7
7
7
7
8
8
8
8
1
PAID FOR PRIVATELY (c&e
1 or 2 h
27
2
3
4
5~1
6
7
7
8
8
o~
UGLORD a% SmUGIUE
mch have yow’has ...... spent altogether on
I
I
to your accomncdation?
r27
5 J’
Tmi%+.
,
T28
Yes
IU4 In.
1
f7uLuoobq)
ms.erlnglopenlng
AnY other
164
ADAPTATION NO. FRC44 CARD
ADAPTATICR4
~dapt~tlOn~
Description.
rmx =1 o
CARD126
Ramps outside instead of steps
Hind ralla outside
Ramps xnslde instead of steps
Hand rails lns]de
Doors altered for better access
(cg doors .]dened)
Sta]r lift
Other alterations
for better access
Fitttd
furniture
altered [en. shelves.
C“ boards, cooker
Me. I athrooa or tol 1ct added
Shouer installed
O.or
@
++
f2g
.,
.;ts
35-39
&o
Are there any adaptations such as those linted
on this card vhich you think wld
help you but
that ycm don’t have at the xoment?
(a) 1? YBS ~
AND DE92RIBE
system
(pLEASE DfSCRIBE)
1
n n 2
Uu
(a) 4 I
BBCTIm
H
ADAFE4TI~
ND.~
01
02
03
04
05
06
07
08
09
10
II
12
I
any colwm)
slow
adaptations
. @
6
7
J-1o
(c) N2L0provided tlm ...?
1
}}
T
I T
r2
.
.
.2-61
ilMW
U1 .
Becau8e of your health problem/disabilIty do
YOU regularly @e
or use any medic ti,es,drugs,
tablets or anythng else which you obtain on a
doctor’s prescription?
Yes
41
u*/m
U2 . Are yOu ....
●xempt f mm prescription
RlJNN2NG
claitig
back payments
charges
for
..u%
......
-U4
prescriptions ....
PmmT
paying for ●ach prescription ......... ......
or paying with a season ticket ~ ..... .. ....
*
(a) Bow -ny mmths does ycur
sea80n ticket cover?
4 mnths
12
U3 .
Row much have you spent on prescriptions
in the past su months because of vour
health
~roblem/dlsability?
U3
+
0
\
)1/ -15
W):
16
Can you lmk
at this list and tell ❑ e whether you
regularly spend extia on any of these items because
of your health problem/disability?
SEON CAsD U4
(a) j7
.U5
IF YES AING NUMBER AT TOP OF COLUNN
AND COMPLETS (a)-(c)
-1
(c) Ce you (or your
spuse) pay for
this ycurself?
Yes
ui9/~
o
1 (1)
l-(i)
2
2
/)
l-(i)
2
‘r
(I) About
●xtra
7
(a)
(
UOK
U4
montlw
U3
how much
did You
r
Ep
l-(i)
2
l-(i)
2
k
fpEI
/2- /(
I
‘Ig
9,
I
24
l-(1)
2
l-(i)
2
Y
to spend uore on but can’t afford to?
us
(a) IF YFSfNTSR
AND DSSCA2BE
ITS14NLNSBSRFROM ~
DMcriptio”
paper/k, tchen roll
Cotton uool
Dr*sslngst*lastOpl
ast
[last]c
bandageslnupports
Tnlcum powder
fintlsept>c or soothing creams
Vltt-lns
Palnklllers
and othor medlcuies not
on prescription
I
Dlslnfectant/bl
each
Other ●edlcal supplles
(pLEAs[ ocscnle[)
)
U6 .
01
02
W3
03
04
05
06
07
,
IT?3MNO.-
a5APl (
.
08
09
10
Does your health problem/d~sabilLty mean
that YOU spend extra on ....
washing
INDIVIDUM.
PROMPT
M/ -
IT7M
CARDU6
T~ssues/toilet
Yes
clothes
or
bed
ltien?
4!s No,
~
W..
++
dry cleaning?
sending
thing.”~”~~”~~z?~~
~
m
IF YSS TO ANY
CUA:NOti
all ....x
●pent in tbe
past 4 weeks cm washing/dry cleaning/
laundry, because of YW
health prahlem/
disability?
UA
(a) How nuch extra have ya
%
&
f
Id.
~j%.
WDK
W you thm.k that YOU need to spnd
more on washing, dry cleaning or laundry
because of your health problem/disability,
but can’t afford to?
-----
9
‘
Yes
0
1
2
‘\
7
166
‘
U8
ooes your health problem/disability man
that you spend axtra on clothing or
bedding, for example any of the things
on this list?
L/g
Yes
‘;’
47
SFKW CARD U8
(a) m YIX (or YOur w-r)
w’ for
the extra cost Of clOthinghedd@
Yourself?
:i) s o
19
(i) Euring the past year, abcut hcu
mch
extra have ycm spant on
clothlng/beddtig because of your
health problem/disability?
j)_53
s+
U9 .
Are there any items on the list uhlch
you need because of your health problem/
disability but can’t afford?
Uq
‘“) 55
Ulo
(a) IF YES ~
ITFM NUMBER FRCS4 CARD
ANO DESJX2BE ITFJ4
,-
Daacriptlon :
CARDU8
Thermal underwear
Other underwear [except
01
Incontinence pants)
PyJnmas/nlghtdresses
Trousers/sk, rts/dresses
02
03
ok
05
06
07
08
09
10
Sh~rt/blouse
sOcks/tights/stockxng$
Card, gansl]umpcrs
Coats/Jackets
Gloves
Shots
Bedding (not protective
Covering%)
Other (PL[M[ DESCRIB[)
!1
12
56-75
Ci7a W
SGQWWCG
u1O
‘a
CoI-s 1-2
OOIS 3-7.
K<CORD 3a
=32
SwznKl
Ooes YOUr health problem/disability mean
that you have to have a sp-scialdiet?
0
1
[a)*(b)
2
111
$
(a) Has this diet been recom.snded
a doctor or dietician7
LUOA
Yes
1
/Nc’
(b) ~
You 9et aw fcod on prescrIption
or any allowance frm the DBSS for
your diet?
10
o&
W
LJ1l.At present, abc$uthow much do ycu/does
your family spend on food each week,
)
Ull
SXCLUDE : CLE4N~G MATSRIAL5 , PST FCOD ,
Cigarettes , ALCOHOL, SWEETS
INCLUDE
COST OF XEl~L/CANTEEN
TAKE-AUAYS
NSALS/
il -Is
(
s
uIIDK
lb
mill
U 12. Imes your health problem/d~sabllity ❑ ean
that you spend more on focal than you
muld if you had no health prablem/
dls.akulity?
U12
a) 17
Yes
Ue
J14
/m
(a) iihydo you need to spend more on fccd~
)
~ uL7rcL0@
tiqx.?J
Require BP-SC
ial
?-
20
Other (5PB21FY) .........
l.f:~g;
~( ~Aw
U 13. Of the money spent on your food each
wee!!,how mch 1s extra because of
your health prcblem/d~sabxlity?
U-25
8
d
“.
U 14.
DO YOU thnk you should be spendmq extra
because of your heal-ihproblem/
on food
dlsablllty but can’t afford to>
Ye
‘J4
168
~~/Nc
o
1
27
2
7’
Slnlm
a@xzD
3+.
l/A =34
~a
COG 3/7
*s&tJo
v.
MOBILITY AND TPANSPORT
V1
SSTABLISH SUBJECT“S DEGRSS OF MOBILITY ON IiIS/NERWH
(IGNOICSTENPDP.ARYSITUATIONS)
VI
BEDFAST (Permanently confined to bed unless
helped to get up) ... ..... ...................
CODE FIR5T
TNAT APPLIES
CNAIP.FAST (Stays m a chair all day. If in
a wheelchair, cannot propel it alone) .........
RESTRICTED WIlliINCUELLING (CaIInotget ar0U31d
i“cludlnq
garden) ...........
whole house/flat
RSSTIUCTEO TO DWZ.LJ,ING[Confined to house/
flat and garden )..............................
USUALLY GOES OUT (usually gces beyond house/
flat and garden)..................... ........
~o Nk$
(a) HCU dlff~cult 1s it to get about your i=d~ate
nelghhourhwd on your ovn, is It......
.
Vlfl
not difficult ● t a21 ....
RUNNING
guite d~fflcult .........
PF02NPT
or very tifflcult?. .....
V2 .
ESTASLISH
SOBJECT ‘ S DEGRXE OF MOBILITY
Assistance
not
WITH
ASSISTANCE
normally
Matins
available.
.
1
J
J
2
3
- V2
8
4
5
.(a)
‘.
?+
V4 q
3
. .
BEDFAST (Permanently confined to bed) .........
CHASRFAST (Stays in a chair all day, excludn~
wheelcnalrs). ................................
CODE FIRST
TNAT APPLIE5
~ Z
RESTRICTED WITHIN DWZLLINGS (CannOt g@
around whole house/flat and garden, even
with help) ....................... ...........
RESTRICTED TO ~ING
(Confzned to house/
flat and garden. Include here If can only
go out Ln ambulance) ............ ............
GOES cXJT (Goes bayond house/flat and
garden wlthaasistance) .......................
USUALLY
V3 .
How diff~cult is It for you to get stout
youY nmedxate nelghbourhocd If someone IS
With you, 1s it......
i3
not dlff~cult at all ......
RUNWING
PRC44F_T
qute
difficult ...........
L
or very dlfflcultq........
●
No assistance avalsble. ..
28
.-
I
*nlu<
V4.
34
RccoRJ)
now often do YOU usually 90 Out, el~er
on your own or with someone?
V4
Svery
day. . .. .........
Several
trees a week ....
About once leek
.......
l,essoften ..............
V5 .
ooes your health problem/dlsablllty
prevent you from going out as often
or as far as you would llke>
Vs
Ye 8
/3
Ail?/No
(a) What prevents you frcm going out
more oftenlfurther?
Transport problems......
fiwf=~
CODE ALL
THAT APPLY
V5A#l I
Access probe.
.........
VSAH2
v541f3
No one to go with/no
one to take= .........
V5AH+
Too much effort or pain.
21
NO confidence/fe
W/
embarrassment...........
Can’t afford It...... ..
Other (specify).........
V6 .
In the past twelve months have you used any of
the forms of transport l~sted on ttms card?
IF YES RING MJHEER AT TOP OF COLUMN AND CCMP=
T
1
,1- 12
=
mu o
(b)
‘s””
n ‘DESCRIFTIONdn = qv
-a
travel
(Pqsc+l
l&&
m
1
.
I!l$
170
9’
mAJ3%@-3
P
“
Fbre
than
About
by
once
once
““es
.?+kut
once
. . . ...?
a week.
a week
.
99
. . .
2
Vlo
(a)-(c)
4
5
1
1
1
1
2
2
2
2
3
3
3
4
4
4
5
5
5
5
6
6
6
6
-10
1/ 3
4
. .
A few trees a year. ..
Less often. .
(a)
3
2
~nti~bc
a month.
1
I
often do you
(c) Hw
Yes
(wJ m
SHOW CABD V6
01
XL
V6
........
1
,“
07
v?
IF
USED ELSCTRIC
PAW~
VEHICLE (eg Eatrlcar)
DNA
“,,”
p.”.
(Batrlcar)
-..=..
,“”.
CA.Z..
.*G
p-vul..z,,
.
M
batrlcar
“e,,.
23
etc.
7opM
v.
WE
V9
cle
V7
?
Self/spouse. ... ........
Friend/relative. ......
Voluntary organisation.
I
I
SEs w
Other (specify)..... ...
l\
.
V8 .
now much did It cost?
w
VWK
IF USSO BUS
.,.~~
\,/,’h- i
DNA: w
=
27
Nb)/ DK
,%
)
(a) How many years ago dld you buy lt?
0./.6
V9 .
E-28
ANIXJNT
USED BUS
.V.WN4...
Does your health problem/disability make
It dlfflcult for you to travel by bus_J
V4
(a) When YOU travel by bus do YOU usually
need someone tm help you or & you manage
on your own?
3+31
y-llrws(
Yes
NFI jNo
V4A
Needs help. ....
Nanages alone. .
V1O a 2
o
1
2
(a) g3
SSSVll
3.&
-SEE Vll
\
,
)
Vlo . IF NOT USED BUS
You said you had not travelled by bus n
past 12 months. Is tlus......
CODE MRST
THAT APPLIES
the
because
Vlo
of your health problem/dlsablllty?
because
you
35
don ‘t want or need to?. .......
or because there 1s no bus available?. ...
Other (SPECIFY)..............
..........
*
171 ~
30
~w-u.vue
Cm
3%
v6@*02
Vll .
vi!Lwfl
IF WSSD TSAIN
DNA . N~
USED TRAIN
.v12
36
Does your health pIcblem/disability make if difficult
for you tn travel by tiain?
Yes
till
w
;
a)
Nhen you travel by tiain do you usually need someone
tn help yo” or do yo” ❑ anage cm your own?
Needs help .
~,,#nages
.
.
/m.
37
(a)
SEs V13
3s
-SEE V13
alone,
lAa
j OL
IF NOT USED lRAIN
V12.
You said you had not travelled by train in the past 12
mnths.
18 this:
VI 2
because of your health problem/
disability~ ..........................
CWM
FIRST
TSAT APPLIES
because you don’t want or need to~ ...
3q
or because there is no train
available? ...........................
Other (SPECIFY) ......................
V13.
~ga s 03
V13DIW
IF USSD cM1/vAN
DNA : NOT u~D
Do you (or dces anyone in your household)
have a car or van?
a)
Ye.9
V13
~
Yes
UQ
00 you go out in the car/van?
fNo
Yes
vi3fi
V14.
j,.
Ce you yourself drive the car/van?
~i3fi
i)
CX4/vl
i
~~/No
40
.v16
.(a)
.V14
4)
.V15
,(1)
4z
.V15
-V,4 43
Nhose car/van do you travel in>
8
Friend
/ relative
outs~de
h’hol
44- 4b
●
mu
LllCotM.D
Hny
Other (specify) ...............
‘3
VI
VI t
Ml
lq~
v14Jf3
.
1?’2
31
I
V15.
00 YOU ~avel in an Ordinary car
specia 1ly adapted in scme way?
m one which
is
Vfi
..... . ....
Ordinary =.......
.V17+7
ordinary car, but must be a“tatic.
Invalid car......... ....... ........
Adapted
(a)-(c)
car ..... .... ........... ....
In what way is the car adapted:
a)
TO cope with leg/foot disability?. ...
fiumuDa
Mn&
‘lbaope with
arm/hand disability?. ...
Other (SP=XIFY).........
. ~
= 3
4$-s0
gK..i...
J i5~H2
v 15fM3
b)
EC+
❑ uch
extra
did it ccmt to have
an
.,
I
adapted cax
rather than an ordinary car?
Vls
61-54
B
I
S%=’
yt~m~
c1
How many years ago did you pay for the adaptations?
kJ4jDK.9f
Vki
v16 .
5;
RJR / “’
==
V17
56-57
c
IF NOT USED CAS
I
You said you had not travelled in a car in the past 12
months. Is this. . . .
V{k
because
of ymur health problem/dinbility?. ..
CODE FINST
because FU
TSAT APPLIES
or because ttere is no car avalla.ble? ..
don’t want or need tn? .....
Sg
Other (SPECIFY) ....... ........... ....
V17
I
M YOU have a Disabled St~cker (Orange Badge)
[or does anyone have one because they use
a car on your behalf) ~
V17
32
Ye:
JNO
PJfl
V18.
V19C7M
IF ANY TR4NSPCRT USED
DNA .
NO transport
(Code 2at
Thinking
about
all
the kinds
of transport
each
muctJ do you usual 1y spend on travel
60
or car used
V6). . ..........
you use,
month~
SSCTION w
how
INCLUDE COST OF RUNNING CAR
- TAX INSUAAWE, PETROL STC
f
“
I
V19 .
a
Sane people with health problem /disabilities
I
spend less on transport than other people
because they can’ t go out so much or because
they can get special cheap fares. Others spend
mere because they have to use more expensive
forms of transport or need transport for short
journeys.
Thinking about hm often you go out and hcu
much It costs, & you think your health problem/
&sability means you spend more, less or about
the same on transprt as you would if you did
not have a problem/disability?
m
m.!!!? . ..
Less.........
o-q)
‘a’ 65
-SECTICN W
Abut
(a) Abut hcu much extra do you
spend per manth on transport>
I
i
33
the
san
- W7
3
I
IF UNDER RSTIP.SMENTAGE
W1.
How old were you when PU flnlshed yOUr
ccmclnuous full time educatlon~
Not yet flrmshed.
140r
under
.
. ..N!..
....
... ... . .
........ ,
15. .. ...
........ .
...... .....
16.
. . ... . .
............
9
.
17. .
. .
-(a)
.... .. ...
18... -------- ........ ........... ..
190r0ver
......... .................
No formaleducatlon. . ..
(a)
.... .. ....
W2
Are you attending/dlciyo” attend
aUNNING
AD ord~nary school. .... ..w!h
F’ROPPT
a special school ........ .......... .
.... .
10
or have special education in an
ordinary school? .... . . ...........
w,?.
DO YOU have any Of the qualifications or have you passed
~Y Of the ex~natlons
llsted on t.hs card?
W2
SHOW CAm
W2
Yes. .. .
N4
(a) ~lch
W3
qualifications.
1s the h~ghest qualification you have obtained?
IF IN WUST
Degree
/No
.(a)
(or
CODE FORE TliANONE
Wu
dsgree level quallf~catlon) ........ ............
Teaching qualification. .. .....
...
...... ......... .
SNC/SND, BEC/TEC Higher. ........
........... .............
City and Guilds Full Technnloglcal Certificate.
~
02
03
.... . . ..
04
Nursing qualifications (SRN, SCM, Midwife)..................
05
Otier qualifications above ‘A’ level. ......................
06
‘A’ levels/SCE Higher
. ...... ....
..
07
.. ..
08
‘O’ level passes (Grade A-c if after 1975) or CSE Grade 1
or SCE Ord~na.q/Schwl
Cert~f~cate. . .
..
........ .
Mn
09
ONC/OND/BEC/TEC not higher
............ ........
. ..
... .. .... .. ..
Clerlcal or ccumerclal quallflcatlon
Other CIiy and Guilds ~
...
....... .
10
... . .
11
full technological
12
CSE grades 2-5, ‘O’ levels (Grade D-E If after 1975) ..
Ipprertlceshlp.
. ..
CSE ungraded
.
Other
... .
qual~f,caclomj
.
.
...
.
(SPECIFY)
...
.
. .
.
..
..
. .
13
.
14
.
c
34
11
DNA
full-time edu~at~On
(Code 1 at Wl)
.. .. ....
StIll
In
Wire) A
W3 .
Dld you do any paid work last week that IS In the 7 days ending last
Sunday - either as a.~employee or
sel<-employed~
c
1
1+
-SEE W35
P44
<
Yes ....
No . . . . .
c
-W4
..
. (a)
(a) Even though you weren’ t working,
dldyou have a lob that you were
away
(i)
Last
frun
week
CODE
FIRST
TEAT
APPLIES
W4 .
last
week?
MS
Yes ....
NO
.....
c
-W4
. (1)
were ye”:
Waltmg to take up a 10b that you had
already obta~ned? .............................
c
lookngf orwork?.. .
.........................
c
lntend~ng to look for mrk by prevented by
temporary sxckness or injury?..... ...........
c
available for work but not act~vely seeking
work?. . ... ................... ...........
.
c
...........
c
permanently unable to work
(USE ONLY FOR NEN AGED 16-64 G W3MEN 16-59) ...
c
retired?
(USE ONLY IF STOPPED W3RX AT AGE 50 OR OVER) ..
c
home or faumly?.............
1
doing Xsue’chlngelse? (SPECIFY)...
1
“Attending Adult Training Centre,
1
going to school or college? ....
(USE ONLY IF AGED 16-49)
lmkmg
after
or
you
were
the
W41
(May I lust check) , last week were you on any
of the government schemes llsted on th~s card?
.
SHOW CARD W4
CcmrnunltyIndustry........................
1
Ccxammuty Progranme.. ........ ..........,
2
Tralnm.g Opportunities Programme (TOPS)...
3
Voluntary PrOJect Proqramne. .
4
v+
Youth Tralnmg
Scheme. ..... .
NONE OF TNESE f$~. ...
/
(a)
...
.. ......
... ..... )
...... ... .
- (a)
7
Last week on your YTS were you-
. ........
5
. ... .
6
or a college cr tralnlng course,
176
college-based YTS.
35
-W5
17
wlth an employer provldlng work experience?
employer-based YTS. .
– W5
:
colv~~~c
W5
al
s4jqu~rJcf
~cof?r.) 36
Are you registered disabled with a Job Ce,tre under :he
Act,
!31sabledPersons Employment
W5
CHECK
DO YOU have a Green card?
Yes
U1
1
No
2
DK
3
&
—
?
U>=m-ia
W6 .
L@
~+ *7y)/4r
3,4- 4
?0 ALL W2T WORKING/N~ ON COMWUNITY INDUSTRY/PROGFUd4ME
/
E~IZIYMZM BASSD YTS
DNA: Working
U6
We) . . . . . . . . . . . . . . . . . .
1
{
Ccmununltyindustry/prcqrar#ne(code 1-2 at w4)
2
I
based YTS (Cede 5 at W4) ............
3
Employer
(codes
01-02
at
way I just check, have you ever had
a pa~d job?
Yes
DCNE WHIIS IN FuLIcTI=
(EW2LUDING JO=
EDUCATION)
N~
/No
Jlo
/9
4
5
27
w
—
~,
~Dw
IF
n7 w~
CVFR R3T
5MENT AGE
old were you when you last worked
in a pa~d ]ob~
Em
W7
Still working ........
Never worked .... ...
Under 30..
IF S~PPED
no
2
ZE
4
50-54. .... ... ......
5
55-59 ... .... .......
6
60-64. .
-1
...... ....
over .........
W35,
P44
3
30-49 . .. . ........
650r
W8
.. ...
1
8
b
—
SSE W8
Wlo
WORK BSFORE STA?’U’P3RY
FJITISUMSNTAGS
(BEFORS 65 - HEN OR 60 - WJMEN)
DNA
Worked beyond age:
65 - men
CODE WITHCXJTASK?NG IF KIJCWN
60 - We
Did your health prablem/dlsability
start before you were (65-usN, 60-h?JMDJ)
~
~#
]
No
Did you retire early because of your health
problem/dltw.bll
lty or for home other reason7
GIVE PRI~ITY
Vq
Health problem/dlsab~l~ty .
TO
.NEALTNRSLCONS
Other reason ..............
1
!4-3
2
b
—
Wlo
.
1
II
—
36
#lo
LI
W8
Yes
W9
\
3
22
w1O . DETAILS OF CUNRSNT/NOST RECENT JOB IF UNDER NETIFCiWShT AG5
NAIN JOB IN WONXING LIFE IF CNER ~I~SN’f
AGE
OCCUPATION
Job tltle:
Descrlptlon
350 * =tqq
kc 23-=
Industry.
yIc=-Zt
2Y
Mo I
Part-tti
..... .
mployee .......
WI02
- ‘%
- W12
Self-employed. .
AJO U&
Wll
(a) IF ~PICMEE
AsK OR F!ZCO~
manage . .................
WIIA
30
foremadsupervisor.. ....
other
employ.. ..........
NON%
(b) How many employees work (cd)
m
the
establlshment~
WI16
1-24. ...................
1
250ru0re
2
.............
~o Nfk
(c) Do/did you work In sheltered employment
such as with:
Reemploy.......................
a local authority ..............
wmG
w,l~
a bllnd asso.lat.on .............
3
w
c
1
!
2
3
32
a voluntary
)
association ........
or m a sheltered place with an
ortinaxy employer? .............
None of
these
4
5
6
@3.
/
(d) Is/was Your employer In the publ~c
MIID
sector, that Is: a natxonallsed
Ye9, public sector,
Industry, a publlc corpratmn,
or
No, private sector
central or local government (or the
hJ~/Not SUIQ (SXPI.UN)
armed forces)7
1
2
L
3
J
33
W13
t
W12. IF SEII-SMPIDYSD
Do/did you employ other people?
. .
Yes, PNf2BE: 1-24......
1
25 or more. .
2
hilz
3
‘0 ‘wlOyees” “M;N&”
(a) Are/were you working with assistance
fror any government or local author~ty
schemes such as
Viw
RUNNING
PR~FT
178
the
Enterprise
Allowance
Scheme.
. . .
“
Q
1
2
3
4
.
the Bllnd homeworkers Scheme..... ...
on Cmwl Account
Schem ? . .
or the Business
None of thes @fi
=/
37
(1
3($
t
3s
-SEE W35
P44
nw
Not
worku.g
W13WJA
(Codes 03-11 at w3, 1 d
Code 3, 4 or 6 at w4)tiq
34
,W2,
tio kjp,
How many hours a week do you
usually work, excludlng meal breaks
but xncl”dlng reqular paid overc~me~
ti13
W14
Do
YOU
go
W14
out
J3K/ruFtH2T
to
.
work
‘tmrk at home only.
.
... .
37-39
(
\
. .
.
M
(or llve at your place of work) ~.
.
I-Jotif?s
TO EMPLOYEES
W15DM
W15
DNA .
Self-employed
How much do you usually earn In your
10b before any compulsory deductions
for Income Tax, Vatlonal Insurance and
SuperannuatlOn~
.
F
W/5DK
.
W17 ~
.. ....
W16
Refused. . .
0-
W15
rd.
Nns
(I) How long a per~od
GROSS EARWING
does chat cover,
Week .....
!+15Di4-
Wl 6
How
lob
for
and
5‘=
49
Year . . . . .
Other
much d~ you usually earn In your
after all compulsory deduct~ons
Income Tax, National Insurance
Superanndatlon~
(SPECIFY)
..
A
x----Ref Ad
/
W19
.
J
%
‘a)$-56
(a) How long a per=od does that cov.er~
‘Week ..... .
Cal month
.
57
;
W14JA
Year.
Other
(SPECIFY) .
II
W17DK
d..
AJQ
N QJ
hJ I 7fJ~-w18
LJllr
.
Refused
W17
HOW much money do you earn from your
business each “eek after ded”ct=q
expenses a“a paying any Income Tax
G ROSS
7SEKLY EARNINGS
#RfA%ed
c+
A’
W113
23
m
t
W19
6
..
TO SELF-EMPLOYED
How much money do you earn from your
buslwss
each week before paying any
Income Tax or National Insurance, but
after deduct=ng expenses,
tt
Ep
I
W16
W17
4\
c
Cal month
w15&
WlbF/
W19
m
W1953
EP
5
IS
:7
P
12”1
w18
57-6s
.
w19
Does
your
health
problem/dlsab~llty
affect
for instance
your work m
any way at present,
does It affect
Wlql
The type of work you can do?
.
~iq~
The amount of work
. .
MAN
Z
you can do?
.
The hours you can work?
The
sort of conditions you can work m>
PRONPT
~~~.s
YOU= journey to work?.
~{~ b
Your attendemce
at work>
Anything
(SPECIFY) ...
WlqT
else>
. ..
...
.
N]qA
INDIVIDUAL ~~q
f’fti-nm~
ffi
es
r
—
8
‘7
/0
-
II
...
.
.
12
.
13
... . .
..
..
SC
‘L#-{6
MI
3
)#1’77ML
Wlq7M3
TO SMP?J.XEES
WODNA
)
DNA
‘3
self-employed
W20 . Has your employer done anything
to make It
easier for you to work with your health problem/
d~sabllltv~
Ou
Yes.
W20
CODE ALL
THAT APPLY
MumoL)60
IYRx
ZJ
Prov~ded
special
Provided
spec~ally
Provided
special
Arranged
adaptat~ons
needed.
141Ki
tralnmg
3ob
.
02
a~ds/equipment.
.
03
designed
d~fferent
W20AM1
Allowed
time off. . .
WzoF$jz
Other
(SPECIFY)
....
hours
. . .
04
.
.
.
. .
1?-30
05
I
06
.
w2Wmi3
M29 AM4
Wzo MS
WmAN6
w21. Thinking about the number of hours you
work, would you prefer a 3ob where
you worked
..
RUNNING
PROMPT
.
/%
.W21
done?
Allowed
)
(a)
No. ..
Nothing
(a) What has your employer
-w21j7
W21
more hours per week
1
fewer hours per week
2
or are You happy with the
number of hours you work
at present?
..
180
39
Nf
[
3
1’
-%
\
C 011 JZW(A6
~Q7.LWCG
34
QE~
oa
*ND
IF
TEMOP.AA3LY
OFF WOSK (COde 02 at h’3(~)) 1, 2,
5&7ddk
&y; ?’rw%qy$yyi
w22
‘3)
w26
3
3%
Are you away fran work at present....
because of your healtl!problem/disability..
W22
or for mme
2N4 .M26
..... .......
other reason?. .
.(a)
1
b
(a) sow long have you been off work?
Less than lmontb ...........
-“in 1
1 month, less than 3 months.
w GUI
33
N2r3
3
3 months, less than 6 month
“
6 months or more .. .......... L
w“.
.>--
IF WIQYES
DWA :
-(a)
Self-5npltied.........
4
Yes............
1
00 you expect to return to your
present
employer?
Ho .............
r 2
‘k
~&wOt sure.......
~
titi
{L
(a)
ym expect to return to the
same lob?
1
Yes .......... ..
,26-
.........
w:::..
w24. DO ycm expect to be flt
to work again?
14fq-
W25. WI1l you look for another paid
lob In tbe futuXe?
-
~
Yes.. .........
1
Ho.
.. .. . . . . . . .
2-
sure .... ...
‘[
3
W\t40t
Yes ...........
c
u&
.. ..........
(a) *Y will/may you not lcok for
another lob?
2554
Sss W35
P44
E
1
-2
............
va5
‘
c
C9
tias~
w24
}
?-
3
HO Zobs available.......
N>
Too old .................
Other (SPECIfY)..........
31
Jc
,8,
40
‘2
\
w26
If you had to fmd another lob, do you
think your health problem/dlsab~llty
would
make It more d~fflcult for you than for
people to f~nd one,
other
W.ti
Yes
(VR
/No
The tYpe of work You coul’d do,
w6A2
~~eamount
wzbf%
~%k
The sort of conditions
.
attendance
else?
. .
you could work =n
at work>
.. .
. ..
. .. .. ..
(SPECIFY) ..
.
. . .
Y
!!%4%
wu(j~j
[F NOT WORKING
DNA. Never worked
How old were you when you left your
last paid lob?
(Code ~
48-50
at w6)
,
AhQ/D1<s 9q
Yes
AIFlj
tizg
i52-53
YEARS
D=d your health problem/dlsabll~ty
have
anything to do with your leavlng your
last ]ob~
No
P
1
‘a) 54
W29
2
I
(a) D1d your employer ask You to leave
you leave of your own accord,
or
d~d
EMP layer asked. .
. ..
I ’2955
-(1)
Left of own accord.
(I)
P44
BUT HAS ~RKED
v270tiA
W28
No N+?
. .. .
...
The ]ourney you could manage?
Anything
SEE W35
P44
of work you could do? . . ...
hours you could work>.
Your
2
Yes
~z~i
~ ~4
PRCMPT
(a)4J
17
(a) Would your health problem/dlsabll=ty
affect
INDIVIDUAL @~.3The
91
1
What was your main reason for
leavlng>
Could no longer do the work
CODE ALL
Could not manage
the Iourne y
Could not manage
the hours. .
5
1
-SC
1
N2fl
THAT APPLY
Other
ti2gA
I MJ
;::::$$.
(SPECIFY)
..
.... .
S6-5i7
3
4
I
41
(N,,
OtW
IF MT
w29.
L
Retired (Code 09 at w3)
Q
w2qoNh
WORXIWC BUT WOT ASTI~
Is the raason that you are not working
● t present because. ...
y
;ss W3
?44 5 +
-
2q
your health problam/dlsabxlity
ixpsstile
COC4f F3JGT
THAT APPLIES
makes It
for you to do any kind of
pa.idvork.................. ..... .............
1
YOU have not found a suitable paid lob..........
~ r 2
Or because you do not want or need a paid
job?.......... ............ . .. .............
II 3i
Other (5PECIFY) ................................
5
-.
/$
-
. .
4
“i$’
Q
Hay I lust check, wuld you be able
to & some kind of sheltered ox parttime work If it were available, or IS
this ~ssible?
Could do sheltered work. ........
!ff2..qMl
Cauld do part-tree work. .......
Wzq flti~
I~sstile
to work. . . . ......
—
n
1
2
i 3k
1=
Are You looku-m
W30 . (May I lust check)
for a job at the nvment~
61-6%’
W30
SE w35
’44
Yes
V30
~~ ) No
(a) Have You look-d for a I&
(Since you last workedj?
at all
()
Yes
tJ30A
Nk
,1
M
2
/
\,
,
you not looked for a ]ob~
W s!utable jobs around - general
amploymcnt sltnat.ion..........................
45-67
w suitable jobs for someone with sukgect’s
health/dlsab~llty............. .. ............
W32
Other (SPECIiW) .............. .. ......... .....
N31.
WY
have you stopped looking for pbs?
kJ3/fW
W31M2
W3f M3
No sulta.bleJobs around - general
emplo~nt
sltuatm”. ..... ...
. ..........
;%70
No suitable lobs for someone with sublect’s
health/d~sabll~ty ...
..
.
...... .
Other (specify)...
.
. ..
. . .....
.
L
t’lu~~D~
WQY+
(!L
1
42
,-
Have you ever/sincaYOU last mrked
w32
&no any of the foil-ing to help g-t a job
4
Q-1
em
Vimitad alocal
Talked toa
1
Job Centre?..............
Careers Officer?.............
k YOU think your health problem/disability
maken it more difficult for you than for
other
people to find a job? M33
(a)
In what way dc=.eYOU health problem/
disability affect finding a job - does
it affect:
u33fi
/
The
#33A2
of wrk
type
~e_Utof
mLu.VID#~Jf%ehow=
~s3~4 me ~rt
PR~
W33AS
you can manage ........ ...........
Yourattandmceatmrk?
ti~fi
can do? ................
you c?ulhurk? .......................
of conditions YOU cm ~rk ‘i? ......
me journey
......................
knything else? (SPECIPY) ......................
ML4LmDo
7UZ
W“R7P13
w34
~,
)
Thinking abut the hours YOU would like to
mrk, would you prefer to work full time
Pill time ..........
or part time?
PUttlme
w%+
(a) About how many hours
,-
YOU vant
to
I
1
(a) /j
2
W34
!
12
)2
12
13
12
/&
12
15
12
IL
17
2
125C
3-
l@3
7FII
W 4
flR* c 3
/0
“es WC.
you can do? ..................
“orkyou
2
1
I
w33
2$
9
Talked to a Disablement Resettlement
Officd? .............................
b
Wo f$J@
..........
malified answer
(SPECIFY) ..........
a week
wuld
ECURS
vork?
~3ti
DK/dQ= ?9
Iiwo
Q
a
1
see W35
p44
2
(a)
21
3
oo-
see w35
P44
9
I
.
184
w NOsf
U-D
GNP
SPOUSS ‘ s
L
S7qG5
3C
CCUS ~2=03
ENPIOY~~
4MWKD
37
Cou
1-2=
COLS
3+
37
DNA: NO SPOWQ . . . . . . . . .
Ti20N X
PEPSON NO. OF
~“
Finl~
3-9
c SCR*
Spqz$tio
IF SPWSE IS DISASWD AND ELI~BLS FWf
INTERVIEN ASK A?UJ NECCRD ~TAILS ON
I
SPWES ‘s am
scfimuLR
-
I
W35%
Details on spouse ‘a schedule X --
W35
IF SPOUSE IS UWDER FSTIRSMINT Am
36 I)
Spouse over retirement age
Did (spcase) dY any paid work la8t
wek - that is -n the 7 days ending last
sun&y - either an an employee or
>
MS
(SPOUSE) w-n’ t ~r~n9
though
CIZON x
7
iJ35bdA
Ow:
(a) Even
10
Yes . . . . . . .
11
’37
m . . . . . . .x
.-.
a)
Yes.......
)2
137
NO .......>
.-.
i)
t ~d
he/she have a job that he/she was away
from last week?
(i) Last
week
was
(SPOUSE) :
up a job that he/she had
to take
already obt.mned~ ......................................
)3
look~ng for work” ........................................
)4
intending to look for work but prevented
bq temporary sickness or injury? .......................
)5
available for work but not actively seeking
work? ..................................................
36
waiting
Cmi?
FIRST
-T
APPLIES
going to school or college? ..............................
(USE ONLY IF AG3D 16-48)
27
pemently
DE
unable
to
work?
. . . . ... . .. . . . . . .. . . . . . .. . .. .. .
IX-13
d37
.
(USE ONLY FCR NEN AG3D 16-64 AND w-N
AQ?,D16-59)
/“, .
retired ..................................................
(USE MY
linking
IF STCPPED ~RK
AT
AI=
50
OR
OVER)
after the home or familY? ........................
or was he/she doing smethin9
el~?
of
(spEcI~)
............
1(
11
— -i_
i436 IF
At
SPOUSE IS
present is
OVER RETIRE1’E~
A=
(SPCUSE)
worklrq
m
W36
apu~jOb?
.. . . . . . . .. . .. . . . . . . .
retired> ..................................
(USE ONLY IF S~PED
KRK
AT 50 OR OVSR)
lcoking after the hare or famly>
.........
or do~ng something else? (SPECIEY)
. . . . . . . .
14
DFXAIL5
OF SKIUSE ‘S
WAIN JOB IN IKRMWG
ti37LlltA
tNA :
Spuse
never wnrked
Occupation
)
1
JC4Y title:
Q
Describe fully :
.
&
.
.
49
.
.
.
Industry :
eEpluyw
u
)
(a)
W38
37
Mlf-employed
-
(b)
U3!
...............
other employee ........
3
)
1-24 .........
lJ38c
250r
[SPOUSE’ S] ~loyer
1
2
Bow -y
employees wxk (cd)
in the establishment?
Is/was
2
....
fOr-/supervis0r
“4
(c)
1
1
—
b/3%A
UF15s
U37
....
IF EMFLOYES
ASX OR RSCORII
-ger
do
.........
more ...
in the
3
1
22
23
2
public sector, mat is a
nationalised industry, a @lie
corpxation
gowrnment
or central or local
(or the armed forces)?
Yes, pblic
9act0r
.. ..
ld3sc
2
:: Z::=iii:
W39.
3
IF SSLF-EHPIJXED
Cees/did
S~SE
employ other people?
Yes PROBE: 1-24 .. ... ..
.-
25 or more .,
kJ39
No employees .........!
.
>.
)
1
186
)
1
2
3
7
—
45
IF SPOUSE IS CUP.NEN’fLY
W3~ING
AS E?EIOYSE
W44
24
- Section
M
‘m’
E?iIt “=’”’
x
earn
in his/her job
W40. How much does . . . . . . usually
before any compulsory deductions for Income T= #
National
InSUI~Ce,
● tC?
Superannuation,
W40BK
‘\,
\-
-W41 27
~f;::;. :...
&-...
- Section
x
W&
Cal Em
long a Pried dms this rover?
Wjbi
weak ........
Cal rnnth ...
L
Year ........
35
(SPECIFY)...
other
W41. How much dces ...... usually earn In his/her
job ~
all coq.lsory deductions?
..........
#
Refused .....
Section
} x
#
5
c
Week ........
(A) Sbw lcmg a period does this cover?
yk;:~
40
Cal month ...
W+\
h
Year
W419
1.135
........
1
J
Other (SPE~FY). . . . . .
.01W
IF PAR~R
)-(a)36-42
NET EASNINGS
w+]
02
fltv”
IS CURRE~Y
su4PL
000C
y.”
43
2
SXLF—EIQL4JYSD
rnA: Nst working ....]
- Section
x
w42. BOW much money does ...... earn fran hi.sfier
business each week before paying any Income
Tax or National Insurance but after deducttig
exnenses?
W4ZDK
ld42&
W43 .
‘ff;;;.
:::::
GRCSS
NSSU.YEARNIN= ‘7
money does ...... earn from his/her
each- week after deductng expenses
and paying any Income Tax or National
HOW much
bus~ness
Insurance?
No
..........
lU4J
Refused .....
w 42PK
50
I.-443
ti43
,-
Od.DKccti
NET NIHZKLYEARNINGS‘(
37
46
ii)!)
Section
%x
;
SZ-58
187
48
x.
IKa4E
xl.
1‘d like to ask now abnut any state banefits ynu
be receiving.
- mew
At present are yo” (and yUUI SPUJSE) m~
● tite benefits?
CeM
~
COM
*U*
sSCx#cARDxl
(and your SPC4EE)
M
~g
❑ay
*T*-
39
i-a-s M
ro~
4-2=
3-7. ~uo
cOU
3.7 . *WO
3?
I
.
Asx TT3sEEor+DERBcas
,.
.
.
1.
Child benefit .................
XIQJ. .
s
2.
One-parent benefit ...........xffl%
If
3.
Fam41y 2nc0m3 Suppl-t
4.
NI Retiremt
,
....%/a$. ”@
Brnsion or Old
x@4 ‘-
“:’ - ‘=’
Age Pension ..................
)
5.
6.
7.
+’@
%5’%%RR:.:w%!w-
&
Sickness benefit ..........X4W.
(NOT ENPIKJYss”
S STATWIURY SICR PAY)
NI
Uneqloyment
benefit
. . . . . . . ..4t17
132
lx
EM W7=6
)
11.
benefit’ ‘“’ion 0’ flon
.........-...........
. ... E
severe D=sableme.t Allowance
(or WCIP or SNCIP)
.X[
,
0 ~~
:-f
‘
.-
-6/
Industrial Injuy Diaablemnt
benefit .....................XLv
War Disable-nt
m
1
2
:
~;~
10.
8
1 w
8.
9.
33-37
7
..>m
Pension .....
*.31
12.
A~~~&c,
13.
Attendance A21GV8DC
14.
Nobility Allowance ...........
15.
Invalid Care Allowance .......W5.
16.
,
Widow’s pension or allmce
ox
other widow’s benefit ...... ..xlJ&
17.
Anyother
(Sk3FY)
~lm
state
EXCEPT
benefit
M-$
or allowance
‘Wsm’‘-fhY-
INCLUDE ‘CONS~
UNDER 10 OR 11
bml!=$’-”
188
receives Attendance Allowance, spouse receives
Invalid Care Allowance ................................. ...
Subject
-SEE X5
%2
Subject receives Attendance A31c+wince,spouse does not
receive ICA ............................................ ...
- x4
Subject does not receive Attendarra Allcuance .......... ...
x3.
bs
Anyone receive Invalid Care Allowance
for looking after you?
- (a)
q
Sss x5
}
.
(a)
.
Who receive~ the Invaifi tie- Allowance?
x
34
10-11
- SEE x5
IF IN E’HOLD GIVE PERSU4 ~. FR@4 E’EOLD SOX _
IF )OT IN ECXX3SHOLD SPSC~
RELATICt4SHIP TO SUSJSC3’
N4=q9
m
. ..”-..
. . .. . . .. . . .. . . . . .. . . . .. . .
x4.
Had yuu heard of Attendance Allowance
before I showed you the card?
x5.
IF SUBJECT DOES NOT ~IVS
DNA:
MSILITY
Receives
MLONANCE
Nobility Allowance ....... x
Had you heard of Nohlfty A310wance
before I showed ydu the card?
-----
3
A
- X6
i3
\
2
X6.
WAR
lF ~DISABLEWP2?T
‘E~ms=&%
%“%I~AT
~A!
What percentage
your ndustr~al
pension?
assess-nt
mjurirs
XI) X 6 DPJ~
-x7
No Ind. Inj. or Wax Ois. Pension
]
4
have you got for
benefit/war disablement
001,/00
4!
Q
48
9
1s-17
Ig
F
x7.
r,
.
Eave you ●ver amked for ●dvice about whether
you m~ght be entitled to any racial security
benefits for disabled ~ple?
Yes
WI jm
X7
(a) Who did you ●sk for advice?
0sss
‘.
Offica
. . . . . . . . . .
Citizens mice
.
.
-E
.
..
Buxea”
.S.xialservices/sccial
~
w.rker ...............
19AT APPLY
voluntary organi=tion
tiu~
X74*I
x 7ML
nm=k
‘
DOctar . . . . . . . . . . . . . . .
J7A’M3
Post office ..........
X#ll&
Job ~tra
...........
?riend/relative..
.....
‘)
> 7AW
X8. If you needed advi-Pie
*O
Wuld
Other (.5PSC2PY)
.......
about benefits
tM/DK
for disabled
YOU ask?
DHSS office
...... ....
Citizen *s Advice Burea,
CIXtf
ALL
~~
APPLY
social services/sOcial
wrker
...............
Voluutary
%f7M I
A ?M%
rector...............
‘#iJi
>rffs
Post Office
J&centre
..........
...........
Friand/relative
)ml 6
)
organisation
Othru
. .....
(SPECIFY) ......
#l@/m
x9.
disabled
pople.
Is it:
very easy
.
-
How easy do you think it is to get adequate
infomtion
about social security benefits for
............
fairlyeasy ...........
.
fairly difficult . ....
X7
or very difficult
,
.-
. ...
1
1
2
3
+4
4
5
IQ(
—. .-. -----
03
. ..
~GtiQ)
-——
38
.
.
X1O. Apart
from
the &ncomc you have already
told
u.e abeut,
& you (or your
partner] receive any lncoue from any of tne sources shown on this card?
SHCW CARD
x 10
PROMPT SACH ITsM
191
rD2
50
.
>
M
t
hJa
—
-/
)
-
Nn
--
)(sq~
Y.sfa-J
%
s ASK
-33
xl,
.=
REcoe.
19-GO.
FRC+4 (I)
XIIDMA
SOWOne
o“tsxde
yow
~-%7
DNA: No tic-
hO”~ehO~d .
Who
frm
(1) .......
;
m 14L~o@
.
~%.
/’
W&x
=+
do you receive
70
Nhat a.. these
%IIMI
Parent (-ti-law) ............
XIIM
Son/daughter (-h-law)
a
)ul~3
lgznmx
pa~~t=
=4
Friend ......................
for?
xll AP12
XII
Pt3
%11J FIL
..----
Other relatlve ..............
XIIAMI
flULliCVD@
‘~
u
D
?UP!4
(a)
Q
fr~
these payments from?
L#
ox
~egulax payments from
fr~ends or relatlves outside the househol~
YQU mentioned that you receive regular pa~nts
Lo
“
tin
1
2
3
4
36-37
X12. M
sew
~U
(and you? SPOUSE) Em’Iage
mmey at the ur.ment?
to
x
Xl 3.
Y*m
tz
un /NO
[
you hAve any money put by n savings,
for example in a bank, a building society
or in Post Office Savings?
44
1
2
00
c
1
-(a)w
2
-X14
—
(a) At present, do your savings (and YOU
S PoUSE’S) tom? to .....
%134
r
Yes
1
Nfl/t
rc
under EICO ................ -1
EICO but legs tlmn Em
RUNNING
PAOxP-r
..
2
E500 but less t&oI E3,~,
or mere?
or f3, ~
N*
P
3
. . . .. . .
w
4
5
.. . . . . . . .
Refused .....
6
L
I
x14.
last year did you have
any money put by M savings?
This
tme
x 1+
v
-SEE X15
SSCIION X
2
L
‘“.
1’‘s (cd’ 1,
“
m
“3
m
“4
)(15 D~~
DNA : No (&.& 2) ~
k%
-Slw’rfm Y
08
Compared with this tune last yeax,
have you got:
X15
.. . .. .. . . . . . . . . .. . .
1
less ...................
;
or aIsautthe same awunt
of money in ~~ti~?
...
A
:
mre
[
49
SECI’IU4Y
1
L-
193
Iof+
52
r
Y.
KSJSESOUI ?INAtA31S
71
Il?l’’ERVISW’ER
CNECK~PAQ!
O?~~ANDCCCZ:
DN2T
SUSJSCT IS A ~~~~
IN A SIXLE ESWIT
(~
1 ●t (b) an frnnt page) ........................
s~
IS A sCQSSNDIJJSR IN A MULTI -~T
...........Y.[ ......
(tied 2 at (b)(i) on front ~gm)
~
IS A lKR+~=
de.....
A&
:%&%&’:’(j$Le-$y+.”..”...”.”..”
(a) Em IS SUBJECT’S:
paraat
(-in-law) ..........
son/daughter (-b-law) ....
YM
othar relative ...........
“.
c narrelatiwe
.)
IF SUS.TSCT IS
Y2 .
Do you
.............
‘~t3&4&yl
A NON-SOUSSSOLDEN
&lSJSCT
AND SPOUSiJ tie ● regular
contribution
to ~OiJ tcwarda, rent, h0W~~Pfi9
or your ahara of any other bille?
Ye!
No
Y2
(a)
EOW
How long a period does that cover?
Week ...............
~a~
Ca3mnth
..........
What
does thLs payment
CODE
~mnO
r3
ALL
TSAT APPLY
-r?
~f’1
r ~
... ...
I
rood
.. .... ... .. ... .
2
nel
bills
Vac Iq 3
Yac~ 4
rin.t.4
1(
(SPECIPY) ....<
Rent/mr.rtgage
-)
~
(b) 1/-s
~~
Other
(c)
[a)-(c)
much do you pay [HOE] altogether?
yti
(b)
yzs
other
17”a0
..... .. ..
(SPBX?Y)
Sc
.
,
,.
Y3 .
baa
(HOE) provide anything for ycu that
you don’ t pay for or only pay for in prt?
Y(
y3
J.
(a)
what does (HOE) provide?
Sverythhg
Houai.ng
CODE ALL
TSAT APPLY
fiUL~COL@
Mqm . 4
194
.........
21
—.—
22-S
............
rood ...............
yaAMl
‘a)
Y25
Y25
Ihlnl...............
YSAIM2
Y3At13
73APA
other (SPBXFY) ....
t_
.— (
/05
53
aamm
s-floqq-
I-2.42
CSG
kQ
~OUSEHOLEER
Coti
IN A MULTI-LMIT
3-7:
[C*
sc~
o
2 at Yl)
m
CID3CXHUJSHIOID ‘OX FOR DETAILS OF O’lliER
ADULTS (AG? 16+) IN HOUSEE201D
Y4 .
%9
b
FOR
ANo
AND
‘%%:Em%-Rl%%.&I%02H5Y4
rG3K AEOW
FXHAOULT IN TURN:
2
10
)-
ao
4
-
Does (ADULT) make a regular Contribu-
(a)
tion to you (and your partner)
towards rent,
other bills?
or any
‘*
w
(b)
L
Yem
Pensw)
/No
gOW much does (AOULT) PaY yOU
BOW long a period
(c)
does
(
1 - (b)
1 -(b;
1 - (b)
-Y5
2 -Y5
2 -Y5
2 -Y5
Ep
Ep
Ep
,116
x
+;
I
G...
. ..yl+
I
I
1
1
1
5
175
5
5
3
3
3
3
..
1
1
Food ...........
2
2
Fuel
...........
3
3
(SPECIFY) .
4
4
1.
1
1
2
2
2
week
that cover?
- (b)
P
Y@
&w%~
altogether?
II
(KIJ
‘
I Rem
(-r-l+
%R
housekeeping
Cal month
Other
l-r
......
(SPEaFY) .
do N*
o
t
(d)
-.
What
does
cover ?
I
payment
Rent/mortgage
Y4DMI
I+f)tj2
Y4DM3
m LU-UC.2D
@
t
ths
Mnx =4.
Other
Y+M+
Y5 -
~
s
YOU (SUHJECT/SFOUSE) PROVIDE
FOR (&LT) TiAT RE/SHE
00ESli2PAY FOR OR ONLY PAYS FOR
IN PART?
YS
ANYTHING
(a)
Yes
Ala fi
Nhat do you provide?
Y54M 1
1
11
. . . . . . .
2
2
Food
. . . . . . . . . .
3
3
Fue 1
. . . . . . .. . . .
4
4
P)mx =4
E No rzecoan
5
5
Housing
ys)lrlz
YslV’13
y5Nl
+
Other
k2
ASK ALL HOUSEHClllERS (HCS3OR SPOUSE)
Y6 .
EO YOU (SUWHCT/SFOUSE )
own or rent this
Cwns
(SPECIPY)
Commu.e
Rents
y6
-
local
.
. . . .
. . . . .
. . . . . . . . . . .. . . . . . . . . . . .
authority/new
town
- hous~ng assoclatmn
-
I
ttC@Co ~i
- with wrtgage/10an
- outright
house/f l.st?
:
. . . .
Everythuq
mU1-73’CZ)DO
0
pr~vately
. . . . . .
...........
unfurmshed .. ......
- pr lvate ly furmshed ...... ....
- other w~th payment ..... ... ..
Rent free .............
......... ....
!/
1
Y7
.
2
Y18
3
4
26
Y12
:q
1
8Ma
195
/06
Y18
-.
‘lWALL WITH KWIYGAGE OR IX)N4 (Ceded 1 at Y6)
Y7 .
00 the mrtgage
or loan payments for this
household cover:
EXCLUDE
both
INPROVEWENT
mms
original
c1
the
Interest
Y7
and part of the
loan ......................
or interest only? ....... ..........
IF IUIEM.ST CNLY
Ye.
19 there an endowment policy through which
the loan will be paid eventually?
IF NO SPECIFY EW
,
.......................................
Y9 . How much was pm
martgage
or l&
NOKIGAGE
wILL
BE PAID
last instahe.nt on the
titerest?
No
Mh
Yll
2
Y8
1
28
smzammm
so‘mYll
Ys’
Y&s
:-
‘1
o
27
lNq
2
Nn /lTo
0
Y9
M
s
“’4
INSURANCE OR MOPSXAGE PR~ION
.
cODE ANCQW1’ AFTER ANY PAYKHNT BY 14XAL AI?lS30RIlY/bESS
EXCLUDE
(a)
How long a period does this cover?
Calendar month
yq~
~NAf7q=##A
Other (SPSCIPY)
.. . .... .. . .. . . .
Y1o. How much was your last%
on the endrxment policy?
stalment
tio A/n s
ylo
(a)
Em
long a
period
&
(a) 3S-39
does this cover?
Calendar month
Nu~9
‘->
AnaJur
Y/Ofl
YIO z DNA
other
(SP5XPY)
Y,,
40
...............
IF PAYS IW1’ESXST AND ORIGINAL LOAN
.
Yll. How much was YOUI last irmtalm?nt
on the mrtgage
or loan?
.
AFll?R ANY PAYKENT BY UCAL AvITIOFUTY/M.SS.
EXCLIJU3 INSURAN~ OR MRTGAQ3
PRO’lECTICN.
/’
(a)
rd.U*
How long a pericd does this cover?
Calendar nwnth
yllll
Other (SPBCIPY)
I
!
(
I
,1
/07
IF PA% 17SNT (Coded 3-1 at Y6)
Y12 . some people qualify for what Used to bs called
a rent or rate rsbete or a rent allowance.
These are now part of housing benefit.
tie you (or your psrtner) recelvmg housing
benefit from your local authority or local
DHSS Office?
L
Yes
1
2
(a)
May I lust check, does the local authority
or local DESS Office pay any pdrt of your
rent or rates?
1
Yi24
2
0
Y13. Is all your rent and rates pa~d for by your
local authority or local DESS office?
Yes
Y13
Nfl
(a) mes
/No
the payment for rent and rates
o
47
1
.
2
- Y14
(a)
v
cover anything else such as llghting,
heating or any other service (eg wsrden) ?
- (i)
so
- Y20
(i)
What does It cover?
r’qqx=+
)’f3/l
ml
y;
Heating
;;:
Other
sl.s~
............
Lighting
Y20
... .. .. ... ..
(SPD211V) ....
Ylrnl MA
Y14 . (Apart from any rent o; rebate/rent allowrmce/
housing benefit) , is anyone e1se pay ng anythng
towards your rent or rates?
}
Ye s
Y/k
Me )No
~
(a)
*O is psying somethmg
rent or rates?
1
-
2
L Y15
(a)
o
towards your
IF IN EIUISSHOLD GIVE PSRSON NO
Y 14
~Ml
IF NCITIN
Yl@-Ja
....
HwSSSOIJI
. .. . . . .
SPSCIFY:
W/w. ?..
.7
(b) How much are they payng?
Y145
(i)
HOW
long
q’NA
fi~n
y[40
=v~f$
a per~od
does
AMUN
this cover~
y/4$t
week ...............
Calendar month
Other
.....
(SPECIFY) ....
o
1-1
5
3
SS
‘>”
mm~~
deauem
02
Qcccqp
41
cocoY15. H- much do you (and your partner) psy in
rent (after deducting any rent rebate/
I-a*
3-7
(&l
a WJW.m
allcwance/housingbenefit/paymantby otherm)?
Ep
y/5
(a)
Nan/r
I
D
g-12
7’
(a)
Bow long a psricd does this COVer?
, ~eek
yjsh
..............
~~ufi
l-l
Calendar rmnth ......
13
5
Other (SPSCI!W .....
3
c
,.
Y16. -s
the rent you mant ioned ticlude any
senices such es lighting, heating, hot
water, TV licence, cleaning, (lift),
services (eg
(gsrdsner) or any other
warden) ?
1“
,.
Yl&b
I
c
yes
/’
M4 ) NO
,.
(a)
IF YSS m
DHm
OF ~
, .-,
il.i t
t~’ I
USE
--
/+
....
. ..=r.
cal
mnth
Other
(SPSCIFY)
1
Y],
rent ticlude rates or
do you pay for ratss separately?
I / <:,
y17
Included in rent .~n
(a)
Y17
~
1< *
YL7. Does you
N3T WATER OR S~GE
‘a)
2
ANo PSRIOD
OFF 13%*
TYPE OF S5snc
0
1
RAIES
3<
.....
1
Y20
Pays rates separately .....
2
(a) -
/
I
@
(b)
Bow often do you pay rates?
Once ayeu
y17#l
Twice
Ten
timss
Other
...............
a year
.. .. .... ......
a year
(SPECI~)
No
.. ... .....
. ..... .....
titis
()
1
2
37
3
‘i
4*
(b)
ROW much was Your last rates
r=-nt
(after
my rate rdatehousng
benefit) ?
ED
Y176
-
ANOUNT
NIL
‘m
z
s y
O@
o
9
/0$7
57
,
I
TO C#tiSR CCCIJPISRSM
Y18.
?FES (co&-
1-2 or 8 at Y6)
you receiving a rate rabate or housing
benefit from your lmcal autlmrity or
local DESS office?
Are
Yes
Y/$
(a)
00
you
general rates
pay
on
’19 4q
td~ }No
(a)
this
hmuse/f lit?
NUT
NA’IZR
OR S13NEIIAGSRATSS
Yes
Ywft
~~
j NO
Y19. Bow often do you pay rates?
a year . . . . . . . . . . .
Once
a year
Twice
Y17
Temtimes
Other
a
. . . . . . . . . .
(Smxn)
How much was your last
payment
rafter any rate
rateg
(-
. . . . . . .
tins
do
(a)
46
......
year
Ylq+l
rebatel
housing benefit) ?
+7-51
~(
S2
ASK
ALL
EOUSSEOLDSRS
Y20. DO you pay water
and
sewerage
rates?
-.
(a)
How often do you
sewerage
pay
water and
1
Yes
yzlo
w #J
2
Y21
53
~
(
y20fi
rate.?
. ....... . ..
1
... ... .. ..
2
times a year ......
3
Once
ayea.r
Twice
Tan
other
a year
(SPSCIFY)
46
. . . . . . .
q.NB@
[ ‘1
E
Q’yzbe.
(b)
(a)-(b)
Ecu much was your last pay-rent
for water and stewera~ rates?
7206
(
~la
199
/10
,.
What types of fual &
for heating, cooking,
●ither in winter
hot Uatar
Nai.ns gas
I
elsa,
(incl oil filled
radiators)
.. .. .
...... ........ .. ... .. ...... .. .... ..
(’)1
2
s-l{
~AT
Solid
APPLY
fuel
(c-l,
coke, wood)
. ......... ... ..
?ual oil ....................................
~21f4/
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pa.rafflrl
yaif’$2
Yalr13
y2 IM4
.
or anythkg
or ~r?
Electricity
OXS? ALL
I
you usc in ycur base/flat
Settled g.es/calor gas .... .. .. ......... ... ...
Y25
ia
4
5
6
v
2.
Y22.
IPUSF5ANY
FUEMCODED
3-6
Electricity/mhs
m:
gas mly
.... x ----
Y23
FDR?LACSFUSL ASK:
(a) Row mch have yaI apnt
on
~J
in the past year?
D
3db&5
solid
fuel
E
DK . . .
Fuel
oil
la- m
Row
ti+!
+-%
U
Bs
Ttifi/PK
Y23 .
E
Bottled
gas
Paraffin
WZJK
y-tc
Y-
do ycu pay for your electricity?
1>
No electricity
.......................
ACC~t
yz3
.. .. .
Slot meter ....................
Beard budgettig schcmdstandimg
order/vouchers
. ........... ... .
(a) Abat
bow -ch
the past year
Uisspaysdlrect
..............
Included
........ ... .. .
tive ycm spent
on electricity?
In rent
h
was y-
1
2
3
‘a) %
4
5
Alexm?r
*
un/m
last payment
$
.
?J
29-31
SES Y24
W&
E
for electric ity?
yzss
~
(c) BOW lcng a period did that cover?
fpartcr .......... .. .
Week ...........
yzx
IF DK ‘TOLAST PAYWZNT
SPECIFY
AIKXINT, PSRIOD AND OATS OF ANY
Y.NW
PA~
IN PAST YSAR
other
(SP~IFY ) ... ..
Nfijm
d,
....... .... ... ..
200
59
-
)
(c) 33“
35
6
1
36
3
‘
OATS
sin?, Y24
6
E
YZ34
y23nDK
(b) How wch
SSS Y24
1
~
~bK
/1
-i
cod
TJld UL
Y24.
SQUG
AJcc
IF USES MAINS CM
03
4)
k6cmD
(Cede 2 at Y21)
CBJA: No -iJIS
do you pay for YOU
gas
>
Y25
y z+
gas~
Slot
2
.. .. ... . .. ... ... . .. .
Account
meter
... .. . ... .... . . .. ..
Beard budgeting echemd
standing orderlvouchere
(a)
lli
. .. .
3
.....
4
LXLSSpays direct .............
5
Included in rent .............
6
37
- (a)
- Y25
E
how much have you spent h
the past year on gas?
About
yaf@
3%-40
~
Y25
(b)-(c) 41.
(b) EOW much was your last paymant
for gas7’
Y+
(.)42-44
~
\/r
(c) How long a period did that cover?
IF DKTOIJ4STP AYNENTSPECIH
Y*
n.:::::
AMOUNT, PENIOD AND DATE OF ANY
IWXiN PAYMENT IN PAST YEAS
tier
(SPSCIFY)
rJfl
/
LX
DATS ................... ....
ASK
ALL
Y25. Some people with a health problem or dieabil ity spend less
on fuel than other people because they are confined to one
room end only have to heat that one; others spend more
because they ere indoore mre or need to keep werm=r or
need to use more hot water.
)-
Doee your health problem/disability mean that you need
to use more. less or abmt the same amount of gas,
electricity” and other fuels as you would if you didn’t
have a probleddisebil ity?
More
yzs
.. . ... .. .. . ....
(a)
Less ...............
Akut
the-
. .. ..
-Y26‘k
(a) About
how nmch extra do you think you
have spent in the past year on fuel
because of your health problem/disability?
Y2S
A
MnJNT
Oe
k3ADK
Y26.
‘rhinkinq back ti lest winter, did You
ever ha;
to go cold because you CCIUldn~t afford fuel for heating?
50
Yej
N ~1 NO
Yuw
Qualified answer (SPE”&~
Yurlz
yfuM3
‘0
Sc
s~51
-53
201
(12
,. i
~7NL&
+~
Y27. 1‘va
0“?” ~D
●sked you mt
already
‘~j
_
of
tha
mtra
●xpanses
health probleddixability.
Does your haalth prcbl~dixxbility man that you spxnd
artm on xnything ●lBe Nch ● s the tbi.nqaon this card
or anything else you havmn’t yet mxntionod?
you mxy hxve
S6W m
1
bxcauxx
of
ycur
Y*S
Y27
1
m
---Y28.
there
any of the things on the list or anything else
that Yhaven-t yet mentioned that you need to xpend
extra on because of your health problem/disability
but
can’ t afford to?
Are
]
yatt
“4
I
L,
1
Yes
un/Nu
(a)mYEEEWrERmm.FR~
AND DESCRIBE:
0 2
(a) 55
r29
~
Item No.+
D
Ya8mt%
Description:
—-
---
,i.
ilul-~
CARD Y27
Phone
Pay]ng
for chlldcarc
Paying
for decorating,
gardemng,
u~J(=Jo
1
03
furniture
04
or furnishings
or buying
56-75
repairs,
etc
Rep8iring/rcplaclng
Payl”g
I
01
02
calls
presents
oeoc.le uho slt ulth
~ak~ YOU out
A“yth~ng else (PLEAS[
for
You or
05
OESCRIB[)
06
1
,’
2(-2
J
=@
SbQU&FIC&
03
kl
RE=O
61
COLS 79-s0
=03
1/3
/
Y29. I*ve baan ●sking you ● lot abmt any ●xtra rests you hava,
but paople with health problea8/disabilities-tines
~wnd
1.SW than other people on sme thj.n9S.For axqla ,
_
XPle
spend less on going out.
Are thre any thingn you spend lese on because of
health probleddisabil ity?
ymr
a’
(a) IF YES DEFCRISE BELC4i.
1
(a)
2
Section Z
OF?
USE
g
I
2
51-
‘J1 -
‘?-28
(
Xlt
ftWXQ?D 41
EW
@u
7*-W=
04
203
/lfj
62
--
—
-—.
.
.
.
--
Z1 . Thinking about how you are managing on your
money at the _nt,
wculd you nay you
wmagimg
RtNNING
quits
well .....
just getting by .........
PRoNPr
/
.
1
2,
2
3
3
ZJ
. werey.:~
REPEAT PRCUQrS AND ~
AT (a)
Z2 . During the pest 12 months have you ever:
End
i)
11)
iii)
lV)
Are
to
use
any
mney
that
you
had
s
in
savings?
NO,
Q
1
241
... . .. .
10
Had to borrow mney fr.m anyone to pay for some big
expense9? ... ..............................Z*Z.
11
Bad to borrow mney from anyone when you were short,
ju9tt0make
end.9meet?.-..
. .............~Z3.
..
12
Fallen behind wLth you
other regular pa~nts?
/3
rent,mortgage ox any
.....................Z*...
you behind
with any payments
at present?
Z3
Yea
~
~No
(a) About how much are yca behind with
at present?
z 34
Under E50 .................
N
/(f
*
Had a big bill that YOU Couldn”t pay on time?.........
v)
Z3 .
4
8
Md thfiing about this time last year,
how were you managtig on your money
.
1
4
hl!l.
t
(al
YEAR
*
or getting into
difficulties? ..........
Other (SP~~)
)LM’f
u
Now
● re:
o
1
(a)
2
Z4
15
E50, but under E200 .......
E200, tut under f1,000 ....
El,000 or uore ............
0
Z4. Thinkhg
about this time lest year, were
you behind with any payu.mts then?
1
2
Z5. IF YZS (Code 1) AT Z3 and 24
OwA:
NO (C@ie
2)
at
23
. ..X
Was the amount you were behind with
tme last year ...
mre
RUWNIWG
PROMPT
204
. ........ ... ... .
less .................
or about the same
as at present?
----,
“see ‘5 17
. Z6
,-
ioq
\
@3xztD
hlux
44.
things paople can buy and & - their hcnmi.ng
26. ‘l’he
leinxa activities, etc - make up
furniture, focal,
their standard of living. HOW aatinfi~ & Y~
feel with your standard of living at present?
you
Cm
choose
an answer
frm
this
card.
=2
Very satisfied .............
SEW CAUD 26
Fairly
~tiSf iti
. ....... ...
Neither satisfied nor
dimaatinf led ..... ....... ...
Fairly
Very
..... ...
disaatiafied
dissatisfied
.. ...... ..
DK/no OpbiOni.~fi .........-
27.
1
!
2
3
4
5
Can you lwk at the things listed on this card and
tell me which YUU have and which you do not have
in your hcuaehold?
SEou CARD 27
CODE IN F2Rs’fcoI.XIn4
mR ANY ITEH CODED 2 (DOeS not have) ASK:
because you & not
(a) DO You not have (I’f!?l’1)
wan; or need one, or because you can’t afford it?
CODE
IN S=~
COL~
.
Grvs
PRIORITY
TO
CODE 1 (~es nOt want).
(a)
I
1.
A colour television -..=fi!.....-m..
2.
A
3.
A
4.
A
5.
A
6.
A
7.
A
8.
A
9.
c
Has
have
IF SM A FRIExSE/F’REEZEA CODE 1 AT 2 AND 3
IF NAS A lUMBLE DRIER INCLUDED IN HASRING MACSINE
CODE 1 AT 4 AND 5.
a
DK/f4
not
I want
afford
m-l”
205
/k
CtmKmrms’fcnluw
AIXXIICAADZ8
-
MY
1=
CCOEO 2 (Does not heve) MXI
(a) DO YCQ not have (~)
bemuse YOU * mt
it?
went it/them or bocnuee you cm’ t afford
CmEm
SP#CQmcoIJJm.
GIVZPAI~
~ -~
(-S =’ -t)
i
I
“s
.. .
“t
e
mas
1.
not
have
1want
P
Can’t
UC/ *
afford
CRA
z%
I
.................
AcOOkedmale~&y
,“
neat or fieh ●very other &y
,:....
3::
—.
.
A rOMt
meat joint (Or iti mVdeOt)
once aveek
.. .. ..... ..... ..
4.
Awa.rm
5.
TWO peirs
6.
New, not .semnd handclothes when ycw
need them ....................zeR$
....
winter
of
coat
. ..... ...
all weather
.
sho
7.
Presents for friends or family once
ayeer .......................
8.
Celebration on special occesions
euch ae Chrbtmas
IPSuBJEmeAscEILrmm
mDER
16:
ZW++DM$)
DNA: m children
undrr16 .....
k.
.>,.
Toys end leieure equi~t
. a
Q.,
.4
for
z~n9
chil&en.......................
.. ...
10.
Money for school tripe and 0ut*c7X?!
,.
1/7
206
65
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---
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‘.
*
I
N
.
m
.
.
.
.
.
+---U.
,,
.
.
---
‘-
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k.
.
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,,
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.
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j
.
.
.
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1
‘1
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