Opportunities to Improve Survey Measures of Late-Life Disability: Part I - Workshop Overview. APPENDIX A: Additional Tables

09/27/2006

TABLE A-1. Measures of Activities of Daily Living in Select National Surveys
Survey Question Activities
American Community Survey (ACS); 1999 and later Does this person have any of the following long-lasting conditions: A condition that substantially limits one or more basic physical activities such as walking, climbing stairs, reaching, lifting, or carrying? Not applicable.
Because of a physical, mental, or emotional condition lasting six months or more, does this person have any difficulty in doing any of the following activities (fill in activity). Dressing, bathing, or getting around inside the home
Health and Retirement Study (HRS); 1995 and later Respondents who report one or more functional limitations are asked: Because of a health or memory problem, do you have any difficulty (fill in activity)?

For transferring and walking (all respondents asked regardless of difficulty): Do you ever use equipment or devices such as a cane, walker or railing when (walking/ transferring)?

Respondents who report difficulty: Does anyone ever help you (fill in activity)?
Bathing or showing
Dressing including putting on socks and shoes
Eating such as cutting up your food
Getting in or out of bed
Using the toilet including getting up and down
Walking across a room
Medicare Current Beneficiary Survey (MCBS); 1992 and later (Community sample) Now I’ll ask about some other everyday activities. I’d like to know whether (you have/sampled person has) any difficulty doing each one by (yourself/himself/herself) and without special equipment. Because of a health or physical problem, do you have any difficulty (fill in activity)?

   If doesn’t do activity: Is this because of a health or physical problem?

For those who report difficulty, ask: You said (your/sampled person’s) health makes (fill in activity) difficult. You said that (fill in activity) is something (you don’t/sampled person doesn’t do) do. (Do you/Does sampled person) receive help from another person with (fill in activity)?

If respondent does not receive help ask: Does someone usually stay nearby just in case (you need/ sampled person needs) help with (fill in activity). That is, does someone usually stay or come into the room to check on (you/him/her)?

For those who report difficulty, ask: (Do you/Does sampled person) use special equipment or aids to help (you/him/her) with (fill in activity)?
Bathing or showering
Dressing
Eating
Getting in or out of bed or chairs
Using the toilet
Walking
Medical Expenditure Panel Survey (MEPS); 1996/ 1997 and later Household Component Survey
Does anyone in the family receive help or supervision with personal care such as bathing, dressing, or getting around the house?
Not applicable
Long-Term Care Supplement
We have some questions about everyday activities such as bathing and eating. We are interested in the kinds of help people receive, not just hands-on help but instructing or prompting or being there just in case help is needed. Because of an impairment or physical or mental health problem, did (reference person) receive help (fill in activity) in the past month?

If received help: Look at this card and tell me which types of help (reference person) received. (1. Hands-on; 2. Instruction or prompting; 3. Staying in room in case help is needed.)
Bathing or showering (including getting to the bath or shower and turning on the water)
Dressing (that is getting clothes and putting them on)
Getting to the toilet or using the toilet
Getting out of bed or chair
Eating (not including meal preparation)
National Health and Nutrition Examination Survey (NHANES); 1999-2000 The next questions ask about difficulties (you/sampled person) may have doing certain activities because of a health problem. By health problem we mean any long-term physical, mental or emotional problem or illness (not including pregnancy). By (yourself/himself/herself) and without using any special equipment, how much difficulty (do you/does sampled person) have (fill in activity). (1. No difficulty; 2. Some difficulty; 3. Much difficulty; 4. Unable to do.) Walking ¼ mile
Walking from one room to another on same level
Getting in or out of bed
Eating, like holding a fork, cutting food or drinking from a glass
Dressing (yourself/himself/ herself) including tying shoes, working zippers and doing buttons
National Health Interview Survey (NHIS); 1997 and later1 Because of a physical, mental, or emotional problem, (do you/does anyone in the family) need the help of other persons with personal care needs, such as eating, bathing, dressing, or getting around inside this home? Who is this? (Anyone else?) (If yes, ask for each person identified: (Do you/Does reference person) need the help of other persons with (fill in activity)?) Bathing or showering
Dressing
Eating
Getting in or out of bed or chair
Using the toilet, including getting to the toilet
Getting around inside the home
National Long Term Care Survey (NLTCS); 1982 and later (Community sample) Screener
I’d like to ask about (sampled person’s) ability to do everyday activities without help. By help I mean either the help of a person, including people who live with (sampled person), or the help of equipment. Does (sampled person) have any problem (fill in activity) without help?

You said that (sampled person) has a problem (Read ADLs marked “Yes”). Have you had (this problem/any of these problems) for three months or longer? If no: Do you expect that (this problem/any of these problems) will last for the next three months or longer? If no: Altogether, from beginning to end, will (this problem/any of these problems) have lasted three months as longer?
Eating
Getting in and out of bed
Getting in and out of chair
Walking around inside
Going outside
Dressing Bathing
Getting to the bathroom or using the toilet
Controlling bowel movements or urination or ever having accidents
Main Questionnaire (Asked to those who reported an ADL and IADL problem that lasted longer than three months in the screener.)
During the past week (since last (day)), did any person help (sampled person) (fill in activity) or did (sampled person) not (fill in activity)?

Did (sampled person) use special equipment like (name special equipment) to (fill in activity)?

Did someone usually stay nearby just in case (sampled person) might need help?

About how long has (sampled person) had help or used (special equipment)/been unable to (fill in activity)?

If no help received: Does (sampled person) need help with (fill in activity)?
Bathe
Dress, that is getting and putting clothes on
Eat
Get in and out of bed
Get to the bathroom or use the toilet
Get around inside
Survey of Income and Program Participation (SIPP); 1991 and later Because of a physical or mental health condition, does (reference person) have difficulty doing any of the following by him/herself (exclude the effects of temporary conditions)? Exclude the effects of temporary conditions--If an aid is used, ask whether the person has difficulty even when using the aid.

If difficulty with activity is reported in difficulty question, respondents are asked: Does (reference person) need the help of another person with (fill in activity)? Mark yes if person sometimes or usually needs help.
Getting around inside
Going outside home
Getting in/out of bed/chair
Taking a bath or shower
Dressing
Walking
Eating
Using or getting to the toilet
Supplement on Aging (SOA); 1995 These questions are about some other activities and how well you are able to do them by yourself and without using special equipment.

Because of a health or physical problem, do you have ANY difficulty (fill in activity)?

   Ask if doesn’t do: Is this because of a health or physical problem? If yes, mark box 1; if no, mark box 3.

By yourself and without using special equipment, how much difficulty do you have (fill in activity), some, a lot, or are you unable to do it?

Do you use any special equipment or aids in (fill in activity)?

Do you receive help from another person in (fill in activity)? Is this hands-on help?

How often do you have hands-on help with (fill in activity)? Would you say always, sometimes, or rarely?

Do you need (more) hands-on help with (fill in activity)?
Bathing or showering
Dressing
Eating
Getting in or out of bed or chairs
Using the toilet, including getting to the toilet
Walking
Getting outside
  1. The NHIS also asks whether because of a health problem the reference person has any difficulty walking without using any special equipment.


TABLE A-2. Measures of Instrumental Activities of Daily Living in Select National Surveys
Survey Question Activities
American Community Survey (ACS); 1999 and later Because of a physical, mental, or emotional condition lasting six months or more, does this person have any difficulty in doing any of the following activities (fill in activity). Going outside the home alone to shop or visit a doctor’s office
Health and Retirement Study (HRS); 1995 and later1 Please tell me whether you have any difficulty with each activity I name. If you don’t do the activity at all, just tell me so. Exclude any difficulties that you expect to last less than three months. Because of a health or memory problem, do you have any difficulty (activity)?

If can’t do or don’t do: Is that because of a health or memory problem?

If yes, don’t know or refused and for those that can’t or don’t do because of a problem: Does anyone help you (fill in activity)?

(Besides any help you have told me about) Do you get any help with (activity) because of your health problems?
Using a map to figure out how to get around a strange place
Preparing a hot meal
Shopping for groceries
Making phone calls
Taking medication
Managing money, such as paying your bills and keeping track of expenses
Work around the house or yard2
Medicare Current Beneficiary Survey (MCBS); 1992 and later (Community sample) Now I’m going to ask about some everyday activities and whether (you have/sampled person has) any difficulty doing them by (yourself/himself/herself). Because of a health or physical problem, do you have any difficulty (fill in activity)?

If don’t do activity: Is this because of a health or physical problem?

You said that (fill in activity) is something that (you have difficulty/you don’t do/sampled person has difficulty doing/ sampled person doesn’t do). (Do you/does sampled person) receive help from another person with (fill in activity)?
Using the telephone
Doing light housework (like washing dishes, straightening up, or light cleaning)
Doing heavy housework (like scrubbing floors or washing windows)
Preparing own meals
Shopping for personal items (such as toilet items or medicines)
Managing money (like keeping track of expenses or paying bills)
Medical Expenditure Panel Survey (MEPS); 1996/ 1997 and later Household Component Survey
The next few questions are about difficulties people may have with everyday activities such as getting around, bathing or taking medications. We are interested in difficulties due to an impairment or a physical or mental health problem.

Does anyone in the family receive help or supervision using the telephone, paying bills, taking medications, preparing light meals, doing laundry, or going shopping?
Not applicable
Long-Term Care Supplement
Now I would like to ask about a few (more) daily activities which some people have difficulty with.

(Do/Does) (reference person) receive help or supervision (fill in activity) because of an impairment or a physical or mental health problem?
Shopping for groceries. Please do not include help in getting to or from the store
Getting around the community outside of walking distance
Preparing meals
Taking medication
Managing money, such as keeping track of expenses or paying bills
Doing laundry
Doing light housework, such as straightening up, putting things away or washing dishes
National Health and Nutrition Examination Survey (NHANES); 1999-20003 The next questions ask about difficulties (you/sampled person) may have doing certain activities because of a health problem. By health problem we mean any long-term care physical, mental or emotional problem or illness (not including pregnancy).

By (yourself/himself/herself) and without using any special equipment, how much difficulty (do you/does sampled person) have (fill in activity)? [1. No difficulty; 2. Some difficulty; 3. Much difficulty; 4. Unable to do.]
Managing money
Doing chores around the house (vacuuming, sweeping, dusting, etc.)
Preparing (your/his/her) own meals
National Health Interview Survey (NHIS); 1997 and later3 Because of a physical, mental, or emotional problem, (do/ does) (you/anyone in the family) need the help of other persons in handling ROUTINE NEEDS, such as everyday household chores, doing necessary business, shopping, or getting around for other purposes? Not applicable
National Long Term Care Survey (NLTCS); 1982 and later (Community sample) Screener (INSTRUCTION--If a person does not do, but is able to do, an activity listed below, mark “Yes” for the activity.)
Are you able to (fill in activity)?

Does a disability or a health problem keep (sampled person) from (read activity marked “No” in item above)?

Which of these activities is (sampled person) unable to do because of a disability or health problem (read IADLs marked “No” above)? Mark (1) all that apply.

You said that (sampled person) has a problem (Read IADLs marked “Yes”). Have you had (this problem/any of these problems) for three months or longer?

If no: Do you expect that (this problem/any of these problems) will last for the next three months or longer?

If no: Altogether, from beginning to end, will (this problem/any of these problems) have lasted three months or longer?
Prepare meals without help
Do laundry without help
Do light housework such as washing dishes
Shop for groceries without help
Manage money such as keeping track of bills and handling cash
Take medicine without help
Make phone calls without help
Main Questionnaire
Does (sampled person) usually do (fill in activity)?

If no, ask: If (sampled person) had to (fill in activity), could...do it?

If had to do activity, but couldn’t, ask: What is the reason (sampled person) cannot do (fill in activity)--is that because of disability or health problem, or is there some other reason? (1. Disability or health problem; 2. Other reason.)

Does someone usually help (sampled person) with (fill in activity) or do it for (sampled person)?

Does (sampled person) need any help (fill in activity)?
Heavy work around the house
Light work around the house such as straightening up, putting things away, or washing dishes
Own laundry
Prepare own meals
Shop for groceries
Get around outside
Go places outside of walking distance
Manage money
Take medicine
Make telephone calls
Survey of Income and Program Participation (SIPP); 1991 and later Because of a physical or mental health condition, does (sampled person) have difficulty doing any of the following by himself/herself)?

Exclude the effects of temporary conditions--If an aid is used, ask whether the person has difficulty even when using the aid.

   If difficulty with activity is reported in difficulty question, respondents are asked: Does (sampled person) need the help of another person with (fill in activity)? Mark yes if person sometimes or usually needs help.
Keeping track of money and bills
Preparing meals
Doing light housework such as washing dishes or sweeping a floor
Taking the right amount of prescribed medicine at the right time
Supplement on Aging (SOA); 1995 These questions are about some other activities. Please tell me about doing them by yourself. Because of a health or physical problem, do you have any difficulty (fill in activity)?

   Ask if doesn’t do: Is this because of a health or physical problem? If yes mark box 1 if no mark box 3.

   If doesn’t do for other reason, ask: Does someone else regularly do this for you?  

Ask the following for each activity marked “yes”.

By yourself, how much difficulty do you have (fill in activity)? (1. Some; 2. A lot; 3. Unable.)

   Do you receive help from another person in (fill in activity)?

   Is this hands-on help?

   How often do you have hands-on help with (fill in activity)? Would you say always, sometimes, or rarely.

   Do you need (more) hands-on help with (fill in activity)?
Preparing own meals
Shopping for personal items (such as toilet items or medicines)
Managing your money (such as keeping track of expenses or paying bills)
Using the telephone
Doing heavy housework (like scrubbing floors or washing windows)
Doing light housework (like doing dishes, straightening up, or light cleaning)
Getting to places outside of walking distance
Managing your medication
  1. The 1994 HRS and 1993 AHEAD also included items but wording differed.
  2. Difficulty question not asked for work around the house or yard.
  3. The NHANES and NHIS also ask about the amount of difficulty with leisure activities such as: Going out to things like shopping, movies, or sporting events; Participating in social activities (visiting friends, attending clubs or meetings or going to parties); and Doing things to relax at home or for leisure (reading, watching TV, sewing, listening to music).


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