Relationship to caregiver
  Relationship to care recipient (CGREL)
  Live in same house as care recipient (CGHOUSE)


Services received
  Receive in-home respite care svc? (CGSVC03)
  Receive adult day respite care svc? (CGSVC04)
  Receive respite care? (CGSVC05)
  Receive adult day care? (CGSVC06)
  Receive case management? (CGSVC07)
  Receive homemaker service? (CGSVC08)
  Receive home health aide svc? (CGSVC09)
  Receive home-delivered meals? (CGSVC10)
  Receive grocery service? (CGSVC11)
  Receive chore service? (CGSVC12)
  Receive transportation service? (CGSVC13)
  Receive information about services? (CGSVC14)
  Receive assistance w/ access to svcs? (CGSVC15)
  Receive indiv caregiver counseling? (CGSVC16)
  Receive caregiver training? (CGSVC17)
  Receive caregiver support group svc? (CGSVC18)
  Rate in-home respite care service (CGQUL03)
  Need more in-home respite care? (CGMOR03)
  Rate adult day respite care service (CGQUL04)
  Need more adult day respite care? (CGMOR04)
  Rate respite care (CGQUL05)
  Need more respite care? (CGMOR05)
  Rate adult daycare (CGQUL06)
  Need more adult daycare? (CGMOR06)
  Rate case management svc (CGQUL07)
  Need more case management? (CGMOR07)
  Rate homemaker service (CGQUL08)
  Need more homemaker service? (CGMOR08)
  Rate home health aide svc (CGQUL09)
  Need more home health aide svc? (CGMOR09)
  Rate home-delivered meals (CGQUL10)
  Need more home-delivered meals? (CGMOR10)
  Rate grocery service (CGQUL11)
  Need more grocery service? (CGMOR11)
  Rate chore service (CGQUL12)
  Need more chore service? (CGMOR12)
  Rate transportation service (CGQUL13)
  Need more transportation service? (CGMOR13)
  Rate information about services (CGQUL14)
  Need more information about services? (CGMOR14)
  Rate assistance w/ access to svcs (CGQUL15)
  Need more assist w/ access to svcs? (CGMOR15)
  Rate indiv caregiver counseling (CGQUL16)
  Need more indiv caregiver counseling? (CGMOR16)
  Rate caregiver training (CGQUL17)
  Need more caregiver training? (CGMOR17)
  Rate caregiver support group svc (CGQUL18)
  Need more caregiver support grp svc? (CGMOR18)


What additional services/information would be valuable?
  Help with housekeeping (CGNEW01)
  Help with shopping (CGNEW02)
  Help with transportation/going places (CGNEW03)
  Help with making meals (CGNEW04)
  Help with personal care (CGNEW05)
  Help administering medicines (CGNEW06)
  Help get family members to caregive (CGNEW07)
  Financial support (CGNEW08)
  Respite care or adult daycare (CGNEW09)
  Money management assistance (CGNEW10)
  Home maintenance service (CGNEW92)
  Information/education service (CGNEW93)
  Companion check service (CGNEW94)
  Help line (central place to call) (CGINF01)
  Counseling/support group (CGINF02)
  Info on care recipient's condition (CGINF03)
  Info on legal changes affecting you (CGINF04)
  Info on selecting care facility (CGINF05)
  Info on how to pay for nursing home (CGINF06)
  Help dealing w/ agencies to get svcs (CGINF07)


Overall questions about the service
  How satisfied w/ services received? (CGSATIS)
  Svcs help you be a better caregiver (CGHELP)
  Svcs help you care for longer time? (CGCARLG)


Experiences as a caregiver
  Help w/ dress/eat/bathe in last mo.? (CGACTI01)
  Help w/ med needs in last mo.? (CGACTI02)
  Help track bills/finance in last mo.? (CGACTI03)
  Help meals/laundry/clean in last mo.? (CGACTI04)
  Help take shopping/Dr. in last mo.? (CGACTI05)
  Anyone relieve you from caregiving? (CGRELEF)
  # family/friends provide unpaid care (CGFAMIL)


Questions about work
  B/c of caregiving, stopped working (CGYOU01)
  B/c of caregiving, retired early (CGYOU02)
  B/c of caregiving, less demanding job (CGYOU03)
  B/c of caregiving, took part time job (CGYOU04)
  B/c of caregiving, reduced work hours (CGYOU05)
  B/c of caregiving, lost benefits (CGYOU06)
  B/c of caregiving, had time conflicts (CGYOU07)
  B/c of caregiving, used vacation time (CGYOU08)
  B/c of caregiving, leave of absence (CGYOU09)
  B/c of caregiving, lost a promotion (CGYOU10)
  B/c of caregiving, out early/in late (CGYOU11)
  Current employment status (CGWORK)


How caregiving affects caregiver
  Most positive aspect of caregiving (CGBEST)
  Caregiving created health problems? (CGHLTH)
  Biggest difficulty faced in caring? (CGDIF)


Background questions
  Disability that affects caregiving? (CGDISAB)
  Any other person you care for? (CGCAROT)
  Number of other persons you care for (CGMANY)

Food you eat on a regular basis
  How many meals do you eat every day? (HMEALDY)
  Servings of fruit per day (HMFRUIT)
  Servings of vegetables per day (HMVEG)
  Servings of bread/cereal per day (HMBREAD)
  Servings of milk/dairy per day (HMMILK)
  Servings of meat/chicken per day (HMMEAT)
  Servings of beans/nuts/soy per day (HMBEANS)
  Number drinks/beer/wine almost daily (HMBEER)


Health questions
  Lost 10+ lbs w/o trying - last 6 mo. (HMLSTLB)
  Gained 10+ lbs w/o trying -last 6 mo. (HMGANLB)
  Changed diet/amount of food b/c ill? (HMEATCG)
  Received info to help change diet? (HMINFO)
  Tooth/mouth prob make it hard to eat? (HMTOOTH)
  Take 3+ prescribed/otc drugs per day? (HMDRUGS)
  Physically able to shop for yourself? (HMSHOP)
  Have someone who can shop for you (HMSHOPB)
  Physically able to cook for yourself? (HMCOOK)
  Have someone who can cook for you (HMCOOKB)
  Physically able to feed yourself (HMFEED)
  Have someone who can feed you (HMFEEDB)
  Enough money/food stamps to buy food? (HMENUF)


Characteristics of the home-delivered meals
  Satisfied w/ delivered food taste? (HMTASTE)
  Satisfied w/delivered food temp? (HMTEMP)
  Satisfied w/ delivered food looks? (HMLOOKS)
  How often meals arrive on time? (HMONTIM)
  Portion of food these meals represent (HMPORTN)


What do you like about the program?
  Do you like the meal? (HMLIK01)
  Like person who delivers the meal? (HMLIK02)
  Like that can get info oth programs? (HMLIK03)
  Like that can get other svc: home svc (HMLIK92)
  Like that can get oth svc: transport (HMLIK93)
  Like that can get other svc: medical (HMLIK94)


How long receiving the meals?
  How long receiving home meals? (HMRECEV)


Home-delivered meals satisfaction measure
  Happy w/ # meals received each week (NHCSM01)
  Meals often arrive late (NHCSM02)
  Like time of the day meals arrive (NHCSM03)
  Sometimes meals fail to be delivered (NHCSM04)
  Generally the svc has meals I like (NHCSM05)
  I need more meals than I get (NHCSM06)
  Most of the meals are great (NHCSM07)
  Meals come too early in the day (NHCSM08)
  Meals are cooked the way I like (NHCSM09)
  The service has poor a selection (NHCSM10)
  Often the food is too bad to eat (NHCSM11)


Emotional well-being
  Mental/emotional health in general (EWEWB)


Social functioning
  Feelings on present social activities (SFENUF)
  Joining svc increased social activity (SFMORE)

Food you eat on a regular basis
  How many meals do you eat every day? (HMEALDY)
  How many meals eat alone each day? (HMEALON)
  Servings of fruit per day (HMFRUIT)
  Servings of vegetables per day (HMVEG)
  Servings of bread/cereal per day (HMBREAD)
  Servings of milk/dairy per day (HMMILK)
  Servings of meat/chicken per day (HMMEAT)
  Servings of beans/nuts/soy per day (HMBEANS)
  Number drinks/beer/wine almost daily (HMBEER)


Health questions
  Lost 10+ lbs w/o trying - last 6 mo. (HMLSTLB)
  Seen doctor about weight loss? (HMDRLLB)
  Gained 10+ lbs w/o trying -last 6 mo. (HMGANLB)
  Seen doctor about weight gain? (HMDRGLB)
  Changed diet/amount of food b/c ill? (HMEATCG)
  Received info to help change diet? (HMINFO)
  Tooth/mouth prob make it hard to eat? (HMTOOTH)
  Take 3+ prescribed/otc drugs per day? (HMDRUGS)
  Physically able to shop for yourself? (HMSHOP)
  Have someone who can shop for you (HMSHOPB)
  Physically able to cook for yourself? (HMCOOK)
  Have someone who can cook for you (HMCOOKB)
  Physically able to feed yourself (HMFEED)
  Enough money/food stamps to buy food? (HMENUF)


Characteristics of the congregate meals
  How satisfied w/ the way food tastes? (CMTASTE)
  How satisfied w/ food temperature? (CMTEMP)
  How satisfied with how food looks? (CMLOOKS)
  Portion of food these meals represent (CMPORTN)
  Happy w/ number of meals each week? (CMLIK01)
  Meal site is a very pleasant place (CMLIK02)
  The meal site is a safe place (CMLIK03)
  Visit with friends at the meal site (CMLIK04)
  Participate in meal site activities (CMLIK05)
  Get oth svcs at meal site: recreation (CMLIK92)
  Get oth svcs at meal site: transport (CMLIK93)
  Get oth svcs at meal site: medical (CMLIK94)
  Get oth svcs at meal site: financial (CMLIK95)


Emotional well-being
  Mental/emotional health in general (EWEWB)


Social functioning
  Feelings on present social activities (SFENUF)
  Joining svc increased social activity (SFMORE)

Experience with homemaker service
  Homemaker is very thorough (HCHM01)
  Homemaker leaves too early (HCHM02)
  Homemaker has become a friend (HCHM03)
  Homemaker is rude to me (HCHM04)
  Homemaker interested in me as person (HCHM05)
  Need more hours of homemaker svc/week (HCHM06)
  Homemaker does things the way I want (HCHM07)
  Homemaker arrives late (HCHM08)
  Homemaker knows what to do (HCHM09)
  Homemaker ignores instructions (HCHM10)
  Homemaker assigned enough time (HCHM11)
  Homemaker does extra things for me (HCHM12)
  I wish homemaker could do more things (HCHM13)


Emotional well-being
  Mental/emotional health in general (EWEWB)


Social functioning
  Feelings on present social activity (SFENUF)
  Joining svc increased social activity (SFMORE)

Purpose for using the service
  Obtain help for self (IAWHY01)
  To get help for a relative (IAWHY02)
  Calling from an agency for a client (IAWHY03)


Reasons for the call
  To get information (IAREAS01)
  To obtain services (IAREAS02)
  To refer a client for services (IAREAS03)
  To follow up on a prior call (IAREAS04)
  To express health insurance concerns (IAREAS05)
  To express financial concerns (IAREAS06)
  To file a complaint (IAREAS07)


Use of service in the past
  Ever used svc before this last call? (IASVCB)
  Number of times used svc past year (IATIMES)


Experience with the last call
  Got busy signal for last call (IABUSY)
  # times called before getting through (IAGTHRU)
  How quickly was call answered? (IAQUICK)
  Phone answered by voice mail/ person (IAVMPER)
  Understood voice mail instructions? (IAUNSTD)
  Did someone call you back? (IACLBAK)
  Did you call them back? (IAUCLBK)
  Person listen to what you wanted? (IALSTN)
  Person understand what you wanted? (IAWANT)
  Person explain in understandable way? (IAEXPLN)


Communication problem on last call
  Language problem (IAPRB01)
  Hearing problem (IAPRB02)
  Operator needs to speak louder/slower (IAPRB03)
  Operator needs to listen more (IAPRB04)


Overall experience with agency
  Received info you were looking for? (IARECIN)
  Expect info received to be helpful? (IAINFHP)
  Satisfied w/ way call was handled? (IASATIS)
  Would you recommend svc to friends? (IARCSVC)


Recommendations
  None (IABETR01)
  Increase hours service is available (IABETR02)
  Reduce wait time to speak to someone (IABETR03)
  Eliminate voice mail (IABETR04)
  Get more knowledgeable people (IABETR05)
  Answer all questions on the 1st call (IABETR06)
  Be more timely returning phone calls (IABETR07)
  Better advertising of services (IABETR08)
  Reduce wait time on services (IABETR09)
  More staff to answer phone (IABETR92)
  Have more services available (IABETR93)


Referrals to other places
  Referred to any other places to call? (IARFPL)
  Did you contact any of these places? (IACNTC)
  Why not contacted these places? (IANOCT)
  Started getting svc fr referred place (IASTART)


Type of service provider you work for
  Type of svc provider you work for? (IAPVTYP)

General questions about the service
  # of days ago last used service (TRDAYS)
  # local trips/month using this svc (TRMONTH)
  In avg mo, how many trips? (TRPROP)
  Where do you get on the vehicle? (TRGTSON)


Overall experience with the service
  The vehicle is clean and comfortable (TRFRE05)
  Vehicles are easy to get in and out (TRFRE06)
  Arrives at destination on time (TRFRE07)
  Driver picks up when suppose to (TRFRE08)
  Service calls for any cancellation (TRFRE09)
  Can get to the places you need to (TRFRE10)
  Trips take too long (TRFRE11)
  The drivers are polite (TRFRE12)
  Drivers offer help going in/out van (TRFRE13)
  Drivers offer help going in/out house (TRFRE14)
  You get the number of rides you need (TRFRE15)
  Rides are at the needed time and days (TRFRE16)
  You have info to schedule/take trips (TRFRE17)
  You get around more than before svc? (TREXP18)
  Recommend this service to a friend? (TREXP19)
  Rate transportation svc you received (TRRATE)


Activities can get to more often with the service
  Work (TRACT01)
  Doctor/health care provider (TRACT02)
  Shopping (TRACT03)
  Volunteer activities (TRACT04)
  Senior center (TRACT05)
  Lunch program (TRACT06)
  Visit friends, neighbors, relatives (TRACT07)
  Social events/recreational activities (TRACT08)
  Clubs and meetings (TRACT09)
  Religious services (TRACT10)


Recommendations on making the service better
  Reduce waiting time for a ride (TRREC01)
  Better buses or vans (TRREC02)
  Be able to go more places (TRREC03)
  Driver give more help into/out of van (TRREC04)
  No suggestions for improvement (TRREC05)
  More drivers/vans/service (TRREC92)
  Communication (TRREC93)


Car in household?
  Car in working condition in household (TRISCAR)
  Do you ever drive that car? (TRDRIVE)


Emotional well-being
  Mental/emotional health in general (EWEWB)


Social functioning
  Feelings on present social activity (SFENUF)
  Joining svc increased social activity (SFMORE)

Receive services from Family Caregiver Support Program?
  Svcs fr family caregiver support prog (CGFCPYN)


Relationship to care recipient
  Relationship to care recipient (CGREL)
  Live in same house w/ care recipient (CGHOUSE)


Activities care recipient needs help with
  Dressing, eating, bathing, toileting (CGACTI01)
  Taking medicine/changing bandages (CGACTI02)
  Tracking bills/checks, financial help (CGACTI03)
  Cooking, laundry, housework (CGACTI04)
  Taking to shop or visit doctor (CGACTI05)
  Coordinating care/services (CGACTI06)
  Telephone reassurance/regular contact (CGACTI07)
  Needs help w/ any of the above (CGACTINO)


Other services received in the last 6 months
  Received in-home respite care (CGSVC04)
  Received adult daycare (CGSVC05)
  Received case management (CGSVC06)
  Received homemaker service (CGSVC07)
  Received home health aide service (CGSVC08)
  Received home-delivered meals (CGSVC09)
  Received chore services (CGSVC10)
  Received transportation service (CGSVC11)
  Received information about services (CGSVC12)
  Receive assistance w/access to svcs (CGSVC13)
  Received indiv caregiver counseling (CGSVC14)
  Received caregiver training/educ (CGSVC15)
  Received caregiver support grp svc (CGSVC16)
  Received lifeline/emerg phone svc (CGSVC17)


Rate other services received in the last 6 months
  Rate in-home respite care service (CGQUL04)
  Rate adult daycare service (CGQUL05)
  Rate case management service (CGQUL06)
  Rate homemaker service (CGQUL07)
  Rate home health aide service (CGQUL08)
  Rate home-delivered meals (CGQUL09)
  Rate chore service (CGQUL10)
  Rate transportation service (CGQUL11)
  Rate information about services (CGQUL12)
  Rate assistance w/access to service (CGQUL13)
  Rate individual caregiver counseling (CGQUL14)
  Rate caregiver training/educ (CGQUL15)
  Rate caregiver support grp svc (CGQUL16)
  Rate lifeline/emerg phone svc (CGQUL17)


What new kinds of services would be valuable
  Help with housekeeping (CGNEW01)
  Help with shopping (CGNEW02)
  Help with transportation (CGNEW03)
  Help with making meals (CGNEW04)
  Help with bathing/dressing/grooming (CGNEW05)
  Help with administering medicines (CGNEW06)
  Help with getting family memb involved (CGNEW07)
  Financial support (tax break/stipend) (CGNEW08)
  In-home respite care (CGNEW09)
  Adult daycare (CGNEW10)
  Money management assistance (CGNEW11)
  Support/social interaction (CGNEW12)
  Help with chores/repairs (CGNEW13)


What new kinds of information would be valuable
  Central place help line to get info (CGINF01)
  Counseling or support grp to talk to (CGINF02)
  Info about care recipient's condition (CGINF03)
  Info on law change affecting situation (CGINF04)
  Help in selecting nursing home (CGINF05)
  Help knowing how to pay nursing home (CGINF06)
  Help dealing with agencies/get svcs (CGINF07)


Rating of program
  How satisfied w/ the svcs received (CGSATIS)
  Rate svcs care recipient received (CGPRATE)
  How difficult to get svcs from agency (CGDIFF)


How services have helped you care
  How much do svcs help you care better (CGHELP)
  Svcs let you care for a longer time (CGCARLG)


Experiences as a caregiver
  Do you get any relief fr caregiving (CGRELEF)
  Family or friends provide unpaid care (CGFAMIL)
  In 24 hrs, how many hrs you caregive (CGHRSWK)
  On weekend, how many hrs/day you care (CGHRSWD)


Caregiver work questions
  Current employment status (CGWORK)
  Working when started providing care (CGWORKYN)
  To caregive have stopped working (CGYOU01)
  To caregive retired early (CGYOU02)
  To caregive took less demanding job (CGYOU03)
  To caregive changed to part time job (CGYOU04)
  To caregive reduced working hours (CGYOU05)
  To caregive lost some benefits (CGYOU06)
  Had time conflict between working/care (CGYOU07)
  Used vacation time to provide care (CGYOU08)
  Taken leave of absence to provide care (CGYOU09)
  Lost promotion (CGYOU10)
  Worked less than normal hours (CGYOU11)
  Caregiving has not affected work (CGWKNOAF)


Positive aspects of caregiving
  How often provides companionship (CGPLS32)
  How often provides sense accomplishmnt (CGPLS33)
  How often provides satisfaction (CGPLS34)
  How often feel like it helps family (CGPLS35)
  How often feel care recip appreciates (CGPLS36)
  Does providing care have other rewards (CGREW)
  Most positive aspect of caregiving (CGBEST)


Negative aspects/burdens of caregiving
  How often creates financial burden (CGMIN39)
  How often leaves no time for yourself (CGMIN40)
  How often leaves no time for family (CGMIN41)
  How often interferes with work (CGMIN42)
  How often makes neg family relations (CGMIN43)
  How often interferes w/ privacy needs (CGMIN44)
  How often creates probs in social life (CGMIN45)
  How often creates stress (CGMIN46)
  Biggest difficulty faced in caring (CGDIF)


Other people caregiver cares for
  Any other persons you care for? (CAROT)
  Number of persons you care for (CGMANY)


Caregiver health information
  Have physical condition or problem (CGDISAB)
  Caregiving created health problems (CGHLTH)


Caregiver paid for caring?
  Are you paid for caregiving? (CGPAID)
  Who pays you for caregiving? (CGWHOPAY)


Care recipient background
  Care recipient gender (CGPMF)

Relationship to care recipient
  Relationship to care recipient (CGREL)
  Live in same house w/ care recipient (CGHOUSE)


Activites care recipient needs help with
  Dressing, eating, bathing, toileting (CGACTI01)
  Taking medicine/changing bandages (CGACTI02)
  Tracking bills/checks, financial help (CGACTI03)
  Cooking, laundry, housework (CGACTI04)
  Taking to shop or visit doctor (CGACTI05)
  Coordinating care/services (CGACTI06)
  Telephone reassurance/regular contact (CGACTI07)
  Needs help w/ any of the above (CGACTINO)


Other services received in the last 6 months
  Received in-home respite care (CGSVC04)
  Rate in-home respite care service (CGQUL04)
  Received adult daycare (CGSVC05)
  Rate adult daycare service (CGQUL05)
  Received case management (CGSVC06)
  Rate case management service (CGQUL06)
  Received homemaker service (CGSVC07)
  Rate homemaker service (CGQUL07)
  Received home health aide service (CGSVC08)
  Rate home health aide service (CGQUL08)
  Received home-delivered meals (CGSVC09)
  Rate home-delivered meals (CGQUL09)
  Received chore services (CGSVC10)
  Rate chore service (CGQUL10)
  Received transportation service (CGSVC11)
  Rate transportation service (CGQUL11)
  Received information about services (CGSVC12)
  Rate information about services (CGQUL12)
  Receive assistance w/access to svcs (CGSVC13)
  Rate assistance w/access to service (CGQUL13)
  Received indiv caregiver counseling (CGSVC14)
  Rate individual caregiver counseling (CGQUL14)
  Received caregiver training/educ (CGSVC15)
  Rate caregiver training/educ (CGQUL15)
  Received caregiver support grp svc (CGSVC16)
  Rate caregiver support grp svc (CGQUL16)
  Received lifeline/emerg phone svc (CGSVC17)
  Rate lifeline/emerg phone svc (CGQUL17)


What new kinds of services would be valuable
  Help with housekeeping (CGNEW01)
  Help with shopping (CGNEW02)
  Help with transportation (CGNEW03)
  Help with making meals (CGNEW04)
  Help with bathing/dressing/grooming (CGNEW05)
  Help with administering medicines (CGNEW06)
  Help with getting family memb involved (CGNEW07)
  Financial support (tax break/stipend) (CGNEW08)
  In-home respite care (CGNEW09)
  Adult daycare (CGNEW10)
  Money management assistance (CGNEW11)
  Support/social interaction (CGNEW12)
  Help with chores/repairs (CGNEW13)
  Central place help line to get info (CGINF01)
  Counseling or support grp to talk to (CGINF02)
  Info about care recipient's condition (CGINF03)
  Info on law change affecting situation (CGINF04)
  Help in selecting nursing home (CGINF05)
  Help knowing how to pay nursing home (CGINF06)
  Help dealing with agencies/get svcs (CGINF07)


Program satisfaction and ratings
  How satisfied w/ the svcs received (CGSATIS)
  Rate svcs care recipient received (CGPRATE)
  Rate support svcs caregiver received (CGRATE)
  How difficult to get svcs from agency (CGDIFF)


Have services helped you with caregiving?
  How much do svcs help you care better (CGHELP)
  Svcs let you care for a longer time (CGCARLG)


Experiences as a caregiver
  Do you get any relief fr caregiving (CGRELEF)
  Is this enough relief for caregiver (CGENRLF)
  Family or friends provide unpaid care (CGFAMIL)
  Portion of care provided excluding fam (CGCARPR)
  In 24 hrs, how many hrs you caregive (CGHRSWK)
  On weekend, how many hrs/day you care (CGHRSWD)


Caregiver work questions
  Current employment status (CGWORK)
  Working when started providing care (CGWORKYN)
  To caregive have stopped working (CGYOU01)
  To caregive retired early (CGYOU02)
  To caregive took less demanding job (CGYOU03)
  To caregive changed to part time job (CGYOU04)
  To caregive reduced working hours (CGYOU05)
  To caregive lost some benefits (CGYOU06)
  Had time conflict between working/care (CGYOU07)
  Used vacation time to provide care (CGYOU08)
  Taken leave of absence to provide care (CGYOU09)
  Lost promotion (CGYOU10)
  Worked less than normal hours (CGYOU11)
  Caregiving has not affected work (CGWKNOAF)


Positive aspects of caregiving
  How often provides companionship (CGPLS32)
  How often provides sense accomplishmnt (CGPLS33)
  How often provides satisfaction (CGPLS34)
  How often feel like it helps family (CGPLS35)
  How often feel care recip appreciates (CGPLS36)
  Does providing care have other rewards (CGREW)
  Most positive aspect of caregiving (CGBEST)


Negative aspects/burdens of caregiving
  How often creates financial burden (CGMIN39)
  How often leaves no time for yourself (CGMIN40)
  How often leaves no time for family (CGMIN41)
  How often interferes with work (CGMIN42)
  How often makes neg family relations (CGMIN43)
  How often interferes w/ privacy needs (CGMIN44)
  How often creates probs in social life (CGMIN45)
  How often creates stress (CGMIN46)
  Biggest difficulty faced in caring (CGDIF)


Other people caregiver cares for
  Any other persons you care for? (CAROT)
  Number of persons you care for (CGMANY)


Caregiver health information
  Have physical condition or problem (CGDISAB)
  Caregiving created health problems (CGHLTH)


Caregiver - how long caring?
  How long have you been caring - months (CGTIME)


Caregiver paid for caring?
  Are you paid for caregiving? (CGPAID)
  Who pays you for caregiving? (CGWHOPAY)


Care recipient background
  Care recipient gender (CGPMF)

Where heard about program
  Where did you hear about the program? (HMHEAR)


Frequency of meals
  How often get meals? (HMATTEND)
  How many meals gotten at a time? (HMATTENA)
  Want to participate more? (HMMORE)


Rating of program
  Rate home delivered meals program (HMRATE)


Eating habits
  How many meals eat every day (HMMEALS)
  # of meals each day from the program (HMMEALSA)
  Servings of fruit eaten per day (HMFRUIT)
  Usually eat fruit provided (HMEATFRT)
  How many servings of vegetables/day (HMVEGS)
  Usually eat vegetables provided (HMEATVEG)
  How many servings bread/rice per day (HMBREAD)
  Usually eat bread/rice/pasta provided (HMEATBRD)
  How many servings milk/cheese per day (HMDAIRY)
  Usually eat dairy products provided (HMEATDAR)
  Servings meat/chicken eaten per day (HMMEAT)
  Usually eat meat provided (HMEATMET)
  Servings of cooked beans/nuts per day (HMBEANS)
  Usually eat nuts/beans provided (HMEATBNS)
  How many glasses of water/day (HMWATER)
  Portion of food these meals represent (HMPORTN)
  Receive hot meals/frozen meals/both (HMRECEIV)


Satisfaction with the food
  How satisfied w/ taste of the food (HMTASTES)
  How satisfied w/ smell of food (HMSMELLS)
  How satisfied w/ the food temperature (HMTEMP)
  How satisfied w/ way the food looks (HMLOOKS)
  How satisfied w/ the variety of food (HMVARITY)
  How often delivery on time (HMONTIME)


Results of participating in home-delivered meals
  Eat more balanced meals (HMBALANC)
  Easier to keep special diet (HMSPECDT)
  Better able to avoid sodium/fat (HMSLTFAT)
  Can maintain weight (HMWEIGHT)
  Have something to look forward to (HMFORWRD)
  Can continue to live in own home (HMSTAYHM)
  Would recommend program to others (HMRECMND)


Services offered by home-delivered meals program
  Offers assistance in getting oth svcs (HMASST34)
  Offers nutrition counseling (HMNUTC34)
  Offers transportation (HMTRPM34)
  Offers help w/shopping (HMSHP34)
  Offers help getting benefits (HMMON34)
  Offers income tax preparation help (HMTAX34)
  Offers insurance counseling (SHIP) (HMINS34)
  Offers health services (HMHLTH34)
  Offers recreation service (HMREC34)


Have used services offered by home-delivered meals
  Have used assistance in get oth svcs (HMASST35)
  Have used nutrition counseling (HMNUTC35)
  Have used transportation (HMTRPM35)
  Have used help w/shopping (HMSHP35)
  Have used help with benefits (HMMON35)
  Have used income tax preparation help (HMTAX35)
  Have used insurance counseling (SHIP) (HMINS35)
  Have used health service (HMHLTH35)
  Have used recreation service (HMREC35)


Would use service if offered by home-delivered meals
  Would use assistance in get oth svcs (HMASST36)
  Would use nutrition counseling (HMNUTC36)
  Would use transportation (HMTRPM36)
  Would use help w/shopping (HMSHP36)
  Would use help with benefits (HMMON36)
  Would use income tax preparation help (HMTAX36)
  Would use insurance counseling (SHIP) (HMINS36)


Physical questions
  Physically able to shop for yourself? (HMSHOP)
  Have someone who can shop for you (HMSHOPB)
  Physically able to cook for yourself? (HMCOOK)
  Have someone who can cook for you (HMCOOKB)
  In general, how is your health (HMRTHLTH)


Health questions
  Past yr, how oft in hosp overnight? (HLMHOSP)
  Past yr, many times in nursing home? (HLMNH)
  Past yr,how often see/talk to doctor? (HLMSEEDR)
  How many different drugs/day? (HLMDRUGS)
  Describe appetite (HLMAPP)


Having enough food to eat
  Have enough food to eat most of time (HLMENUF)


Satisfaction measures
  Happy w/number of meals each week (NRHCSM1)
  Meals often arrive late (NRHCSM2)
  Like the time of day meals arrive (NRHCSM3)
  Sometime meals not delivered at all (NRHCSM4)
  Service has meals you like (NRHCSM5_)
  You need more meals than you get (NRHCSM6)
  Most of the meals are great (NRHCSM7)
  Meals come too early in the day (NRHCSM8)
  Meals are cooked the way you like (NRHCSM9)
  Poor selection of meals (NRHCSM10)
  Food is so bad you don't eat it (NRHCSM11)


Emotional well-being
  Describe mental/emot hlth in general (EWEWB)


Social functioning
  How feel about present socl activity? (SFENUF)
  Socl actvty incrsd since invlvd w/svc (SFMORE)

Where heard about program
  Where learn about congregate meals? (CMHEAR)


Frequency of meals
  How often attend meals? (CMATTEND)
  Want to attend congregate meals more? (CMMORE)


Rating of program
  Rate congregate meals program (CMRATE)


Eating habits
  How many meals do you eat every day? (CMMEALS)
  # of those meals from the program (CMMEALSA)
  # of servings of fruit eaten per day (CMFRUIT)
  Usually eat the fruit served? (CMEATFRT)
  # of servings of vegetables eaten/day (CMVEGS)
  Usually eat the vegetables served? (CMEATVEG)
  # of servings of bread,rice,pasta/day (CMBREAD)
  Usually eat the bread,rice,pasta srvd (CMEATBRD)
  # of serving of dairy products per day (CMDAIRY)
  Usually eat the dairy products served (CMEATDAR)
  How many servings of meat/day (CMMEAT)
  Usually eat the meat served (CMEATMET)
  # of servings of beans/nuts eaten/day (CMBEANS)
  Usually eat the nuts/beans served (CMEATBNS)
  # of glasses of water per day (CMWATER)
  Portion of day's food meal represents (CMPORTN)


Satisfaction with the food
  How satisfied w/ taste of the food (CMTASTES)
  How satisfied w/ smell of food (CMSMELLS)
  How satisfied w/ the food temperature (CMTEMP)
  How satisfied w/ way the food looks (CMLOOKS)
  How satisfied w/ the variety of food (CMVARITY)
  How satisfied with the program (CMPROGRM)


Results of participating in congregate meals program
  Eat more balanced meals (CMBALANC)
  Easier to keep special diet (CMSPECDT)
  Better able to avoid sodium/fat (CMSLTFAT)
  Can maintain weight (CMWEIGHT)
  Enjoy mealtime more b/c of company (CMCOMPY)
  Have something to look forward to (CMFORWRD)
  Can continue to live in own home (CMSTAYHM)
  Would recommend program to others (CMRECMND)


Services offered by congregate meals program
  Offers assistance in getting oth svcs (CMASST34)
  Offers nutrition counseling (CMNUTC34)
  Offers transportation (CMTRPM34)
  Offers continuing education (CMCLAS34)
  Offers physical fitness activities (CMFTNS34)
  Offers help getting benefits (CMMON34)
  Offers income tax preparation help (CMTAX34)
  Offers support groups (CMSUP34)
  Offers health screenings (CMHLTH34)
  Offers insurance counseling (SHIP) (CMINS34)
  Offers other counseling (CMCSL34)
  Offers entertainment/recreation (CMENT34)
  Offers home-delivered meals service (CMHDM34)


Have used services offered by congregate meals program
  Have used assistance to get oth svcs (CMASST35)
  Have used nutrition counseling (CMNUTC35)
  Have used transportation (CMTRPM35)
  Have used continuing education (CMCLAS35)
  Have used physical fitness activities (CMFTNS35)
  Have used help with benefits (CMMON35)
  Have used income tax preparation help (CMTAX35)
  Have used support groups (CMSUP35)
  Have used health screenings (CMHLTH35)
  Have used insurance counseling (SHIP) (CMINS35)
  Have used other counseling (CMCSL35)
  Have used entertainment/recreation (CMENT35)
  Have used home-delivered meals svc (CMHDM35)


Would you use services offered by congregate meals?
  Would use assistance to get oth svcs (CMASST36)
  Would use nutrition counseling (CMNUTC36)
  Would use transportation (CMTRPM36)
  Would use continuing education (CMCLAS36)
  Would use physical fitness activities (CMFTNS36)
  Would use help with benefits (CMMON36)
  Would use income tax preparation help (CMTAX36)
  Would use support groups (CMSUP36)
  Would use health screenings (CMHLTH36)
  Would use insurance counseling (SHIP) (CMINS36)
  Would use other counseling (CMCSL36)


Suggestions to improve program
  Any suggestions to improve program? (CMSGST)


Health questions
  In general, how is your health? (CMRTHLTH)
  Past yr,how oft in hosp overnight? (HLMHOSP)
  Past yr, many times in nursing home? (HLMNH)
  Past yr,how often see/talk to doctor? (HLMSEEDR)
  How many different drugs/day? (HLMDRUGS)
  Describe appetite (HLMAPP)
  Have enough food to eat most of time (HLMENUF)


Emotional well-being
  Describe mental/emot hlth in general (EWEWB)


Social functioning
  How feel about present socl activity? (SFENUF)
  Socl actvty incrsd since invlvd w/svc (SFMORE)

Rating of homemaker service
  Rate homemaker service you received (HCARATE)


Physical functioning
  In general, how is your health? (PFHLTH)


Emotional well-being
  Describe mental/emot hlth in general (EWEWB)


Social functioning
  How feel about present socl activity? (SFENUF)
  Socl actvty incrsd since invlvd w/svc (SFMORE)

Topics called about
  To obtain help or services for self (IAWHY01)
  To get help/svcs for relative/friend (IAWHY02)
  Calling from an agency for a client (IAWHY03)


Reason why called
  To get information (IARESINF)
  To obtain services (e.g. meals) (IARESSVC)
  To refer a client for services (IARESCL)
  To follow up on a prior call (IARESPC)
  To express health insurance concerns (IARESHI)
  To express financial concerns (IARESFIN)
  About the family caregiver program (IARESFCG)
  To file a complaint (IASRFC)


Using this service in the past
  Ever use info svc before last call (IASVCB)
  # times use info svc before last call (IATIMES)


Experience with the last call
  Got busy signal (IABUSY)
  # times called before getting through (IAGTHRU)
  How quickly was call answered (IAQUICK)
  Phone answered by voice mail/person (IAVMPER)
  How well understand voice mail instruc (IAUNSTD)
  Did someone call you back (IACLBAK)


Questions about the person you spoke to
  Listened carefully to what you want (IALSTN)
  Understood what you wanted (IAWANT)
  Explained things in way you understood (IAEXPLN)


Communication problems
  Language problem (IAPRB01)
  Hearing problem (IAPRB02)
  Needed to speak louder or more slowly (IAPRB03)
  Needed to listen more (IAPRB04)
  No problems (IAPRB05)
  Any communication problems (IAPRBNO)


Overall experience and rating of the call
  Received information was looking for (IARECIN)
  Rate the way call was handled (IASATIS)
  Would you recommend svc to a friend (IARCSVC)
  Info received helpful resolving issue (IAINFHP_)


Referrals to other places
  Referred to any other places to call (IARFPL)
  Did you contact any places referred to (IACNTC)
  Started getting svc fr referred place (IASTART)


Made any other calls besides the referral?
  Made oth calls to get info/help needed (IAOTHCL)
  Did you get the info/help needed (IAINFND)
  # calls made till got info needed (IACLSMK)


Recommendations to make the agency better
  Increase hours service is available (IABETR01)
  Reduce wait time to speak to someone (IABETR02)
  Eliminate voice mail system (IABETR03)
  Get more knowledgeable people (IABETR04)
  Answer all questions on the 1st call (IABETR05)
  Be more timely returning phone calls (IABETR06)
  Better advertising of services (IABETR07)
  Reduce wait time on services (IABETR08)
  Need more money to fund services (IABETR09)


Rating of the service
  Rate info assistance service received (IARATE)


Type of service provider you work for
  Type of service provider you work for (IAPVTYP)

How long ago last used service
  How long ago did you use the service? (HOWLONG)


Use transportation service for how many trips
  Average # local 1 way trips/month (TRMONTH)
  Average month, how much rely on svc (TRPROP)
  For majority of local trips, how travel (USUTRAVL)


Where get on the vehicle
  Where do you get on the vehicle (TRGTSON)


Overall experience with the transportation service
  The vehicles are comfortable (TRFRE05)
  Vehicles are easy to get in and out of (TRFRE06)
  Arrives at destination on time (TRFRE07)
  Driver picks up when supposed to (TRFRE08)
  Service calls for any cancellation (TRFRE09)
  Can get to places (TRFRE10)
  Trips take too long (TRFRE11)
  The drivers are polite (TRFRE12)
  Drivers offer help getting in/out van (TRFRE13)
  Drivers offer help into/out of house (TRFRE14)
  One gets the ride one needs (TRFRE15)
  Ride at the time and days you need (TRFRE16)
  Has info to schedule/take local trip (TRFRE17)
  Gets around more than before had svc (TREXP18)
  Would recommend the svc to a friend (TREXP19)
  Rate transportation service received (TRRATE)


Activities transportation helps you get to more often
  Going to work (TRACT01)
  Going to the doctor (TRACT02)
  Going shopping (TRACT03)
  Doing volunteer activities (TRACT04)
  Going to the senior center (TRACT05)
  Going to lunch program (TRACT06)
  Friends, neighbors, and relatives (TRACT07)
  Social events/recreation (TRACT08)
  Going to clubs/meetings (TRACT09)
  Attend religious services (TRACT10)
  Personal business (TRACT11)
  None of the above (TRACTNON)


Recommendations to make the program better
  Provide service more hours of the day (TRMORHRS)
  Provide service more days of the week (TRMORDAY)
  Reduce the waiting time for a ride (TRREWAIT)
  Need better vehicles for older riders (TRBTRVEH)
  Need to be able to go more places (TRMORPLA)
  The drivers should provide more help (TRMORHLP)
  More vans/trips/volunteers (TRMORSVC)
  Drivers/schedulers be more polite (TRPOLITE)
  None of the above (TRRECNON)


Car in household?
  Car in working condition in household (TRISCAR)
  Do you ever drive that car (TRDRIVE)


Difficulty going outside alone?
  Any difficulty for going outside alone (TRPRBGO)


Emotional well-being
  Describe mental/emot hlth in general (EWEWB)


Social functioning
  How feel about present socl activity? (SFENUF)
  Socl actvty incrsd since invlvd w/svc (SFMORE)

NFCSP- General questions
  Have you heard of the NFCSP? (CGHAVHD)
  Where did you first hear of the NFCSP? (CGHEAR)


NFCSP - Respite care
  Received respite care (CGRSPT)
  # hrs/wk respite care usually receive (CGHRWK)
  Extent respite care svcs helped you (CGRSPTHP)


NFCSP- Help or information given
  Someone ever help connect you to svcs (CGINFO)


NFCSP - Training and education
  Received caregiver training/education (CGEDU)
  Extent caregiver training helped you (CGEDUHLP)


NFCSP - Suplemental services provided
  Home modifications? (CGSUP01)
  Nutritional supplements (e.g. Ensure) (CGSUP02)
  Assistive devices walkers,canes,crutch (CGSUP03)
  Emergency response systems? (CGSUP04)
  Specialized equipment CPAP, oth equip (CGSUP05)


Result of Services Received
  Extent these services helped you? (CGSUPHLP)
  Which service was most helpful (CGMSTHLP)
  Result-more time for personal activity (CGAFECA)
  Result-feel less stress (CGAFECB)
  Result-find it easier to caregive (CGAFECC)
  Result-know better how to obtain svcs (CGAFECD)
  Result-know more about recip's illness (CGAFECE)
  Care recip benefit fr services you get? (CGAFECF)
  Are there any other positive benefits? (CGAFECG)
  Extent svcs help you be better caregvr (CGHELP)
  Have svcs let you care for longer time (CGCARLG)
  Rate caregiver services provided (CGRATE)
  How hard get svcs for care recipient (CGDIFF)


Questions about the caregiver employment
  Current employment status (CGWORK)
  Caregiving:made you quit/retire early (CGQUIT)
  Caregiving interfered with your job (CGINTRFR)
  How much caregiving interfered w/ job (CGINTJB)
  Extent svcs helped deal w/ wrk probs (CGSRVHLP)


Questions about experiences as a caregiver
  How much physical strain is caring (CGPSTRN)
  How emotionally stressful is caring (CGEMSTRS)
  How financially burdensome is caring (CGFINHD)
  How much overall hardship is caring (CGHDSHP)
  Biggest difficulty faced in caring (CGDIF)
  Extent svcs helped deal w/ caring (CGALLEV)
  You have health prb affecting caring (CGDISAB)
  Caregiving created/worsened hlth prob (CGHLTH)


Questions about the care recipient
  How long you cared for care recipient (CGTIMEYR)
  How far away live fr care recipient (CGMINUT)
  Does the care recipient live alone? (CGALONE)
  Care recip can be left alone all day? (CGLFTLN)
  # hrs help ea wk care recipient need (CGHRS7)
  # hrs you care per week (CGHRSWK5)
  # hours you care on the weekend (CGHRSWD2)
  Hours help caregiver provides per wk (CGHRSWK7)
  Anyone else relieve you fr caregiving (CGRELEF)


Receive other services in the past year?
  Congregate meal (SVCCM)
  Home-delivered meals (SVCHDM)
  Homemaker service (SVCHOUSE)
  Case management service (SVCCSEMG)
  Rate these case management services (CSRATE)
  Transportation service (SVCTRAN)
  Adult daycare service (SVCDYCR)
  Personal care service (SVCPCR)
  Chore services (SVCHORE)
  Legal assistance (SVCLGL)
  Information and assistance (SVCIAA)
  No other service (SVCNONE)
  Food stamps (SVC2A)
  Energy assistance (SVC2B)
  Medicaid (SVC2C)
  Housing assistance (SVC2D)
  Subsidized prescriptions (SVC2F)
  Any other assistance (SVC2E)
  Rate the services care recip receives (CGPRATE)
  Care recip svc let you caregive longer (CGCARLCR)
  Svcs let care recip stay in own home (CGDFPLC)
  If not for svcs, where care recip live (CGWHER)


Does care recipient receive help from other places?
  Other family members,friends (CGOTHLP1)
  Local agency (CGOTHLP2)
  Other community agencies (CGOTHLP3)
  Paid help from family (CGOTHLP4)
  Who does most of the caregiving? (CGCARE)


Caregiver payment
  Are you paid to caregive? (CGPAID)
  Who pays you for caregiving? (CGWHOPAY)


Caregiver had a coice in caregiving duties?
  Had a choice in caregiving duties (CGCHOIC)


New kinds of information valuable to know about
  Central place help line (CGINF01)
  Counseling services or a support group (CGINF02)
  Info on care recipient's condition (CGINF03)
  Info on law changes affecting your sit (CGINF04)
  Help knowing how select nursing home (CGINF05)
  Help knowing how pay for nursing home (CGINF06)
  Help in deal w/ agencies to get svcs (CGINF07)
  Info on medicine and drug interactions (CGINF08)
  No additional info would be valuable (CGINFNO9)


Health questions
  In general, how is care recip's health (CGCRHL)
  Dr. said care recip has arthritis (PFDISACG)
  Dr. said care recip has hypertension (PFDISBCG)
  Dr. said care recip has heart disease (PFDISCCG)
  Dr. said care recip has high cholest (PFDISDCG)
  Dr. said care recip has diabetes (PFDISECG)
  Dr. said care recip has breathing prob (PFDISFCG)
  Dr. said care recip has cancer (PFDISGCG)
  Dr. said care recip has had a stroke (PFDISHCG)
  Dr. said care recip has anemia (PFDISICG)
  Dr. said care recip has osteoporosis (PFDISJCG)
  Dr. said care recip has kidney disease (PFDISKCG)
  Dr. said care recip has eye problems (PFDISLCG)
  Dr. said care recip has hearing probs (PFDISMCG)
  Dr. said care recip has depress/anxiet (PFDISNCG)
  Dr. said care recip has Alzheimer's (PFDISOCG)
  Dr. said care recip has seizures (PFDISQCG)
  Dr. said care recip has Parkinson's (PFDISRCG)
  Dr. said care recip has something else (PFDISPCG)


Demographics
  # persons caring for (not care recip) (CGMANY)
  In general, how is your health (CGHEALTH)

Service length
  How long getting home-delivered meals? (HMRECEV)


Questions on days when get home-delivered meals
  How many meals do you get? (HMATTENA)
  # days each week you receive meals (HMDAYSWK)
  # days past week ate 1+ meals (HMDAYPST)
  When get meals, # meals you eat (HMMEALS)
  What portion is meal of all food daily (HMPORTN)


Questions on days when do not get home-delivered meals
  How many meals do you eat? (HMNOEAT)
  Eat same amount as days when get meals (HMDYNOFD)
  What do you usually do for meals (HMNOMLA)


Amount and types of food usually eaten
  Servings of fruit usually eat per day (HMFRUIT)
  Usually eat fruit provided (HMEATFRT)
  Servings of potatoes eat per day (HMPOTATO)
  Usually eat potatoes provided (HMEATPOT)
  Servings of vegetables usually eat/day (HMVEGS)
  Usually eat the vegetables provided (HMEATVEG)
  How many servings bread/rice per day (HMBREAD)
  Usually eat bread/rice/pasta provided (HMEATBRD)
  How many servings milk/cheese per day (HMDAIRY)
  Usually eat dairy products provided (HMEATDAR)
  Servings meat/chicken/fish eaten/day (HMMEAT)
  Usually eat meat/chicken/fish provided (HMEATMET)
  Servings of tofu/beans/nuts per day (HMBEANS)
  Usually eat tofu/beans/nuts provided (HMEATBNS)
  Do you drink Boost? (HNRBOST)
  Do you drink Ensure? (HNRENSR)
  Do you drink Sustical? (HNRSUST)
  Do you drink Carnation Instant Brkfst (HNRCAR)
  Do you drink Glucerna? (HNRGLU)
  Do you drink other dietary supplements (HNRELS)
  # cups of fluids usually drink/day (HMWATER)


Opinion about the home-delivered meals
  How satisfied w/ taste of the food (HMTASTES)
  How satisfied w/ smell of food (HMSMELLS)
  How satisfied w/ way the food looks (HMLOOKS)
  How satisfied w/ the variety of food (HMVARITY)
  How satisfied w/ the food temperature (HMTEMP)
  How often delivery on time (HMONTIME)
  Satisfied that deliverer is friendly (HNRFRND)
  Do you like the meals you get? (HNRLIKE)
  Rate the program overall (HMRATE)
  Would recommend this program to others (HNRRECOM)


Results of participating in home-delivered meals
  Eat healthier foods (HMVARFD)
  Eat a greater variety of foods (HMVR2FD)
  Easier to keep a special diet (HMSPECDT)
  Can maintain a healthy weight (HMWEIGHT)
  Help you improve your health (HMFLBTR)
  Help you feel better (HMFLBR2)
  Help you feel less hungry (LESSHGRY)
  Help you continue to live in own home (HMSTAYHM)


Nutrition counseling through home-delivered meals
  Received this education/counseling? (HNREDUYN)


Receive other services (past year) from local agency?
  Congregate meals (SVCCM)
  Homemaker/housekeeping svcs (SVCHOUSE)
  Case management services (SVCCSEMG)
  Transportation services (SVCTRAN)
  Adult daycare services (SVCDYCR)
  Personal care services (SVCPCR)
  Chore services (SVCHORE)
  Legal assistance (SVCLGL)
  Information & assistance services (SVCIAA)
  Any other services (SVCOTH)
  Service combinations (SVCCOUNT)
  No additional services received (SVCNONE)


Receive other types of assistance?
  Food stamps (SVC2A)
  Energy assistance (SVC2B)
  Medicaid (SVC2C)
  Housing assistance (SVC2D)
  Prescriptions (SVC2F)
  Any other types of assistance (SVC2E)


Questions on buying food
  Always enough $/food stamps for food? (HMENUF)
  Past month-chose btwn food,medicicine (HMRXFD)
  Past month-chose btwn food, bills (HMBILFD)
  Past month,ever skip meals due to $ (HMSKP)


Health questions
  In general, how is your health? (PFHLTH)
  Dr. said you have arthritis? (PFDISA)
  Dr. said you have had hypertension (PFDISB)
  Dr. said you have heart disease? (PFDISC)
  Dr. said you have high cholesterol? (PFDISD)
  Dr. said you have diabetes? (PFDISE)
  Dr. said you have breathing problems (PFDISF)
  Dr. said you had cancer (PFDISG)
  Dr. said you had a stroke (PFDISH)
  Dr. said you had anemia (PFDISI)
  Dr. said you have osteoporosis (PFDISJ)
  Dr. said you have kidney disease (PFDISK)
  Dr. said you have an eye condition (PFDISL)
  Dr. said you have hearing problems (PFDISM)
  Dr. said you have depression/anxiety (PFDISN)
  Dr. said you have Alzheimer's/dementia (PFDISO)
  Dr. said you have seizures/brn disord (PFDISQ)
  Dr. said you have Parkinson's Disease (PFDISR)
  Dr. said you had oth musculoskel cond (PFDISS)
  Dr. said you have something else (PFDISP)
  # different prescription meds per day (HLMDRUGS)
  Past yr,how oft in hosp overnight? (HLMHOSP)
  Past yr, overnight in nursing home? (HLMNH)


Social functioning
  # days past 2 wks left home,any reason (SFACT09)
  Feel doing enough social activities (SFENUF)
  Past 4 wks:# times hlth hamper actvty (SFINTFR)

Screening questions
  How long ago last used this svc (TRDAYSGC)


Service frequency
  # local, 1-way trips/month make w/ svc (TRMONTHC)
  # local trips using svc in avg month (TRPROP)


Usual mode of travel
  For most local trips,how do you travel (USUTRAVL)


Where get on vehicle?
  Where get on transportat svc vehicle (TRGTSON)


Overall experience with the service
  How often are the vehicles comfortable (TRFRE05)
  How often vans easy to get in/out of (TRFRE06)
  How often at destination on time (TRFRE07)
  How often drivers pick up when should (TRFRE08)
  How often informed if ride cancelled (TRFRE09)
  How often get to places want to go (TRFRE10)
  How often do the trips take too long (TRFRE11)
  How often are the drivers polite (TRFRE12)
  How often drivers help in/out of van (TRFRE13)
  How often drivers help in/out of homes (TRFRE14)
  How often get the # rides you need (TRFRE15)
  How often get rides at needed time/day (TRFRE16)
  How often have info to schedule trips (TRFRE17)
  Get around more than before the svc (TREXP18)
  Would recommend svc to a friend? (TREXP19)
  Rate the transportation service (TRRATE)


Transportation service destinations
  Use service to go to work (TRACT01)
  Use service to go to doctors (TRACT02)
  Use service to go to shopping (TRACT03)
  Use service to volunteer activities (TRACT04)
  Use service to go to senior center (TRACT05)
  Use service to go to a lunch program (TRACT06)
  Use service to go to friends,relative (TRACT07)
  Use service to go to social events (TRACT08)
  Use service to go to clubs, meetings (TRACT09)
  Use service to go to religious svcs (TRACT10)
  Use service to go to some place else (TRACTOT)
  Use service for none of the above (TRACTNON)


Go to these destinations more often because of service?
  Work (TRACTB01)
  Doctors and health care providers (TRACTB02)
  Shopping (TRACTB03)
  Volunteer activities (TRACTB04)
  Senior center (TRACTB05)
  Lunch program (TRACTB06)
  Friends, neighbors, and relatives (TRACTB07)
  Social events, recreation activities (TRACTB08)
  Clubs and meetings (TRACTB09)
  Religious services (TRACTB10)
  Anywhere else (TRACTBOT)
  None of the above (TRACTBNO)


Recommendations to make transportation service better
  Provide service more hours of the day (TRMORHRS)
  Provide service more days of the week (TRMORDAY)
  Reduce the waiting time for a ride (TRREWAIT)
  Get better vehicles for older riders (TRBTRVEH)
  Need to be able to go more places (TRMORPLA)
  Drivers provide more help boarding van (TRMORHLP)
  Publicize service availability (TRPUBLIC)
  More vans/trips/volunteers (TRMORSVC)
  Something else (TRRECOTH)
  None of the above (TRRECNON)


Car in household?
  Is there working car in the household (TRISCAR)
  Do you ever drive that car (TRDRIVE)


Received other services (past year) from local agency?
  Congregate meals (SVCCM)
  Home-delivered meals (SVCHDM)
  Homemaker/housekeeping services (SVCHOUSE)
  Case management (SVCCSEMG)
  Adult daycare services (SVCDYCR)
  Personal care services (SVCPCR)
  Chore services (SVCHORE)
  Legal assistance (SVCLGL)
  Information and assistance services (SVCIAA)
  Any other services (SVCOTH)
  Service combinations (SVCCOUNT)
  No additional services (SVCNONE)


Receive other types of assistance?
  Food stamps (SVC2A)
  Energy assistance (SVC2B)
  Medicaid (SVC2C)
  Housing assistance (SVC2D)
  Subsidized prescriptions (SVC2F)
  Any other types of assistance (SVC2E)


Physical functioning
  In general, how is your health (PFHLTH)
  Dr. said you have arthritis (PFDISA)
  Dr. said you have had hypertension (PFDISB)
  Dr. said you have heart disease (PFDISC)
  Dr. said you have high cholesterol (PFDISD)
  Dr. said you have diabetes (PFDISE)
  Dr. said you have breathing problems (PFDISF)
  Dr. said you had cancer (PFDISG)
  Dr. said you had a stroke (PFDISH)
  Dr. said you had anemia (PFDISI)
  Dr. said you have osteoporosis (PFDISJ)
  Dr. said you have kidney disease (PFDISK)
  Dr. said you have an eye condition (PFDISL)
  Dr. said you have hearing problems (PFDISM)
  Dr. said you have depression/anxiety (PFDISN)
  Dr. said you have Alzheimer's/dementia (PFDISO)
  Dr. said you have seizures/brn disord (PFDISQ)
  Dr. said you have Parkinson's Disease (PFDISR)
  Dr. said you had oth musculoskel cond (PFDISS)
  Dr. said you have something else (PFDISP)
  # different prescription meds per day (HLMDRUGS)
  Past yr,how oft in hosp overnight (HLMHOSP)
  Past yr, overnight in nursing home (HLMNH)


Social functioning
  # days past 2 wks left home,any reason (SFACT09)
  Feel doing enough social activities (SFENUF)
  Past 4 wks:# times hlth hamper actvty (SFINTFR)