General Social Survey (GSS) - 2012 - Questionnaire

• Date of birth of respondent (BDR)
• Confirmation of marital status of the respondent (CMR)
• Number of children (NLC)
• Main activity of respondent (MAR)
• Respondent ever worked (REW)
• Care receiving by respondent (CAR)
• Main health condition for which respondent received help (PRA)
• Activities for which respondent received help (ARE)
• Hours of help received by respondent (HAR)
• Number of people helping respondent (NPA)
• Relationship of people helping respondent (RPA)
• Types of people helping respondent (TPA)
• Age of people helping respondent (APA)
• Receiving emotional support by respondent (RES)
• Professional help received by activity (PAA)
• Number of hours of professional help provided to the respondent (DPA)
• Care needed and received by respondent (CNR)
• Prefer help from professional (PHP)
• Prefer help from family (PHF)
• Balance of help from family and professionals (BFP)
• Need for help (NFA)
• The primary caregiver (PGN)
• Relationship between the respondent and the primary caregiver (PGG)
• Work information of primary caregiver (PGW)
• Year when respondent started to receive help from primary caregiver (PGS)
• Still receiving help from primary caregiver (SRE)
• Month and year when receiving help ended (PGE)
• Difficulty finding help - If respondent had not received help (DFA)
• Distance between the respondent's and the caregiver's dwellings (PGD)
• Usual dwelling of respondent (care receiver) (PGU)
• Frequency of contact with primary caregiver (PGH)
• Transportation… (AGT)
• Meal preperation… (AGI)
• House maintenance… (AGO)
• Personal care… (AGP)
• Medical treatments… (AGM)
• Scheduling… (AGS)
• Banking… (AGB)
• Visiting… (AGV)
• Emotional help… (AGX)
• Caregiving by respondent (ICG)
• Types of help provided by respondent (APR)
• Number of hours of help provided by respondent (HAP)
• Number of people helped by respondent (PAR)
• Relationship of respondent to people receiving help (RRA)
• Demographics of people receiving help from respondent (DPR)
• Age of people receiving help from respondent (APX)
• Respondent providing emotional support (RPE)
• The primary care receiver (PRN)
• Gender and relationship (PRG)
• Health condition which requires help (PRP)
• Work information of primary care receiver (PRW)
• Year when respondent started to provide help (PRS)
• Still providing help to primary care receiver (SPR)
• Month and year when providing help ended (PRE)
• Distance between the respondent's and the care receiver's dwellings (PRD)
• Usual dwelling of primary care receiver (PRU)
• Frequency of contact with primary care receiver (PRH)
• Transportation… (ART)
• Meal preparation… (ARI)
• House maintenance… (ARO)
• Personal care… (ARP)
• Medical procedures… (ARM)
• Scheduling… (ARS)
• Banking… (ARB)
• Visiting… (ARV)
• Emotional help… (ARX)
• Care receiver considers respondent their primary caregiver (CCP)
• Number of other people who help primary care receiver (CGN)
• Relationship of other caregivers to primary care receiver (RNA)
• Demographics of other caregivers helping the primary care receiver (DNA)
• Relationship of the other person providing help to primary care receiver (ROA)
• Demographics of other person providing help to primary care receiver (DOA)
• Help provided to primary care receiver of respondent from paid workers, government agencies or voluntary organizations (HPO)
• Hours of received help (for primary care receiver of respondent) from paid workers or government or non-government organizations (HRA)
• Accommodate caregiving duties (ACD)
• Other type of support to accommodate caregiving duties (OAC)
• Caregiving history (CGH)
• Caregiving incident detail (CGI)
• End-of-life care (CGE)
• Currently providing end-of-life care (CPE)
• Preferred to provide end-of-life care at home (PEH)
• Conditions needed to provide end-of-life care at home (CEH)
• Compassionate care leave (CCL)
• Family life (ICL)
• Healthy behaviour (ICB)
• Physical health (ICP)
• Emotional health/Stress (ICS)
• Find it stressful - Related to caregiving (FIS)
• Caregiving responsibilities and the respondent's health (CRH)
• Coping methods to help the respondent deal with caregiving responsibilities (CMC)
• Finances (ICF)
• Best estimate of expenses (BEE)
• Education and employment of respondent (EOR)
• Consequences of caregiving on education (ICE)
• Work activities - Employment type (WET)
• Work activities - Last year employer information (WLY)
• Work activities - Hours worked (WHW)
• Work activities - Telework information (WTI)
• Work activities - Flexible work arrangements (FWA)
• Work-life balance (WLB)
• Satisfaction of respondent with current balance between job and home life (SRC)
• Impact of caregiving on employment in the past 12 months - Work leave (ITL)
• Impact of caregiving on employment in the last 12 months - Full days off work (ITA)
• Impact of caregiving on employment in the last 12 months - Gave up employment entirely (ITE)
• Impact of caregiving on employment in the last 12 months - Loss of Job (ITJ)
• Impact of caregiving on employment in the last 12 months - Other impacts (ITO)
• Interest in employment (INE)
• Impact of caregiving on employment prior to the last 12 months - Reducing hours (IPL)
• Impact of caregiving on employment prior to the last 12 months - Leave (days off) (IPA)
• Impact of caregiving on employment prior to the last 12 months - Gave up employment entirely (IPE)
• Impact of caregiving on employment prior to the last 12 months - Other impacts (IPO)
• Impact of caregiving on employment - Plans for retirement (IPR)
• Dwelling of respondent (DOR)
• Accessible housing of respondent (AHR)
• Self-rated health - Physical health (SHP)
• Self-rated health - Mental health (SHM)
• Healthy Eating Habits (HEH)
• Physical activity (PHS)
• Life satisfaction of respondent (LSR)
• Self-rated stress (SRS)
• Sleep (SLP)
• Feelings (FLG)
• Vision (VIS)
• Hearing (HRG)
• Speech (SPC)
• Mobility (GTA)
• Dexterity (HAF)
• Emotion (EMO)
• Memory (MEM)
• Cognition (TKG)
• Pain and discomfort (PAD)
• Long-term Health Conditions (CHC)
• Birthplace of respondent (BPR)
• Immigration status (RIM)
• Ethnic ancestry (ETH)
• Religion (RLR)
• Language of respondent (LNR)
• Income (INR)

Date of birth of respondent (BDR)

BDR_Q100

What is your date of birth?

(MIN: 1) (MAX: 31)

DK, RF

BDR_Q105

What is your date of birth?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. DK, RF

BDR_Q110

What is your date of birth?

(MIN: 1881) (MAX: 2017)

DK, RF

BDR_Q120

So, your age is ^BDR_D120. Is that correct?

1. Yes
2. No, return and correct date of birth
3. No, collect age
4. DK, RF

BDR_Q130

What is your age?

(MIN: 1) (MAX: 130)

DK, RF

BDR_R140

This survey is for persons aged 15 and older. So, for this household, the survey is now completed. Thank you for your co-operation.

Confirmation of marital status of the respondent (CMR)

CMR_Q100

I'd like to confirm your marital status. Are you ^piSelRespMarS?

1. Yes
2. No
3. DK, RF

CMR_Q110

What is your marital status? Are you:

1. married?
2. living common-law?
3. widowed?
4. separated?
5. divorced?
6. single, never married?
7. DK, RF

Number of children (NLC)

NLC_Q100

How many children do you have? Please include all birth, step and adopted children.

(MIN: 0) (MAX: 20)

DK, RF

Main activity of respondent (MAR)

MAR_Q110

During the past 12 months, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?

1. Working at a paid job or business
2. Looking for paid work
3. Going to school
4. Caring for children
5. Household work
6. Retired
7. Maternity/paternity or parental leave
8. Long term illness
9. Volunteering
10. Providing care to family or friends for a long term health condition
11. Other - Specify
12. DK, RF

MAR_S110

(During the past 12 months, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?)

(80 spaces)

DK, RF

MAR_Q133

Were you employed or self-employed at any time last week?

1. Yes
2. No
3. DK, RF

MAR_Q134

In the last four weeks, did you look for a job?

1. Yes
2. No
3. DK, RF

MAR_Q135

Were you employed or self-employed at any time during the past 12 months?

1. Yes
2. No
3. DK, RF

Respondent ever worked (REW)

REW_Q10

Have you ever been employed or self-employed?

1. Yes
2. No
3. DK, RF

REW_Q20

In what year did you last do any paid work?

(MIN: 1900) (MAX: 2017)

DK, RF

REW_Q30

How old were you when you last did any paid work?

(MIN: 10) (MAX: 130)

DK, RF

Care receiving by respondent (CAR)

CAR_R110

The next questions ask about help or care you may have received for a long-term illness, disability or aging. This help may come from family, friends, neighbours, paid workers or organizations. It may include help with driving, shopping, housework, personal care or anything else.

CAR_Q110

During the past 12 months, have you received help or care for a long-term health condition or a physical or mental disability?

1. Yes
2. No
3. DK, RF

CAR_Q115

During the past 12 months, have you received help for problems related to aging?

1. Yes
2. No
3. DK, RF

Main health condition for which respondent received help (PRA)

PRA_Q10

What is the main health condition or problem for which you have received help?

1. Arthritis (e.g., rheumatoid arthritis, osteoarthritis, lupus or gout)
2. Osteoporosis
3. Cardiovascular disease (including angina, heart attack, stroke and hypertension)
4. Kidney disease
5. Asthma
6. Chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD)
7. Diabetes
8. Migraine
9. Back problems
10. Cancer
11. Mental illness (e.g., depression, bipolar disorder, mania or schizophrenia)
12. Alzheimer's disease or dementia
13. All other neurological diseases (e.g., Parkinson's disease, multiple sclerosis, spina bifida, cerebral palsy)
14. Urinary or bowel incontinence
15. Digestive disease (e.g., celiac disease, irritable bowel syndrome, stomach ulcers, Crohn's disease)
16. Fibromyalgia, chronic fatigue syndrome or multiple chemical sensitivities
17. Developmental disability or disorder
18. Injury resulting from an accident
19. Aging / old age / frailty
20. Other - Specify
21. DK, RF

PRA_S10

(What is the main health condition or problem for which you have received help?)

(80 spaces)

(DK, RF not allowed)

PRA_Q15

Would you say that this condition is mild, moderate or severe?

1. Mild
2. Moderate
3. Severe
4. DK, RF

Activities for which respondent received help (ARE)

ARE_R10

The next questions ask about the types of help you received for the health condition or problem you just mentioned. Here we are talking about help only from family, friends, or neighbours. Exclude help from paid workers or organizations.

ARE_Q10

During the past 12 months, have you received help with:

… transportation to do shopping or errands, or to get to medical appointments, or social events?

1. Yes
2. No
3. DK, RF

ARE_Q20

During the past 12 months, have you received help with:

… meal preparation, meal clean-up, house cleaning, laundry or sewing?

1. Yes
2. No
3. DK, RF

ARE_Q30

During the past 12 months, have you received help with:

… house maintenance or outdoor work?

1. Yes
2. No
3. DK, RF

ARE_Q40

During the past 12 months, have you received help with:

… personal care, such as bathing, dressing, toileting, hair care, or care of nails?

1. Yes
2. No
3. DK, RF

ARE_Q50

During the past 12 months, have you received help with:

… medical treatments, such as changing bandages, taking medications, or other medical procedures?

1. Yes
2. No
3. DK, RF

ARE_Q60

During the past 12 months, have you received help with:

… scheduling or coordinating care-related tasks, such as making appointments or hiring professional help?

1. Yes
2. No
3. DK, RF

ARE_Q70

During the past 12 months, have you received help with:

… banking, bill paying or managing your finances?

1. Yes
2. No
3. DK, RF

ARE_Q80

During the past 12 months, have you received help with anything else?

1. Yes - Specify
2. No
3. DK, RF

ARE_S80

(During the past 12 months, have you received help with anything else?)

(80 spaces)

DK, RF

Hours of help received by respondent (HAR)

HAR_Q10

In an average week, how many hours of care or help did you receive with these activities?

(MIN: 0) (MAX: 168)

DK, RF

Number of people helping respondent (NPA)

NPA_Q10

During the past 12 months, how many family members, friends or neighbours have helped you with any of the previous activities?

(MIN: 1) (MAX: 60)

DK, RF

Relationship of people helping respondent (RPA)

RPA_Q10

How many of these people are your:

… immediate family (spouse or partner, children, parents and siblings)?

(MIN: 0) (MAX: 20)

DK, RF

RPA_Q20

How many of these people are your:

… extended family (e.g. cousins, grandparents, aunts, uncles, in-laws)?

(MIN: 0) (MAX: 20)

DK, RF

RPA_Q30

How many of these people are your:

… friends and neighbours?

(MIN: 0) (MAX: 20)

DK, RF

Types of people helping respondent (TPA)

TPA_Q10

How many of these people were women?

(MIN: 0) (MAX: 20)

DK, RF

TPA_Q20

At the time they were helping you, how many of these people were:

… employed?

(MIN: 0) (MAX: 20)

DK, RF

TPA_Q30

At the time they were helping you, how many of these people were:

… retired?

(MIN: 0) (MAX: 20)

DK, RF

TPA_Q40

At the time they were helping you, how many of these people were:

… unemployed?

(MIN: 0) (MAX: 20)

DK, RF

TPA_Q50

At the time they were helping you, how many of these people were:

… students?

(MIN: 0) (MAX: 20)

DK, RF

Age of people helping respondent (APA)

APA_Q10

How many of these people were:

… below the age of 19?

(MIN: 0) (MAX: 20)

DK, RF

APA_Q20

How many of these people were:

… 19 to 44?

(MIN: 0) (MAX: 20)

DK, RF

APA_Q30

How many of these people were:

… 45 to 64

(MIN: 0) (MAX: 20)

DK, RF

APA_Q40

How many of these people were:

… 65 to 79

(MIN: 0) (MAX: 20)

DK, RF

APA_Q50

How many of these people were:

… 80 years of age or older?

(MIN: 0) (MAX: 20)

DK, RF

Receiving emotional support by respondent (RES)

RES_Q10

During the past 12 months, have you received emotional support?

1. Yes
2. No
3. DK, RF

Professional help received by activity (PAA)

PAA_Q05

Now some questions about help from professionals. By professionals, we mean paid workers or organizations.

Have you received any types of help or care from professionals for a long-term health condition, disability or problems related to aging?

1. Yes
2. No
3. DK, RF

PAA_Q10

During the past 12 months, have you received professional help with:

… transportation to do shopping or errands, or to get to medical appointments, or social events?

1. Yes
2. No
3. DK, RF

PAA_Q20

During the past 12 months, have you received professional help with:

… meal preparation, meal clean-up, house cleaning, laundry or sewing?

1. Yes
2. No
3. DK, RF

PAA_Q30

During the past 12 months, have you received professional help with:

… house maintenance or outdoor work?

1. Yes
2. No
3. DK, RF

PAA_Q40

During the past 12 months, have you received professional help with:

… personal care, such as bathing, dressing, toileting, hair care, or care of nails?

1. Yes
2. No
3. DK, RF

PAA_Q50

During the past 12 months, have you received professional help with:

… medical treatments, such as changing bandages, taking medications or other medical procedures?

1. Yes
2. No
3. DK, RF

PAA_Q60

During the past 12 months, have you received professional help with:

… scheduling or coordinating care-related tasks such as making appointments or hiring professional help?

1. Yes
2. No
3. DK, RF

PAA_Q70

During the past 12 months, have you received professional help with:

… banking, bill paying or managing your finances?

1. Yes
2. No
3. DK, RF

PAA_Q80

During the past 12 months, did a professional provide you with emotional support?

1. Yes
2. No
3. DK, RF

PAA_Q90

During the past 12 months, did a professional provide you with any other type of help?

1. Yes - Specify
2. No
3. DK, RF

PAA_S90

During the past 12 months, did a professional provide you with any other type of help?

(80 spaces)

DK, RF

Number of hours of professional help provided to the respondent (DPA)

DPA_Q10

In an average week, how many hours of professional help did you receive with these activities?

(MIN: 0) (MAX: 168)

DK, RF

Care needed and received by respondent (CNR)

CNR_Q10

In general, did you receive the care or help you needed during the past 12 months? Please think of both professional care, and care from family and friends.

1. Yes
2. No
3. DK, RF

CNR_Q20

Why not?

(80 spaces)

DK, RF

Prefer help from professional (PHP)

PHP_Q10

For the types of help we have just talked about, would you rather have had professional help than help from family and friends?

1. Yes
2. No
3. DK, RF

Prefer help from family (PHF)

PHF_Q10

For the types of help we have just talked about, would you rather have had help from family and friends than help from professionals?

1. Yes
2. No
3. DK, RF

Balance of help from family and professionals (BFP)

BFP_Q10

For all the types of help we have just talked about, are you satisfied with the balance of help from family and friends, and from professionals?

1. Yes
2. No
3. DK, RF

BFP_Q20

Would you have preferred to receive more professional help or more help from family and friends?

1. More professional help
2. More family/friend help
3. DK, RF

Need for help (NFA)

NFA_Q10

During the past 12 months, did you need help or care for a long-term health condition, physical or mental disability, or problems related to aging?

1. Yes
2. No
3. DK, RF

NFA_Q30

Did you ask for help?

1. Yes
2. No
3. DK, RF

NFA_Q50

If you had needed help, would you have been able to get it?

1. Yes
2. No
3. DK, RF

NFA_Q60

If you had asked for help, do you think that you would have been able to get it?

1. Yes
2. No
3. DK, RF

NFA_Q70

Who would have provided this help to you?

1. 11. Immediate family (spouse or partner, children, parents and siblings)
2. 12. Extended family
3. 13. Friends, neighbours
4. 14. Paid workers, government, non-governmental organizations
5. DK, RF

The primary caregiver (PGN)

PGN_R10

Now some questions about the person who, over the past 12 months, has spent the most time and resources helping you because of a long-term health condition, a physical or mental disability, or problems related to aging. Exclude assistance from professionals.

PGN_Q10

What is the first name of this person?

(30 spaces)

DK, RF

PGN_Q20

How old is ^DT_PGN_Q10_R_E?

(MIN: 10) (MAX: 995)

DK, RF

PGN_Q30

How old was ^DT_PGN_Q10_R_E at the time of his/her death?

(MIN: 10) (MAX: 130)

DK, RF

Relationship between the respondent and the primary caregiver (PGG)

PGG_Q10

What ^DT_ISWAS the relationship of ^piPGN_Q10 to you?

1. Spouse/partner of respondent
2. Ex-spouse/Ex-partner of respondent
3. Son of respondent
4. Daughter of respondent
5. Father of respondent
6. Mother of respondent
7. Brother of respondent
8. Sister of respondent
9. Grandson of respondent
10. Granddaughter of respondent
11. Grandfather of respondent
12. Grandmother of respondent
13. Son-in-law of respondent
14. Daughter-in-law of respondent
15. Father-in-law of respondent
16. Mother-in-law of respondent
17. Brother-in-law of respondent
18. Sister-in-law of respondent
19. Nephew of respondent
20. Niece of respondent
21. Uncle of respondent
22. Aunt of respondent
23. Cousin of respondent
24. Close friend of respondent
25. Neighbour of respondent
26. Co-worker of respondent
27. Other - Specify
28. DK, RF

PGG_S10

(What ^DT_ISWAS the relationship of ^piPGN_Q10 to you?)

(80 spaces)

(DK, RF not allowed)

PGG_Q20

What ^DT_ISWAS ^piPGN_Q10's sex?

1. Male
2. Female
3. DK, RF

Work information of primary caregiver (PGW)

PGW_Q10

At the time you were receiving help:

… was ^piPGN_Q10 employed or self-employed?

1. Yes
2. No
3. DK, RF

PGW_Q20

At the time you were receiving help:

… did ^piPGN_Q10 work 30 hours or more in an average week?

1. Yes
2. No
3. DK, RF

Year when respondent started to receive help from primary caregiver (PGS)

PGS_Q10

In what year did you start to receive help from ^piPGN_Q10?

(MIN: 1910) (MAX: 2017)

DK, RF

PGS_Q20

How old were you when you started to receive help from ^piPGN_Q10?

(MIN: 0) (MAX: 130)

DK, RF

Still receiving help from primary caregiver (SRE)

SRE_Q10

Are you still receiving help from ^piPGN_Q10?

1. Yes
2. No
3. DK, RF

SRE_Q20

Why are you no longer receiving help from ^piPGN_Q10?

1. Respondent no longer needs help
2. Respondent moved
3. Caregiver moved
4. Caregiver is no longer able to provide care
5. Caregiver has become ill
6. Caregiver has died
7. Paid professional now provides care
8. Other - Specify
9. DK, RF

SRE_S20

(Why are you no longer receiving help from ^piPGN_Q10?)

(80 spaces)

DK, RF

Month and year when receiving help ended (PGE)

PGE_Q10M

In what month and year did you stop receiving help from ^piPGN_Q10?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. DK, RF

PGE_Q10Y

In what month and year did you stop receiving help from ^piPGN_Q10?

(MIN: 1911) (MAX: 2017)

DK, RF

Difficulty finding help - If respondent had not received help (DFA)

DFA_Q10

If ^piPGN_Q10 had not helped you, would you have had difficulty finding help from someone else?

1. Yes
2. No
3. DK, RF

Distance between the respondent's and the caregiver's dwellings (PGD)

PGD_Q10

How close does ^piPGN_Q10 live to you:

1. … in the same household?
2. … in the same building?
3. … less than 10 minutes by car?
4. … 10 minutes to less than 30 minutes by car?
5. … 30 minutes to less than 1 hour by car?
6. … 1 hour to less than 3 hours by car?
7. … 3 hours or more by car?
8. DK, RF

Usual dwelling of respondent (care receiver) (PGU)

PGU_Q10

Do you live:

1. … in a private household?
2. … in supportive housing?
3. … in an institution or care facility (such as hospital or nursing home)?
4. … in some other type of housing?
5. DK, RF

PGU_S10

(What type of housing?)

(80 spaces)

DK, RF

PGU_Q20

Did you move residences, in order to live closer to ^piPGN_Q10?

1. Yes
2. No
3. DK, RF

Frequency of contact with primary caregiver (PGH)

PGH_Q10

During the past 12 months, on average, how often did ^piPGN_Q10 see you? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

PGH_Q20

During the past 12 months, on average, how often did ^piPGN_Q10 have contact with you by letter, email or phone? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

Transportation... (AGT)

AGT_Q10

During the past 12 months, has ^piPGN_Q10 helped you with transportation to do shopping or errands, or to get to medical appointments, or social events?

1. Yes
2. No
3. DK, RF

AGT_Q20

How often has ^DT_AGGEND_E helped you with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

AGT_Q30

In an average ^DT_AGTIME_E, how much time has ^piPGN_Q10 spent helping you with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

AGT_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

AGT_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Meal preparation... (AGI)

AGI_Q10

During the past 12 months, has ^piPGN_Q10 helped you with meal preparation, meal clean-up, house cleaning, laundry or sewing?

1. Yes
2. No
3. DK, RF

AGI_Q20

How often has ^DT_AGGEND_E helped you with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

AGI_Q30

In an average ^DT_AGTIME_E, how much time has ^piPGN_Q10 spent helping you with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

AGI_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

AGI_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

House maintenance... (AGO)

AGO_Q10

During the past 12 months, has ^piPGN_Q10 helped you with house maintenance or outdoor work?

1. Yes
2. No
3. DK, RF

AGO_Q20

How often has ^DT_AGGEND_E helped you with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

AGO_Q30

In an average ^DT_AGTIME_E, how much time has ^piPGN_Q10 spent helping you with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

AGO_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

AGO_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Personal care… (AGP)

AGP_Q10

During the past 12 months, has ^piPGN_Q10 helped you with personal care?

1. Yes
2. No
3. DK, RF

AGP_Q20

How often has ^DT_AGGEND_E helped you with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

AGP_Q30

In an average ^DT_AGTIME_E, how much time has ^piPGN_Q10 spent helping you with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

AGP_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

AGP_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Medical treatments… (AGM)

AGM_Q10

During the past 12 months, has ^piPGN_Q10 helped you with medical treatments or procedures?

1. Yes
2. No
3. DK, RF

AGM_Q20

How often has ^DT_AGGEND_E helped you with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

AGM_Q30

In an average ^DT_AGTIME_E, how much time has ^piPGN_Q10 spent helping you with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

AGM_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

AGM_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Scheduling... (AGS)

AGS_Q10

During the past 12 months, has ^piPGN_Q10 helped you with scheduling or coordinating care-related tasks, such as making appointments or hiring professional help?

1. Yes
2. No
3. DK, RF

AGS_Q20

How often has ^DT_AGGEND_E helped you with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

AGS_Q30

In an average ^DT_AGTIME_E, how much time has ^piPGN_Q10 spent helping you with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

AGS_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. heures ou plus?
4. DK, RF

AGS_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Banking… (AGB)

AGB_Q10

During the past 12 months, has ^piPGN_Q10 helped you with banking, bill paying or managing your finances?

1. Yes
2. No
3. DK, RF

AGB_Q20

How often has ^DT_AGGEND_E helped you with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

AGB_Q30

In an average ^DT_AGTIME_E, how much time has ^piPGN_Q10 spent helping you with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

AGB_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

AGB_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Visiting… (AGV)

AGV_Q10

During the past 12 months, has ^piPGN_Q10 checked up on you by visiting or calling to make sure you were okay?

1. Yes
2. No
3. DK, RF

AGV_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Emotional help… (AGX)

AGX_Q10

During the past 12 months, has ^piPGN_Q10 provided you with emotional support?

1. Yes
2. No
3. DK, RF

AGX_Q40

Was there anyone else who could have provided this help to you?

1. Yes
2. No
3. DK, RF

Caregiving by respondent (ICG)

ICG_R110

The next questions ask about help or care you may have given to family, friends or neighbours for a long-term illness, disability or aging. This help may include driving them, shopping with or for them, helping with housework, personal care or anything else.

ICG_Q110

During the past 12 months, have you helped or cared for someone who had a long-term health condition or a physical or mental disability?

1. Yes
2. No
3. DK, RF

ICG_Q115

During the past 12 months, have you helped or cared for someone who had problems related to aging?

1. Yes
2. No
3. DK, RF

Types of help provided by respondent (APR)

APR_R10

The next questions ask about the types of help you have given to family, friends, or neighbours.

APR_Q10

During the past 12 months, have you helped someone with:

… transportation to do shopping or errands, or to get to medical appointments, or social events?

1. Yes
2. No
3. DK, RF

APR_Q20

During the past 12 months, have you helped someone with:

… meal preparation, meal clean-up, house cleaning, laundry or sewing?

1. Yes
2. No
3. DK, RF

APR_Q30

During the past 12 months, have you helped someone with:

… house maintenance or outdoor work?

1. Yes
2. No
3. DK, RF

APR_Q40

During the past 12 months, have you helped someone with:

… personal care, such as bathing, dressing, toileting, hair care, or care of nails?

1. Yes
2. No
3. DK, RF

APR_Q50

During the past 12 months, have you helped someone with:

… medical treatments, such as changing bandages, taking medications or other medical procedures?

1. Yes
2. No
3. DK, RF

APR_Q60

During the past 12 months, have you helped someone with:

… scheduling or coordinating care-related tasks, such as making appointments or hiring professional help?

1. Yes
2. No
3. DK, RF

APR_Q70

During the past 12 months, have you helped someone with:

… banking, bill paying or managing their finances?

1. Yes
2. No
3. DK, RF

APR_Q80

During the past 12 months, have you helped someone with:

… anything else?

1. Yes
2. No
3. DK, RF

APR_S80

(Anything else? )

(80 spaces)

DK, RF

Number of hours of help provided by respondent (HAP)

HAP_Q10

In an average week, how many hours of care or help did you provide with these activities?

(MIN: 0) (MAX: 168)

DK, RF

Number of people helped by respondent (PAR)

PAR_Q10

During the past 12 months, how many family members, friends or neighbours have you helped with any of the previous activities?

(MIN: 1) (MAX: 60)

DK, RF

Relationship of respondent to people receiving help (RRA)

RRA_Q10

How many of these people are your:

… immediate family (spouse or partner, children, parents and siblings)?

(MIN: 0) (MAX: 20)

DK, RF

RRA_Q20

How many of these people are your:

… extended family (e.g. cousins, grandparents, aunts, uncles, in-laws)?

(MIN: 0) (MAX: 20)

DK, RF

RRA_Q30

How many of these people are your:

… friends or neighbours?

(MIN: 0) (MAX: 20)

DK, RF

Demographics of people receiving help from respondent (DPR)

DPR_Q10

How many of these people are women?

(MIN: 0) (MAX: 20)

DK, RF

DPR_Q20

At the time you were helping them, how many were:

… employed?

(MIN: 0) (MAX: 20)

DK, RF

DPR_Q30

At the time ^YOU1 ^WERE helping them, how many were:

… retired?

(MIN: 0) (MAX: 20)

DK, RF

DPR_Q40

At the time ^YOU1 ^WERE helping them, how many were:

… unemployed?

(MIN: 0) (MAX: 20)

DK, RF

DPR_Q50

At the time ^YOU1 ^WERE helping them, how many were:

… students?

(MIN: 0) (MAX: 20)

DK, RF

Age of people receiving help from respondent (APX)

APX_Q10

How many of these people were:

… below the age of 19?

(MIN: 0) (MAX: 20)

DK, RF

APX_Q20

How many of these people were:

… 19 to 44

(MIN: 0) (MAX: 20)

DK, RF

APX_Q30

How many of these people were:

… 45 to 64

(MIN: 0) (MAX: 20)

DK, RF

APX_Q40

How many of these people were:

… 65 to 79

(MIN: 0) (MAX: 20)

DK, RF

APX_Q50

How many of these people were:

… 80 years of age or older?

(MIN: 0) (MAX: 20)

DK, RF

Respondent providing emotional support (RPE)

RPE_Q10

During the past 12 months, have you provided emotional support?

1. Yes
2. No
3. DK, RF

The primary care receiver (PRN)

PRN_R10A

Now some questions about the person you have helped during the past 12 months.

PRN_R10B

Now some questions about the person to whom, over the past 12 months, you have dedicated the most time and resources because of a long-term health condition, a physical or mental disability, or problems related to aging.

PRN_Q10

What is the first name of this person?

(30 spaces)

DK, RF

PRN_Q20

How old is ^DT_PRN_Q10_R_E?

(MIN: 0) (MAX: 995)

DK, RF

PRN_Q30

How old was ^DT_PRN_Q10_R_E at the time of his/her death?

(MIN: 0) (MAX: 130)

DK, RF

PRN_Q40

Did ^DT_PRN_Q10_R_E die in:

1. … a hospital?
2. … a long-term care facility?
3. … their home?
4. … your home?
5. … some other place?
6. DK, RF

Gender and relationship (PRG)

PRG_Q10

What ^DT_ISWAS the relationship of ^piPRN_Q10 to you?

1. Spouse/partner of respondent
2. Ex-spouse/Ex-partner of respondent
3. Son of respondent
4. Daughter of respondent
5. Father of respondent
6. Mother of respondent
7. Brother of respondent
8. Sister of respondent
9. Grandson of respondent
10. Granddaughter of respondent
11. Grandfather of respondent
12. Grandmother of respondent
13. Son-in-law of respondent
14. Daughter-in-law of respondent
15. Father-in-law of respondent
16. Mother-in-law of respondent
17. Brother-in-law of respondent
18. Sister-in-law of respondent
19. Nephew of respondent
20. Niece of respondent
21. Uncle of respondent
22. Aunt of respondent
23. Cousin of respondent
24. Close friend of respondent
25. Neighbour of respondent
26. Co-worker of respondent
27. Other - Specify
28. DK, RF

PRG_S10

(What ^DT_ISWAS the relationship of ^piPRN_Q10 to you?)

(80 spaces)

DK, RF

PRG_Q20

What ^DT_ISWAS ^piPRN_Q10's sex?

1. Male
2. Female
3. DK, RF

Health problems which requires help (PRP)

PRP_Q10

What ^DT_ISWAS the main health condition or problem for which ^piPRN_Q10 received help?

1. Arthritis (e.g., rheumatoid arthritis, osteoarthritis, lupus or gout)
2. Osteoporosis
3. Cardiovascular disease (including angina, heart attack, stroke and hypertension)
4. Kidney disease
5. Asthma
6. Chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD)
7. Diabetes
8. Migraine
9. Back problems
10. Cancer
11. Mental illness (e.g., depression, bipolar disorder, mania or schizophrenia)
12. Alzheimer's disease or dementia
13. All other neurological diseases (e.g., Parkinson's disease, multiple sclerosis, spina bifida, cerebral palsy)
14. Urinary or bowel incontinence
15. Digestive disease (e.g., celiac disease, irritable bowel syndrome, stomach ulcers, Crohn's disease)
16. Fibromyalgia, chronic fatigue syndrome or multiple chemical sensitivities
17. Developmental disability or disorder
18. Injury resulting from an accident
19. Aging / old age / frailty
20. Other - Specify
21. DK, RF

PRP_S10

(What ^DT_ISWAS the main health condition or problem for which ^piPRN_Q10 received help?)

(80 spaces)

(DK, RF not allowed)

PRP_Q15

Would you say that this condition is mild, moderate or severe?

1. Mild
2. Moderate
3. Severe
4. DK, RF

Work information of primary care receiver (PRW)

PRW_Q10

At the time you were providing help:

… was ^piPGN_Q10 employed or self-employed?

1. Yes
2. No
3. DK, RF

PRW_Q20

At the time you were providing help:

… did ^piPRN_Q10 work 30 hours or more in an average week?

1. Yes
2. No
3. DK, RF

Year when respondent started to provide help (PRS)

PRS_Q10

In what year did you start to help ^piPRN_Q10?

(MIN: 1910) (MAX: 2017)

DK, RF

PRS_Q20

How old were you when you started to help ^piPRN_Q10?

(MIN: 0) (MAX: 130)

DK, RF

Still providing help to primary care receiver (SPR)

SPR_Q10

Are you still helping ^piPRN_Q10?

1. Yes
2. No
3. DK, RF

SPR_Q20

Why are you no longer helping ^piPRN_Q10?

1. Care receiver no longer need help
2. Care receiver moved to care facility
3. Respondent moved
4. Respondent is no longer able to provide help
5. Respondent has become ill
6. Another family / friend / neighbour now provides help
7. Paid professional caregiver now provides care
8. Other - Specify
9. DK, RF

SPR_S20

(Why are you no longer helping ^piPRN_Q10?)

(80 spaces)

DK, RF

Month and year when providing help ended (PRE)

PRE_Q10M

In what month and year did you stop helping ^piPRN_Q10?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. DK, RF

PRE_Q10Y

In what month and year did you stop helping ^piPRN_Q10?

(MIN: 1911) (MAX: 2017)

DK, RF

Distance between the respondent's and the care receiver's dwellings (PRD)

PRD_Q10

How close does ^piPRN_Q10 live to you:

1. … in the same household?
2. … in the same building?
3. … less than 10 minutes by car?
4. … 10 minutes to less than 30 minutes by car?
5. … 30 minutes to less than 1 hour by car?
6. … 1 hour to less than 3 hours by car?
7. … 3 hours or more by car?
8. DK, RF

Usual dwelling of primary care receiver (PRU)

PRU_Q10

Does ^piPRN_Q10 live:

1. … in a private household?
2. … in supportive housing?
3. … in an institution or care facility (such as hospital or nursing home)?
4. … in some other type of housing?
5. DK, RF

PRU_S10

What type of housing?

(80 spaces)

DK, RF

PRU_Q20

Did you move residences, in order to live closer to ^piPRN_Q10?

1. Yes
2. No
3. DK, RF

Frequency of contact with primary care receiver (PRH)

PRH_Q10

During the past 12 months, on average, how often did you see ^piPRN_Q10? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

PRH_Q20

During the past 12 months, on average, how often did you have contact with ^piPRN_Q10 by phone, email or letter? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

Transportation... (ART)

ART_Q10

During the past 12 months, have you helped ^piPRN_Q10 with transportation to do shopping or errands, or to get to medical appointments, or social events?

1. Yes
2. No
3. DK, RF

ART_Q20

How often have you helped ^DT_ARGEND_E with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

ART_Q30

In an average ^DT_ARTIME_E, how much time have you spent helping with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

ART_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

ART_Q40

Was there anyone else, other than a paid caregiver, who could have provided this help to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Meal preparation... (ARI)

ARI_Q10

During the past 12 months, have you helped ^piPRN_Q10 with meal preparation, meal clean-up, house cleaning, laundry or sewing?

1. Yes
2. No
3. DK, RF

ARI_Q20

How often have you helped ^DT_ARGEND_E with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

ARI_Q30

In an average ^DT_ARTIME_E, how much time have you spent helping with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

ARI_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

ARI_Q40

Was there anyone else, other than a paid caregiver, who could have provided this help to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

House maintenance... (ARO)

ARO_Q10

During the past 12 months, have you helped ^piPRN_Q10 with house maintenance or outdoor work?

1. Yes
2. No
3. DK, RF

ARO_Q20

How often have you helped ^DT_ARGEND_E with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

ARO_Q30

In an average ^DT_ARTIME_E, how much time have you spent helping with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

ARO_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

ARO_Q40

Was there anyone else, other than a paid caregiver, who could have provided this assistance to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Personal care... (ARP)

ARP_Q10

During the past 12 months, have you helped ^piPRN_Q10 with personal care?

1. Yes
2. No
3. DK, RF

ARP_Q20

How often have you helped ^DT_ARGEND_E with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

ARP_Q30

In an average ^DT_ARTIME_E, how much time have you spent helping with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

ARP_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

ARP_Q40

Was there anyone else, other than a paid caregiver, who could have provided this assistance to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Medical procedures... (ARM)

ARM_Q10

During the past 12 months, have you helped ^piPRN_Q10 with medical treatments or procedures?

1. Yes
2. No
3. DK, RF

ARM_Q20

How often have you helped ^DT_ARGEND_E with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

ARM_Q30

In an average ^DT_ARTIME_E, how much time have you spent helping with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

ARM_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

ARM_Q40

Was there anyone else, other than a medically trained professional, who could have provided this help to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Scheduling… (ARS)

ARS_Q10

During the past 12 months, have you helped ^piPRN_Q10 with scheduling or coordinating care-related tasks, such as making appointments or hiring professional help?

1. Yes
2. No
3. DK, RF

ARS_Q20

How often have you helped ^DT_ARGEND_E with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

ARS_Q30

In an average ^DT_ARTIME_E, how much time have you spent helping with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

ARS_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

ARS_Q40

Was there anyone else, other than a paid caregiver, who could have provided this assistance to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Banking… (ARB)

ARB_Q10

During the past 12 months, have you helped ^piPRN_Q10 with banking, bill paying or managing finances?

1. Yes
2. No
3. DK, RF

ARB_Q20

How often have you helped ^DT_ARGEND_E with these tasks? Was it:

1. daily?
2. at least once a week?
3. at least once a month?
4. less than once a month?
5. DK, RF

ARB_Q30

In an average ^DT_ARTIME_E, how much time have you spent helping with these tasks? Was it:

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

ARB_Q35

Would that be:

1. 10 hours to less than 15 hours?
2. 15 hours to less than 20 hours?
3. 20 hours or more?
4. DK, RF

ARB_Q40

Was there anyone else who could have provided this help to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Visiting… (ARV)

ARV_Q10

During the past 12 months, have you checked up on ^piPRN_Q10 by visiting or calling to make sure ^DT_GEND1_E was okay?

1. Yes
2. No
3. DK, RF

ARV_Q40

Was there anyone else who could have provided this help to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Emotional help… (ARX)

ARX_Q10

During the past 12 months, have you provided ^piPRN_Q10 with emotional support?

1. Yes
2. No
3. DK, RF

ARX_Q40

Was there anyone else who could have provided this help to ^DT_ARGEND_E?

1. Yes
2. No
3. DK, RF

Care receiver considers respondent their primary caregiver (CCP)

CCP_Q10

Would you say that ^piPRN_Q10 consider^DT_CCP10_E you to be ^DT_GEND_E primary caregiver?

1. Yes
2. No
3. DK, RF

CCP_Q20

Do you believe you ^DT_CCP20_E the main contact or coordinator for ^piPRN_Q10's care arrangements?

1. Yes
2. No
3. DK, RF

Number of other people who help primary care receiver (CGN)

CGN_R120

Now we would like to know about people other than you who provided help to ^piPRN_Q10.

CGN_Q120

How many other friends and family members have helped ^piPRN_Q10 during the past 12 months?

(MIN: 0) (MAX: 60)

DK, RF

Relationship of other caregivers to primary care receiver (RNA)

RNA_Q10

How many of these people are your:

… immediate family (spouse or partner, children, parents and siblings)?

(MIN: 0) (MAX: 20)

DK, RF

RNA_Q20

How many of these people are your:

… extended family (e.g. cousins, grandparents, aunts, uncles, in-laws)?

(MIN: 0) (MAX: 20)

DK, RF

RNA_Q30

How many of these people are your:

… friends or neighbours?

(MIN: 0) (MAX: 20)

DK, RF

Demographics of other caregivers helping the primary care receiver (DNA)

DNA_Q10

How many of these people are women?

(MIN: 0) (MAX: 20)

DK, RF

DNA_Q20

At the time they were providing help to ^piPRN_Q10:

… how many of these people were employed?

(MIN: 0) (MAX: 20)

DK, RF

DNA_Q31

At the time they were providing help to ^piPRN_Q10:

… how many of these people were below the age of 19?

(MIN: 0) (MAX: 20)

DK, RF

DNA_Q32

At the time they were providing help to ^piPRN_Q10:

… how many of these people were between 19 and 44?

(MIN: 0) (MAX: 20)

DK, RF

DNA_Q33

At the time they were providing help to ^piPRN_Q10:

… how many of these people were between 45 and 64?

(MIN: 0) (MAX: 20)

DK, RF

DNA_Q34

At the time they were providing help to ^piPRN_Q10:

… how many of these people were between 65 and 79?

(MIN: 0) (MAX: 20)

DK, RF

DNA_Q35

At the time they were providing help to ^piPRN_Q10:

… how many of these people were 80 years of age or older?

(MIN: 0) (MAX: 20)

DK, RF

Relationship of the other person providing help to primary care receiver (ROA)

ROA_Q10

What is the relationship between ^piPRN_Q10 and this person who provided help?

1. Spouse/partner of ^piPRN_Q10
2. Son of ^piPRN_Q10
3. Daughter of ^piPRN_Q10
4. Father of ^piPRN_Q10
5. Mother of ^piPRN_Q10
6. Brother of ^piPRN_Q10
7. Sister of ^piPRN_Q10
8. Grandson of ^piPRN_Q10
9. Granddaughter of ^piPRN_Q10
10. Son-in-law of ^piPRN_Q10
11. Daughter-in-law of ^piPRN_Q10
12. Nephew of ^piPRN_Q10
13. Niece of ^piPRN_Q10
14. Close friend of ^piPRN_Q10
15. Neighbour of ^piPRN_Q10
16. Other - Specify
17. DK, RF

ROA_S10

(What is the relationship between ^piPRN_Q10 and this person who provided help?)

(80 spaces)

(DK, RF not allowed)

Demographics of other person providing help to primary care receiver (DOA)

DOA_Q10

What is the sex of this person?

1. Male
2. Female
3. DK, RF

DOA_Q20

While providing help to ^piPRN_Q10, was this person employed?

1. Yes
2. No
3. DK, RF

DOA_Q30

How old is this person?

(MIN: 10) (MAX: 130)

DK, RF

Help provided to primary care receiver of respondent from paid workers, government agencies or voluntary organizations (HPO)

HPO_Q10

During the past 12 months, has piPRN_Q10 received help from professionals that is paid workers or organizations?

1. Yes
2. No
3. DK, RF

Hours of received help (for primary care receiver of respondent) from paid workers or government or non-government organizations (HRA)

HRA_Q10

In an average week, how many hours of help has ^DT_HESHE received from professionals?

1. less than 1 hour?
2. 1 hour to less than 3 hours?
3. 3 hours to less than 5 hours?
4. 5 hours to less than 10 hours?
5. 10 hours or more?
6. DK, RF

Accommodate caregiving duties (ACD)

ACD_R10

The next questions are about support you may have received from others to help you with your caregiving responsibilities.

ACD_Q10

To accommodate your caregiving duties:

… has your spouse or partner modified their life and work arrangements?

1. Yes
2. No
3. DK, RF

ACD_Q20

To accommodate your caregiving duties:

… have your children provided you with help (such as helping with household chores)?

1. Yes
2. No
3. DK, RF

ACD_Q30

To accommodate your caregiving duties:

… have your extended family members provided you with help?

1. Yes
2. No
3. DK, RF

ACD_Q40

To accommodate your caregiving duties:

… have your close friends or neighbours provided you with help?

1. Yes
2. No
3. DK, RF

ACD_Q50

To accommodate your caregiving duties:

… have your community, spiritual community, or cultural or ethnic groups provided you with help?

1. Yes
2. No
3. DK, RF

ACD_Q60

To accommodate your caregiving duties:

… have you had occasional relief or respite care?

1. Yes
2. No
3. DK, RF

ACD_Q70

To accommodate your caregiving duties:

… have your family or friends provided you with financial support?

1. Yes
2. No
3. DK, RF

ACD_Q80

To accommodate your caregiving duties:

… have you received money from government programs?

1. Yes
2. No
3. DK, RF

ACD_Q90

Have you received any Federal tax credits for which caregivers may be eligible (e.g., caregiver tax credit, infirm dependant tax credit, medical expense tax credit)?

1. Yes
2. No
3. DK, RF

Other type of support to accommodate caregiving duties (OAC)

OAC_Q20

Is there any other type of support that you would like to have to help with your caregiving duties?

1. Yes
2. No
3. DK, RF

OAC_Q30

What kinds of support would you like to have?

1. 11. Home care / support provided to recipient
2. 12. Financial support / Government assistance / Tax credit
3. 13. Information / Advice
4. 14. Emotional support / Counselling
5. 15. Help from medical professionals
6. 16. Occasional relief / Respite care
7. 17. Voluntary / Community services
8. 18. Other - Specify
9. DK, RF

OAC_S30

(What kinds of support would you like to have?)

(80 spaces)

DK, RF

Caregiving history (CGH)

CGH_Q100

Have you ever provided care to someone with a long-term health condition, disability or problems related to aging? Exclude paid assistance to clients or patients and volunteering on behalf of an organization.

1. Yes
2. No
3. DK, RF

CGH_Q110

Not including the people you have helped during the past 12 months, have you ever provided care to anyone else with a long-term health condition, a physical or mental disability or problems related to aging? Exclude paid assistance to clients or patients and volunteering on behalf of an organization.

1. Yes
2. No
3. DK, RF

CGH_Q120

How many people have you provided care to?

(MIN: 1) (MAX: 10)

DK, RF

Caregiving incident detail (CGI)

CGI_R100

We have a few questions about some of those people.

CGI_Q110

In what year did you begin to provide care to ^DT_PERSON?

(MIN: 1911) (MAX: 2017)

DK, RF

CGI_Q111

At what age did you begin to provide care to this person?

(MIN: 0) (MAX: 130)

DK, RF

CGI_Q120

In what year did you stop providing care to this person?

(MIN: 1911) (MAX: 2017)

DK, RF

CGI_Q121

At what age did you stop providing help to this person?

(MIN: 15) (MAX: 130)

DK, RF

CGI_Q130

What was the relationship of this person to you?

1. Spouse/partner of respondent
2. Ex-spouse/Ex-partner of respondent
3. Son of respondent
4. Daughter of respondent
5. Father of respondent
6. Mother of respondent
7. Brother of respondent
8. Sister of respondent
9. Grandson of respondent
10. Granddaughter of respondent
11. Grandfather of respondent
12. Grandmother of respondent
13. Son-in-law of respondent
14. Daughter-in-law of respondent
15. Father-in-law of respondent
16. Mother-in-law of respondent
17. Brother-in-law of respondent
18. Sister-in-law of respondent
19. Nephew of respondent
20. Niece of respondent
21. Uncle of respondent
22. Aunt of respondent
23. Cousin of respondent
24. Close friend of respondent
25. Neighbour of respondent
26. Co-worker of respondent
27. Other - Specify
28. DK, RF

CGI_S130

(What was the relationship of this person to you?)

(80 spaces)

DK, RF

CGI_Q140

Would you say that, other than professional care, this person considered you to be his or her primary caregiver (the person from whom he or she received the most time and resources)?

1. Yes
2. No
3. DK, RF

CGI_Q160

Did this person also receive professional care?

1. Yes
2. No
3. DK, RF

End-of-life care (CGE)

CGE_R100

Now I would like to ask about any end-of-life care you may have provided to family, friends or neighbours. Exclude paid assistance to clients or patients and volunteering on behalf of an organization.

CGE_Q100

Have you ever provided end-of-life care?

1. Yes
2. No
3. DK, RF

CGE_Q150

Have you provided end-of-life care during the past 12 months?

1. Yes
2. No
3. DK, RF

Currently providing end-of-life care (CPE)

CPE_Q10

^DT_CPE01_E you currently providing end-of-life care?

1. Yes
2. No
3. DK, RF

CPE_Q20

^DT_CPE01_E you provide this care in your home?

1. Yes
2. No
3. DK, RF

Preferred to provide end-of-life care at home (PEH)

PEH_Q10

Would you ^DT_PEH01_E to provide end-of-life care in your home?

1. Yes
2. No
3. DK, RF

Conditions needed to provide end-of-life care at home (CEH)

CEH_Q10

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… physical modifications to your home?

1. Yes
2. No
3. DK, RF

CEH_Q20

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… financial assistance to cover additional costs?

1. Yes
2. No
3. DK, RF

CEH_Q30

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… time off work without loss of pay?

1. Yes
2. No
3. DK, RF

CEH_Q40

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… better physical health or stamina?

1. Yes
2. No
3. DK, RF

CEH_Q50

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… health-related training?

1. Yes
2. No
3. DK, RF

CEH_Q60

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… home care support?

1. Yes
2. No
3. DK, RF

CEH_Q70

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… some other condition?

1. Yes
2. No
3. DK, RF

CEH_S70

What conditions would ^DT_CEH01_E you to provide end-of-life care to this person in your home? Would it be:

… some other condition?

(80 spaces)

DK, RF

Compassionate care leave (CCL)

CCL_Q10

Have you ever taken "Compassionate Care Leave" to care for a terminally ill family member or friend?

1. Yes
2. No
3. DK, RF

CCL_Q20

Did you take this leave during the past 12 months?

1. Yes
2. No
3. DK, RF

Family life (ICL)

ICL_R100

Now some questions about how all your caregiving responsabilities during the past 12 months may have affected your life?

Some questions may not apply to you but we have to ask the same questions of everyone.

ICL_Q100

In general, how have you been coping with your caregiving responsibilities? Would you say:

1. very well?
2. generally well?
3. not very well?
4. not well at all?
5. DK, RF

ICL_Q110

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time with your spouse or partner?

1. Yes
2. No
3. DK, RF

ICL_Q120

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time with your children?

1. Yes
2. No
3. DK, RF

ICL_Q130

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time with ^DT_OTHER family members?

1. Yes
2. No
3. DK, RF

ICL_Q135

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time with friends?

1. Yes
2. No
3. DK, RF

ICL_Q140

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time on social activities or hobbies?

1. Yes
2. No
3. DK, RF

ICL_Q150

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time on relaxing or taking care of yourself?

1. Yes
2. No
3. DK, RF

ICL_Q152

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time volunteering for an organization?

1. Yes
2. No
3. DK, RF

ICL_Q154

In the past 12 months, have your caregiving responsibilities caused you to:

… spend less time participating in political, social or cultural groups?

1. Yes
2. No
3. DK, RF

ICL_Q160

In the past 12 months, have your caregiving responsibilities caused you to:

… make holiday plans and change or cancel them?

1. Yes
2. No
3. DK, RF

ICL_Q170

In the past 12 months, have your caregiving responsibilities caused you to:

… not make holiday plans at all?

1. Yes
2. No
3. DK, RF

ICL_Q180

In the past 12 months, have your caregiving responsibilities caused you to:

… move residences?

1. Yes
2. No
3. DK, RF

ICL_Q210

In the past 12 months, have your caregiving responsibilities caused strain in your relationship with family members or friends?

1. Yes
2. No
3. DK, RF

Healthy behaviour (ICB)

ICB_Q10

In the past 12 months, have your caregiving responsibilities affected the amount of exercise that you usually get?

1. Yes
2. No
3. Ne fait pas d'exercice
4. DK, RF

ICB_Q15

Did the amount of exercise increase or decrease?

1. Increased
2. Decreased
3. DK, RF

ICB_Q20

In the past 12 months, have your eating habits changed as a result of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ICB_Q25

Have your eating habits become more healthy or less healthy?

1. More healthy
2. Less healthy
3. DK, RF

ICB_Q30

During the past 12 months, have your caregiving responsibilities affected the amount of alcohol you consume?

1. Yes
2. No
3. Don't drink alcohol
4. DK, RF

ICB_Q35

Did you:

1. … increase your drinking?
2. … decrease your drinking?
3. … stop drinking?
4. … start drinking?
5. DK, RF

ICB_Q40

In the past 12 months, have your smoking habits changed because of your caregiving responsibilities?

1. Yes
2. No
3. Don't smoke
4. DK, RF

ICB_Q45

Did you:

1. … increase the number of cigarettes you smoke?
2. … decrease the number of cigarettes you smoke?
3. … stop smoking?
4. … start smoking?
5. DK, RF

Physical health (ICP)

ICP_Q10

During the past 12 months, has your overall health suffered because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ICP_Q15

During the past 12 months, how physically strenuous were your caregiving responsibilities? Were they:

1. … very strenuous?
2. … strenuous?
3. … somewhat strenuous?
4. … not at all strenuous?
5. DK, RF

ICP_Q20

During the past 12 months, how often did you see a medical professional for your own health problems which resulted from your caregiving responsibilities?

1. Never
2. Once
3. 2 to 3 times
4. 4 or more times
5. DK, RF

ICP_Q25

Have your caregiving responsibilities prevented you from seeing a medical professional for health problems of your own?

1. Yes
2. No
3. DK, RF

ICP_Q30

During the past 12 months, have you suffered any injuries while peRForming your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ICP_Q35

Did you suffer one injury or more than one injury?

1. One injury
2. More than one injury
3. DK, RF

ICP_Q40

Did your most serious injury cause you to:

… limit your daily activities for at least one day?

1. Yes
2. No
3. DK, RF

ICP_Q50

Did your most serious injury cause you to:

… seek treatment from a medical professional?

1. Yes
2. No
3. DK, RF

ICP_Q60

Did your most serious injury cause you to:

… take time off from caregiving duties?

1. Yes
2. No
3. DK, RF

ICP_Q70

Did your most serious injury cause you to:

… take time off from your job or business?

1. Yes
2. No
3. DK, RF

Emotional health/Stress (ICS)

ICS_Q10

Do you feel you had a choice in taking on your caregiving responsibilities during the past 12 months?

1. Yes
2. No
3. DK, RF

ICS_Q20

Has your relationship with the person or persons you have been caring for strengthened during this time?

1. Yes
2. No
3. Stayed the same
4. DK, RF

ICS_Q30

How rewarding have your caregiving experiences been during the past 12 months? Were they:

1. … very rewarding?
2. … rewarding?
3. … somewhat rewarding?
4. … not at all rewarding?
5. DK, RF

ICS_Q40

How stressful have your caregiving responsibilities been during the past 12 months? Were they:

1. … very stressful?
2. … stressful?
3. … somewhat stressful?
4. … not at all stressful?
5. DK, RF

Find it stressful - Related to caregiving (FIS)

FIS_Q10

What specifically did you find stressful about caregiving?

1. 11. Managing own emotions
2. 12. Meeting needs of care receiver
3. 13. Making decisions for care receiver(s)
4. 14. Dealing with care receiver’s declining health
5. 15. Managing family conflict about caregiving
6. 16. Finding services for care receiver(s)
7. 17. Getting along with care receiver / managing care receiver’s mood
8. 18. Balancing caregiving and other responsibilities
9. 19. Other - Specify
10. DK, RF

FIS_S10

(What specifically did you find stressful about caregiving?)

(80 spaces)

DK, RF

Caregiving responsibilities and the respondent's health (CRH)

CRH_Q10

During the past 12 months, have your caregiving responsibilities caused you to feel:

… tired?

1. Yes
2. No
3. DK, RF

CRH_Q20

During the past 12 months, have your caregiving responsibilities caused you to feel:

… worried or anxious?

1. Yes
2. No
3. DK, RF

CRH_Q30

During the past 12 months, have your caregiving responsibilities caused you to feel:

… overwhelmed?

1. Yes
2. No
3. DK, RF

CRH_Q35

During the past 12 months, have your caregiving responsibilities caused you to feel:

… lonely or isolated?

1. Yes
2. No
3. DK, RF

CRH_Q40

During the past 12 months, have your caregiving responsibilities caused you to feel:

… short-tempered or irritable?

1. Yes
2. No
3. DK, RF

CRH_Q50

During the past 12 months, have your caregiving responsibilities caused you to feel:

… resentful?

1. Yes
2. No
3. DK, RF

CRH_Q60

During the past 12 months, have your caregiving responsibilities caused you to feel:

… depressed?

1. Yes
2. No
3. DK, RF

CRH_Q70

During the past 12 months, have your caregiving responsibilities caused you to feel:

… experience loss of appetite?

1. Yes
2. No
3. DK, RF

CRH_Q80

During the past 12 months, have your caregiving responsibilities caused you to feel:

… experience disturbed sleep?

1. Yes
2. No
3. DK, RF

CRH_Q90

During the past 12 months, have your caregiving responsibilities caused you to feel:

… experience any other symptoms?

1. Yes
2. No
3. DK, RF

CRH_S90

What were these symptoms?

(80 spaces)

DK, RF

Coping methods to help the respondent deal with caregiving responsibilities (CMC)

CMC_Q10

There are many ways of handling difficult situations. In the past 12 months, have you used any specific coping methods to help you deal with your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

CMC_Q20

What were these coping methods?

1. 11. Exercising / Walking / Yoga
2. 12. Professional counselling / Therapy
3. 13. Socializing or talking to friends or other caregivers
4. 14. Religious or spiritual practices / Meditation
5. 15. Reading / TV / Music
6. 16. Eating / Drinking / Smoking
7. 17. Other - Specify
8. DK, RF

CMC_S20

(What were these coping methods?)

(80 spaces)

DK, RF

CMC_Q30

In the past 12 months, have you used prescription drugs to help you cope with your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

Finances (ICF)

ICF_R210

The next questions ask about expenses you may have incurred in the past 12 months as a result of all your caregiving responsibilities. We are talking about out-of-pocket expenses that are not reimbursed.

ICF_Q210

In the past 12 months, have you had any out-of-pocket expenses for home modifications to accommodate your ^DT_CARERECEIVER needs?

1. Yes
2. No
3. DK, RF

ICF_Q220

In the past 12 months, have you had any out-of-pocket expenses for professional services for your ^DT_CARERECEIVER healthcare or rehabilitation?

1. Yes
2. No
3. DK, RF

ICF_Q230

In the past 12 months, have you had any out-of-pocket expenses for hiring people to help with your ^DT_CARERECEIVER daily activities?

1. Yes
2. No
3. DK, RF

ICF_Q240

In the past 12 months, have you had any out-of-pocket expenses for transportation, travel or accommodation because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ICF_Q250

During the past 12 months, have you had any out-of-pocket expenses for specialized aids or devices for your ^DT_CARERECEIVER use?

1. Yes
2. No
3. DK, RF

ICF_Q260

In the past 12 months, have you had any out-of-pocket expenses for prescription or non-prescription drugs for your ^DT_CARERECEIVER use?

1. Yes
2. No
3. DK, RF

ICF_Q270

During the past 12 months, have you had any other out-of-pocket expenses because of your caregiving responsibilities that we haven't covered so far?

1. Yes
2. No
3. DK, RF

ICF_Q271

What were these expenses for?

(200 spaces)

DK, RF

ICF_Q280

During the past 12 months, have you experienced financial hardship because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ICF_Q290

Have you had to:

… borrow money from family or friends?

1. Yes
2. No
3. DK, RF

ICF_Q300

Have you had to:

… take loans from a bank or financial institution?

1. Yes
2. No
3. DK, RF

ICF_Q310

Have you had to:

… use or defer savings?

1. Yes
2. No
3. DK, RF

ICF_Q320

Have you had to:

… modify your spending?

1. Yes
2. No
3. DK, RF

ICF_Q330

Have you had to:

… sell off assets?

1. Yes
2. No
3. DK, RF

ICF_Q340

Have you had to:

… file for bankruptcy?

1. Yes
2. No
3. DK, RF

ICF_Q350

Have you had to do anything else?

1. Yes
2. No
3. DK, RF

ICF_S350

Have you had to do anything else?

(80 spaces)

DK, RF

Best estimate of expenses (BEE)

BEE_Q10

What is your best estimate of these expenses ^PHRASE_E?

(MIN: 1) (MAX: 50000)

DK, RF

BEE_Q20

Which of the following categories did these expenses ^PHRASE_E fall into? Was it:

1. … less than $200?
2. … $200 to less than $500?
3. … $500 to less than $1,000?
4. … $1,000 to less than $2,000?
5. … $2,000 to less than $5,000?
6. … $5,000 or more?
7. DK, RF

Education of respondent (EOR)

EOR_R01

Now some questions about your education and employment.

EOR_Q01

Are you currently attending school, college, CEGEP or university?

1. Yes
2. No
3. DK, RF

EOR_Q02

What type of educational institution ^DT_EOR02_E you attend?

1. Elementary, junior high school or high school
2. Trade school, college, CEGEP or other non-university institution
3. University
4. DK, RF

EOR_Q03

^DT_EOR03_E you:

1. a full-time student?
2. a full-time student?
3. both a full-time and part-time student?
4. DK, RF

EOR_Q04

What is the highest level of education that you have completed?

1. Less than high school diploma or its equivalent
2. High school diploma or a high school equivalency certificate
3. Trade certificate or diploma
4. College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
5. University certificate or diploma below the bachelor's level
6. Bachelor's degree (e.g. B.A., B.Sc., LL.B.)
7. University certificate, diploma, degree above the bachelor's level
8. DK, RF

Consequences of caregiving on education (ICE)

ICE_Q20

In the past 12 months, have you postponed enrolling in an education or training program because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ICE_Q30

Did you postpone plans:

1. … indefinitely?
2. … to the next available starting date?
3. To some other date
4. DK, RF

ICE_Q50

In the past 12 months, have your studies been affected because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

Work activities - Employment type (WET)

WET_Q110

For how many weeks during the past 12 months were you employed?

(MIN: 1) (MAX: 52)

DK, RF

WET_Q120

Were you mainly:

1. a paid worker?
2. self-employed?
3. an unpaid family worker?
4. DK, RF

Work activities - Last year employer information (WLY)

WLY_Q110

What is the name of your business?

(80 spaces)

DK, RF

WLY_Q120

What kind of business, industry or service ^DT_WLY120_E this?

(80 spaces)

DK, RF

WLY_Q130

What kind of work ^DT_WLY130_E you doing?

(80 spaces)

DK, RF

WLY_Q140

What ^DT_WLY140_E your most important activities or duties?

(80 spaces)

DK, RF

WLY_Q145

Are you still working ^DT_WLY145_E?

1. Yes
2. No
3. DK, RF

WLY_Q150

Which of the following best describes your terms of employment in this job? ^DT_WLY150_E you a:

1. regular employee (no contractual or anticipated termination date)?
2. seasonal employee (employment on this job is intermittent according to the seasons of the year)?
3. term employee (term of employment has a set termination date)?
4. casual or on-call employee?
5. DK, RF

WLY_Q160

^DT_WLY150_E you a union member or covered by a union contract or collective agreement in this job?

1. Yes
2. No
3. DK, RF

Work activities - Hours worked (WHW)

WHW_Q110

Did you have more than one paid job last week?

1. Yes
2. No
3. DK, RF

WHW_Q120

How many hours a week ^DT_WHW120_E you usually work at your job?

(MIN: 0.1) (MAX: 168.0)

DK, RF

WHW_Q130

How many hours a week do you usually work at your main job?

(MIN: 0.1) (MAX: 168.0)

DK, RF

WHW_Q140

How many hours a week do you usually work at your main job(s)?

(MIN: 0.1) (MAX: 168.0)

DK, RF

WHW_Q160

Why ^DT_WHW160_E you usually work less than 30 hours a week?

1. 11. Own illness or disability
2. 12. Child care responsibilities
3. 13. Care responsibilities for an adult
4. 14. Other personal or family responsibilities
5. 15. Going to school
6. 16. Could only find part-time work
7. 17. Did not want full-time work
8. 18. Requirement of the work
9. 19. Full-time work is defined under 30 hours per week
10. 20. Other - Specify
11. DK, RF

WHW_S160

(Why ^DT_WHW160_E you usually work less than 30 hours a week?)

(80 spaces)

DK, RF

WHW_Q210

How many days a week ^DT_WHW210_E you usually work (including all jobs)?

(MIN: 1) (MAX: 7)

DK, RF

WHW_Q230

Which of the following best describes your usual work schedule at your ^DT_WHW230_E1? ^DT_WHW230_E2 it:

1. a regular daytime schedule or shift?
2. a regular evening shift?
3. a regular night shift?
4. a rotating shift? (one that changes periodically from days to evenings or to nights)
5. a split shift? (one consisting of two or more distinct periods each day)
6. a compressed work week?
7. on call or casual?
8. an irregular schedule?
9. Other - Specify
10. DK, RF

WHW_S230

(Which of the following best describes your usual work schedule at your ^DT_WHW230_E1? ^DT_WHW230_E2 it:)

(80 spaces)

DK, RF

Work activities - Telework information (WTI)

WTI_Q110

Excluding overtime, ^DT_WTI110_E you usually work any of your scheduled hours at home?

1. Yes
2. No
3. Not applicable
4. DK, RF

WTI_Q120

How many paid hours per week ^DT_WTI120_E you usually work at home?

(MIN: 1) (MAX: 168)

DK, RF

WTI_Q130

What is the main reason you ^DT_WTI130_E some of your work at home?

1. Taking care of children
2. Provide care to family or friends for long term health problem
3. Other personal or family responsibilities
4. Requirements of the job, no choice
5. Home is usual place of work
6. Better conditions of work
7. Saves time, money
8. Live too far from work to commute
9. Other - Specify
10. DK, RF

WTI_S130

(What is the main reason you ^DT_WTI130_E some of your work at home?)

(80 spaces)

(DK, RF not allowed)

Work activities - Flexible work arrangements (FWA)

FWA_Q120

^DT_FWA120_E you have a flexible schedule that ^DT_ALLOW_E you to choose the time begin and end your work day?

1. Yes
2. No
3. DK, RF

FWA_Q132

^DT_FWA130_E your employer:

… provide you with the option to work part-time?

1. Yes
2. No
3. DK, RF

FWA_Q133

^DT_FWA130_E your employer:

… provide you with the ability to take leave, paid or unpaid, to take care of your child(ren)?

1. Yes
2. No
3. DK, RF

FWA_Q134

^DT_FWA130_E your employer:

… provide you with the ability to take leave, paid or unpaid, to take care of your spouse, partner or other family members?

1. Yes
2. No
3. DK, RF

FWA_Q136

^DT_FWA130_E your employer:

… provide you with the ability to take extended leave without pay for personal reasons?

1. Yes
2. No
3. DK, RF

FWA_Q137

^DT_FWA130_E your employer:

… provide you with the option to telework?

1. Yes
2. No
3. DK, RF

FWA_Q150

Do you think you could ^DT_FWA150_E these flexible work arrangements without a negative impact on your career?

1. Yes
2. No
3. DK, RF

Work-life balance (WLB)

WLB_Q10

In the past 12 months, how often has it been difficult to fulfill family responsibilities because of the amount of time you spent on your job? Was it:

1. all of the time?
2. most of the time?
3. sometimes?
4. never?
5. DK, RF

WLB_Q20

In the past 12 months, how often has it been difficult to concentrate or fulfill your work responsibilities because of your family responsibilities? Was it:

1. all of the time?
2. most of the time?
3. sometimes?
4. never?
5. DK, RF

Satisfaction of respondent with current balance between job and home life (SRC)

SRC_Q10

How satisfied are you with the current balance between your job and home life? Are you:

1. very satisfied?
2. satisfied?
3. neither satisfied nor dissatisfied?
4. dissatisfied?
5. very dissatisfied?
6. DK, RF

SRC_Q20

Why are you dissatisfied?

1. 11. Not enough time for family (include spouse/partner and children)
2. 12. Spends too much time on job/main activity
3. 13. Not enough time for other activities (exclude work or family related activities)
4. 14. Cannot find suitable employment
5. 15. Employment related reason(s) (exclude spending too much time on job)
6. 16. Health reasons (include sleep disorders)
7. 17. Family related reason(s) (exclude not enough time for family)
8. 18. Other - Specify
9. DK, RF

SRC_S20

(Why are you dissatisfied?)

(80 spaces)

DK, RF

Impact of caregiving on employment in the last 12 months - Work leave (ITL)

ITL_R10

The next questions ask about the impact that caregiving may have had on your employment during the past 12 months.

ITL_Q10

How many times during the past 12 months did you go to work late, leave early or take time off during the day because of your caregiving responsibilities?

(MIN: 0) (MAX: 95)

DK, RF

ITL_Q20

Were you paid for this time off?

1. Yes
2. No
3. Some paid, some unpaid
4. DK, RF

ITL_Q30

Did you reduce your regular weekly hours of work because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ITL_Q40

How many fewer hours per week did you work because of your caregiving responsibilities?

(MIN: 0.5) (MAX: 60.0)

DK, RF

ITL_Q50

Did you lose some or all of your employment benefits because of this reduction in hours?

1. Yes - Some
2. Yes - All
3. No
4. DK, RF

ITL_Q51

Did you lose your:

… extended health benefits?

1. Yes
2. No
3. DK, RF

ITL_Q52

Did you lose your:

… dental benefits?

1. Yes
2. No
3. DK, RF

ITL_Q53

Did you lose your:

… employer-provided pension?

1. Yes
2. No
3. DK, RF

ITL_Q54

Did you lose your:

… life insurance?

1. Yes
2. No
3. DK, RF

ITL_Q55

Did you lose your:

… prescription medication coverage?

1. Yes
2. No
3. DK, RF

ITL_Q56

Did you lose your:

… any other type of benefit?

1. Yes
2. No
3. DK, RF

ITL_S56

(Did you lose your:

… any other type of benefit?))

(80 spaces)

DK, RF

Impact of caregiving on employment in the last 12 months - Full days off work (ITA)

ITA_Q10

How many times during the past 12 months did you take one or more days off from your job because of your caregiving responsibilities?

(MIN: 0) (MAX: 95)

DK, RF

ITA_Q20

How long was your longest time off?

1. Days
2. Weeks
3. Months
4. DK, RF

ITA_Q21

How long was your longest time off?

(MIN: 1) (MAX: 365)

DK, RF

ITA_Q22

How long was your longest time off?

(MIN: 1) (MAX: 52)

DK, RF

ITA_Q23

How long was your longest time off?

(MIN: 1) (MAX: 12)

DK, RF

ITA_Q30

Was this time off paid or unpaid?

1. Paid
2. Unpaid
3. Partly paid
4. DK, RF

ITA_Q35

What were your annual earnings before taxes from this job?

(MIN: -9000000) (MAX: 90000000)

DK, RF

Impact of caregiving on employment in the last 12 months - Gave up employment entirely (ITE)

ITE_Q10

During the past 12 months, did you quit a job because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ITE_Q20

For how long were you unemployed after you quit your job?

1. Weeks
2. Months
3. DK, RF

ITE_Q22

For how long were you unemployed after you quit your job?

(MIN: 1) (MAX: 52)

DK, RF

ITE_Q23

For how long were you unemployed after you quit your job?

(MIN: 1) (MAX: 12)

DK, RF

ITE_Q30

What circumstances would have enabled you to keep working while providing care at the same time?

1. 11. Availability of acceptable alternative care
2. 12. Affordable alternative care
3. 13. Ability to work flexible hours
4. 14. Ability to work fewer hours
5. 15. Help from family
6. 16. Did not want to keep working - preferred to care full time
7. 17. Other - Specify
8. DK, RF

ITE_S30

(What circumstances would have enabled you to keep working while providing care at the same time?)

(80 spaces)

DK, RF

ITE_Q35

What were your annual earnings before taxes from this job?

(MIN: -9000000) (MAX: 90000000)

DK, RF

Impact of caregiving on employment in the last 12 months - Loss of Job (ITJ)

ITJ_Q10

During the past 12 months, were you fired, laid off, or asked to resign from a job because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ITJ_Q20

How long were you unemployed after you lost your job?

1. Weeks
2. Months
3. DK, RF

ITJ_Q22

How long were you unemployed after you lost your job?

(MIN: 1) (MAX: 52)

DK, RF

ITJ_Q23

How long were you unemployed after you lost your job?

(MIN: 1) (MAX: 12)

DK, RF

ITJ_Q35

What were your annual earnings before taxes from this job?

(MIN: -9000000) (MAX: 9000000)

DK, RF

Impact of caregiving on employment in the last 12 months - Other impacts (ITO)

ITO_Q10

During the past 12 months, did you turn down a job offer or promotion, or decide not to apply for a job, because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ITO_Q20

Did you take a less demanding job because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

ITO_Q25

Did this less demanding job pay less or more than your previous job?

1. Paid less
2. Paid more
3. Paid the same
4. DK, RF

ITO_Q26

Did this less demanding job provide fewer or more benefits than your previous job?

1. Fewer benefits
2. More benefits
3. Same benefits
4. DK, RF

Interest in employment (INE)

INE_Q10

Have your caregiving responsibilities prevented you from working at a paid job?

1. Yes
2. No
3. DK, RF

INE_Q20

Are you interested in finding paid employment?

1. Yes
2. No
3. DK, RF

INE_Q30

Would you like a full or part-time job?

1. Full time
2. Part time
3. DK, RF

INE_Q41

What would enable you to work at a paid job?

1. 11. Ability to work from home
2. 12. Flexible hours
3. 13. Affordable care for care receiver
4. 14. Possibility of working fewer hours
5. 15. Better public transport
6. 16. Access to affordable childcare
7. 17. Other - Specify
8. DK, RF

INE_S41

(What would enable you to work at a paid job?)

(80 spaces)

DK, RF

Impact of caregiving on employment prior to the last 12 months - Reducing hours (IPL)

IPL_R05

The next questions ask about the impact that caregiving may have had on your employment over the years prior to the past 12 months.

IPL_Q05

Excluding the past 12 months, have you ever worked at a paid job while providing care?

1. Yes
2. No
3. DK, RF

IPL_Q10

Excluding the past 12 months, did you ever reduce your regular weekly hours of employment because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

IPL_Q20

Did you lose some or all of your employment benefits because you reduced your weekly hours?

1. Yes - Some
2. Yes - All
3. No
4. DK, RF

Impact of caregiving on employment prior to the last 12 months - Leave (days off) (IPA)

IPA_Q10

Excluding the past 12 months, did you ever have to take a leave from a job because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

IPA_Q20

How long was your longest leave?

1. Days
2. Weeks
3. Months
4. Years
5. DK, RF

IPA_Q21

How long was your longest leave?

(MIN: 1) (MAX: 365)

DK, RF

IPA_Q22

How long was your longest leave?

(MIN: 1) (MAX: 52)

DK, RF

IPA_Q23

How long was your longest leave?

(MIN: 1) (MAX: 12)

DK, RF

IPA_Q24

How long was your longest leave?

(MIN: 1.0) (MAX: 25.0)

DK, RF

IPA_Q30

Was this leave paid or unpaid?

1. Paid
2. Unpaid
3. Partly paid
4. DK, RF

IPA_Q35

What were your annual earnings before taxes from this job?

(MIN: -9000000) (MAX: 90000000)

DK, RF

Impact of caregiving on employment prior to the last 12 months - Gave up employment entirely (IPE)

IPE_Q10

Excluding the past 12 months, how many times did you have to quit a job because of your caregiving responsibilities?

(MIN: 0) (MAX: 995)

DK, RF

IPE_Q30

What circumstances would have enabled you to keep working while providing care at the same time?

1. 11. Availability of acceptable alternative care
2. 12. Affordable alternative care
3. 13. Ability to work flexible hours
4. 14. Ability to work fewer hours
5. 15. Help from family
6. 16. Did not want to keep working - preferred to care full time
7. 17. Other - Specify
8. DK, RF

IPE_S30

(What circumstances would have enabled you to keep working while providing care at the same time?)

(80 spaces)

DK, RF

Impact of caregiving on employment prior to the last 12 months - Other impacts (IPO)

IPO_Q10

Excluding the past 12 months, how many times were you ever fired, asked to resign or laid off from a job because of your caregiving responsibilities?

(MIN: 0) (MAX: 995)

DK, RF

IPO_Q20

Excluding the past 12 months, how many times did you turn down a job offer or promotion, or take a less demanding job because of your caregiving responsibilities?

(MIN: 0) (MAX: 995)

DK, RF

Impact of caregiving on employment - Plans for retirement (IPR)

IPR_Q10

Have you ever retired from a job or business?

1. Yes
2. No
3. DK, RF

IPR_Q20

^DT_TIMING_E affected because of your caregiving responsibilities?

1. Yes
2. No
3. DK, RF

IPR_Q30

Did you retire earlier or later than you would have preferred to?

1. Earlier
2. Later
3. Neither earlier nor later
4. DK, RF

IPR_Q40

How much ^DT_TIME_E?

1. Months
2. Years
3. DK, RF

IPR_Q43

How much ^DT_TIME_E?

(MIN: 1) (MAX: 12)

DK, RF

IPR_Q44

How much ^DT_TIME_E?

(MIN: 1) (MAX: 20)

DK, RF

IPR_Q50

What were your annual earnings before taxes from the last job you held before retiring?

(MIN: -9000000) (MAX: 90000000)

DK, RF

Dwelling of respondent (DOR)

DOR_R110

The following questions are about your housing characteristics.

DOR_Q110

In what type of dwelling are you now living? Is it a:

1. single detached house?
2. semi-detached or double (side by side)?
3. garden home, town-house or row house?
4. duplex (one above the other)?
5. low-rise apartment (less than 5 stories)?
6. high-rise apartment (5 or more stories)?
7. mobile home or trailer?
8. Other - Specify
9. DK, RF

DOR_S110

(In what type of dwelling are you now living? Is it a:)

(80 spaces)

DK, RF

DOR_Q119

Is this dwelling:

1. … owned by you or a member of this household, even if it is still being paid for?
2. … rented, even if no cash rent is paid?
3. DK, RF

DOR_Q130

Is there a mortgage on this dwelling?

1. Yes
2. No
3. DK, RF

DOR_Q210

How long have you lived in this dwelling?

1. Less than 6 months
2. 6 months to less than 1 year
3. 1 year to less than 3 years
4. 3 years to less than 5 years
5. 5 years to less than 10 years
6. 10 years and over
7. DK, RF

DOR_Q215

How long have you lived in this neighbourhood?

1. Less than 6 months
2. 6 months to less than 1 year
3. 1 year to less than 3 years
4. 3 years to less than 5 years
5. 5 years to less than 10 years
6. 10 years and over
7. DK, RF

DOR_Q216

How long have you lived in this city or local community?

1. Less than 6 months
2. 6 months to less than 1 year
3. 1 year to less than 3 years
4. 3 years to less than 5 years
5. 5 years to less than 10 years
6. 10 years and over
7. DK, RF

DOR_Q220

Would you say that you know:

1. … most of the people in your neighbourhood?
2. … many of the people in your neighbourhood?
3. … a few of the people in your neighbourhood?
4. … none of the people in your neighbourhood?
5. DK, RF

DOR_Q221

Would you say this neighbourhood is a place where neighbours help each other?

1. Yes
2. No
3. DK, RF

DOR_Q222

In the past month, have you done a favour for a neighbour?

1. Yes
2. No
3. Just moved into the area
4. DK, RF

DOR_Q223

In the past month, have any of your neighbours done a favour for you?

1. Yes
2. No
3. Just moved into the area
4. DK, RF

DOR_Q224

In your neighbourhood, is public transportation available (for example, bus, rapid transit or subway)?

1. Yes
2. No
3. DK, RF

Accessible housing of respondent (AHR)

AHR_R100

The next questions ask about how accessible your home may be to someone using a wheelchair.

AHR_Q100

Does your home have:

… a street level entrance with no steps?

1. Yes
2. No
3. DK, RF

AHR_Q110

Does your home have:

… a ramp at the entrance?

1. Yes
2. No
3. DK, RF

AHR_Q120

Does your home have:

… doorways that are wide enough for a wheelchair?

1. Yes
2. No
3. DK, RF

AHR_Q130

Does your home have:

… lowered counters in the kitchen or bathroom?

1. Yes
2. No
3. DK, RF

AHR_Q140

Does your home have:

… grab bars in the bathroom?

1. Yes
2. No
3. DK, RF

AHR_Q150

Does your home have:

… easy to open doors, including lever handles?

1. Yes
2. No
3. DK, RF

AHR_Q160

Does your home have:

… an elevator or lift device?

1. Yes
2. No
3. DK, RF

AHR_Q200

Are you aware of any government grants to make homes more accessible to persons with disabilities?

1. Yes
2. No
3. DK, RF

Self-rated health - Physical health (SHP)

SHP_R10

The following questions ask about your day-to-day health.

SHP_Q10

In general, would you say your health is:

1. excellent?
2. very good?
3. good?
4. fair?
5. poor?
6. DK, RF

Self-rated health - Mental health (SHM)

SHM_Q10

In general, would you say your mental health is:

1. excellent?
2. very good?
3. good?
4. fair?
5. poor?
6. DK, RF

Healthy Eating Habits (HEH)

HEH_Q100

In general, would you say that your eating habits are:

1. excellent?
2. very good?
3. good?
4. fair?
5. poor?
6. DK, RF

Physical activity (PHS)

PHS_Q10

In the past week, how many times did you participate in moderate or vigorous physical activity for leisure, work, housework or transportation?

(MIN: 0) (MAX: 50)

DK, RF

PHS_Q20

About how much time did you spend on each occasion?

1. Less than 15 minutes
2. 16 to 30 minutes
3. 31 to 60 minutes
4. More than 1 hour
5. DK, RF

Life satisfaction of respondent (LSR)

LSR_Q110

Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?

1. 0. Very dissatisfied
2. 1.   |
3. 2.   |
4. 3.   |
5. 4.   |
6. 5.   |
7. 6.   |
8. 7.   |
9. 8.   |
10. 9.   V
11. 10. Very satisfied
12. DK, RF

Self-rated stress (SRS)

SRS_Q10

Thinking of the amount of stress in your life, would you say that most days are:

1. … not at all stressful?
2. … not very stressful?
3. … a bit stressful?
4. … quite a bit stressful?
5. … extremely stressful?
6. DK, RF

Sleep (SLP)

SLP_Q110

Do you regularly have trouble going to sleep or staying asleep?

1. Yes
2. No
3. DK, RF

SLP_Q120

Do you take any medication to help you sleep?

1. Yes
2. No
3. DK, RF

Feelings (FLG)

FLG_R310

For each of the following six questions, please indicate whether the statement describes your feelings, using the categories: yes, more or less, or no.

FLG_Q310

I experience a general sense of emptiness.

1. Yes
2. More or less
3. No
4. DK, RF

FLG_Q320

There are plenty of people I can rely on when I have problems.

1. Yes
2. More or less
3. No
4. DK, RF

FLG_Q330

There are many people I can trust completely.

1. Yes
2. More or less
3. No
4. DK, RF

FLG_Q340

There are enough people I feel close to.

1. Yes
2. More or less
3. No
4. DK, RF

FLG_Q350

I miss having people around.

1. Yes
2. More or less
3. No
4. DK, RF

FLG_Q360

I often feel rejected.

1. Yes
2. More or less
3. No
4. DK, RF

Vision (VIS)

VIS_R110

The next set of questions ask about your day-to-day abilities.

VIS_Q110

Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?

1. Yes
2. No
3. DK, RF

VIS_Q120

Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?

1. Yes
2. No
3. DK, RF

VIS_Q130

Are you able to see at all?

1. Yes
2. No
3. DK, RF

VIS_Q140

Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?

1. Yes
2. No
3. DK, RF

VIS_Q150

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?

1. Yes
2. No
3. DK, RF

Hearing (HRG)

HRG_Q110

Are you usually able to hear what is said in a group conversation with at least three other people without a hearing aid?

1. Yes
2. No
3. DK, RF

HRG_Q120

Are you usually able to hear what is said in a group conversation with at least three other people with a hearing aid?

1. Yes
2. No
3. DK, RF

HRG_Q125

Are you able to hear at all?

1. Yes
2. No
3. DK, RF

HRG_Q130

Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?

1. Yes
2. No
3. DK, RF

HRG_Q140

Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?

1. Yes
2. No
3. DK, RF

Speech (SPC)

SPC_Q110

Are you usually able to be understood completely when speaking with strangers in your own language?

1. Yes
2. No
3. DK, RF

SPC_Q120

Are you able to be understood partially when speaking with strangers?

1. Yes
2. No
3. DK, RF

SPC_Q130

Are you able to be understood completely when speaking with those who know you well?

1. Yes
2. No
3. DK, RF

SPC_Q140

Are you able to be understood partially when speaking with those who know you well?

1. Yes
2. No
3. DK, RF

Mobility (GTA)

GTA_Q110

Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?

1. Yes
2. No
3. DK, RF

GTA_Q120

Are you able to walk at all?

1. Yes
2. No
3. DK, RF

GTA_Q130

Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?

1. Yes
2. No
3. DK, RF

GTA_Q140

Do you require the help of another person to be able to walk?

1. Yes
2. No
3. DK, RF

GTA_Q150

Do you require a wheelchair to get around?

1. Yes
2. No
3. DK, RF

GTA_Q160

How often do you use a wheelchair?

1. Always
2. Often
3. Sometimes
4. Never
5. DK, RF

GTA_Q170

Do you need the help of another person to get around in a wheelchair?

1. Yes
2. No
3. DK, RF

Dexterity (HAF)

HAF_Q110

Are you usually able to grasp and handle small objects such as a pencil or scissors?

1. Yes
2. No
3. DK, RF

HAF_Q120

Do you require the help of another person because of limitations in the use of hands or fingers?

1. Yes
2. No
3. DK, RF

HAF_Q130

Do you require the help of another person with:

1. … some tasks?
2. … most tasks?
3. … almost all tasks?
4. … all tasks?
5. DK, RF

HAF_Q140

Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of hands or fingers?

1. Yes
2. No
3. DK, RF

Emotion (EMO)

EMO_Q10

Would you describe yourself as being usually:

1. … happy and interested in life?
2. … somewhat happy?
3. … somewhat unhappy?
4. … unhappy with little interest in life?
5. … so unhappy that life is not worthwhile?
6. DK, RF

Memory (MEM)

MEM_Q110

How would you describe your usual ability to remember things? Are you:

1. … able to remember most things?
2. … somewhat forgetful?
3. … very forgetful?
4. … unable to remember anything at all?
5. DK, RF

Cognition (TKG)

TKG_Q110

How would you describe your usual ability to think and solve day-to-day problems? Are you:

1. … able to think clearly and solve problems?
2. … having a little difficulty?
3. … having some difficulty?
4. … having a great deal of difficulty?
5. … unable to think or solve problems?
6. DK, RF

Pain and discomfort (PAD)

PAD_Q110

Are you usually free of pain or discomfort?

1. Yes
2. No
3. DK, RF

PAD_Q120

How would you describe the usual intensity of your pain or discomfort?

1. Mild
2. Moderate
3. Strong
4. DK, RF

PAD_Q130

How many activities does your pain or discomfort prevent?

1. None
2. A few
3. Some
4. Most
5. DK, RF

Long-term Health Conditions (CHC)

CHC_Q100

Do you have any long-term health conditions, or physical or mental disabilities ^DT_CONDITION_E?

1. Yes
2. No
3. DK, RF

CHC_Q110

What is this condition?

1. 11. Arthritis (e.g., rheumatoid arthritis, osteoarthritis, lupus or gout)
2. 12. Osteoporosis
3. 13. Maladie cardiovasculaire (incluant angine, crise cardiaque, infarctus et hypertension)
4. 14. Kidney disease
5. 15. Asthma
6. 16. Chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD)
7. 17. Diabetes
8. 18. Migraine
9. 19. Back problems
10. 20. Cancer
11. 21. Mental illness (e.g., depression, bipolar disorder, mania or schizophrenia)
12. 22. Alzheimer's disease or dementia
13. 23. All other neurological diseases (e.g., Parkinson's disease, multiple sclerosis, spina bifida, cerebral palsy)
14. 24. Urinary or bowel incontinence
15. 25. Digestive disease (e.g., celiac disease, irritable bowel syndrome, stomach ulcers, Crohn's disease)
16. 26. Fibromyalgia, chronic fatigue syndrome or multiple chemical sensitivities
17. 27. Developmental disability or disorder
18. 28. Injury resulting from an accident
19. 29. Aging / old age / frailty
20. 30. Other - Specify
21. DK, RF

CHC_S110

(What is this condition?)

(80 spaces)

DK, RF

Birthplace of respondent (BPR)

BPR_R10

Now, I'd like to ask a few general questions.

BPR_Q10

In what country were you born?

(50 spaces)

DK, RF

BPR_S10

(In what country were you born?)

(80 spaces)

DK, RF

BPR_Q20

In which province or territory?

1. 10. Newfoundland and Labrador
2. 11. Prince Edward Island
3. 12. Nova Scotia
4. 13. New Brunswick
5. 24. Quebec
6. 35. Ontario
7. 46. Manitoba
8. 47. Saskatchewan
9. 48. Alberta
10. 59. British Columbia
11. 60. Yukon
12. 61. Northwest Territories
13. 62. Nunavut
14. DK, RF

Immigration status (RIM)

RIM_Q10

In what year did you first come to Canada to live?

(MIN: 1900) (MAX: 9995)

DK, RF

RIM_Q20

Are you now, or have you ever been, a landed immigrant in Canada?

1. Yes
2. No
3. DK, RF

RIM_Q30

In what year did you first become a landed immigrant in Canada?

(MIN: 1900) (MAX: 2011)

DK, RF

Ethnic ancestry (ETH)

ETH_Q110

What were the ethnic or cultural origins of your ancestors?

1. Canadian
2. English
3. French
4. Scottish
5. Irish
6. German
7. Italian
8. Aboriginal (North American Indian, Métis or Inuit)
9. Ukrainian
10. Chinese
11. Dutch (Netherlands)
12. Polish
13. South Asian (East Indian, Sri Lankan, Pakistani, Punjabi, etc.)
14. Jewish
15. Portuguese
16. Other - Specify
17. DK, RF

ETH_S110

(What were the ethnic or cultural origins of your ancestors?)

(80 spaces)

DK, RF

Religion (RLR)

RLR_Q100

What is your religion?

(50 spaces)

DK, RF

RLR_S100

(What is your religion?)

(80 spaces)

DK, RF

RLR_Q105

Not counting events such as weddings or funerals, during the past 12 months, how often did you participate in religious activities or attend religious services or meetings?

1. At least once a week
2. At least once a month
3. At least 3 times a year
4. Once or twice a year
5. Not at all
6. DK, RF

RLR_Q110

How important are your religious or spiritual beliefs to the way you live your life? Would you say they are:

1. very important?
2. somewhat important?
3. not very important?
4. not important at all?
5. DK, RF

RLR_Q120

In the past 12 months, how often did you engage in religious or spiritual activities on your own? This may include prayer, meditation and other forms of worship taking place at home or in any other location.

1. At least once a day
2. At least once a week
3. At least once a month
4. At least 3 times a year
5. Once or twice a year
6. Not at all
7. DK, RF

Language of respondent (LNR)

LNR_Q100

What language did you first speak in childhood?

1. 11. English
2. 12. French
3. 13. Italian
4. 14. Chinese
5. 15. German
6. 16. Portuguese
7. 17. Polish
8. 18. Ukrainian
9. 19. Spanish
10. 20. Vietnamese
11. 21. Greek
12. 22. Punjabi
13. 23. Arabic
14. 24. Tagalog (Filipino)
15. 25. Hungarian
16. 26. Other - Specify
17. DK, RF

LNR_S100

(What language did you first speak in childhood?)

(80 spaces)

(DK, RF not allowed)

LNR_Q111

Do you still understand English?

1. Yes
2. No
3. DK, RF

LNR_Q112

Do you still understand French?

1. Yes
2. No
3. DK, RF

LNR_Q113

Do you still understand Italian?

1. Yes
2. No
3. DK, RF

LNR_Q114

Do you still understand Chinese?

1. Yes
2. No
3. DK, RF

LNR_Q115

Do you still understand German?

1. Yes
2. No
3. DK, RF

LNR_Q116

Do you still understand Portuguese?

1. Yes
2. No
3. DK, RF

LNR_Q117

Do you still understand Polish?

1. Yes
2. No
3. DK, RF

LNR_Q118

Do you still understand Ukrainian?

1. Yes
2. No
3. DK, RF

LNR_Q119

Do you still understand Spanish?

1. Yes
2. No
3. DK, RF

LNR_Q120

Do you still understand Vietnamese?

1. Yes
2. No
3. DK, RF

LNR_Q121

Do you still understand Greek?

1. Yes
2. No
3. DK, RF

LNR_Q122

Do you still understand Punjabi?

1. Yes
2. No
3. DK, RF

LNR_Q123

Do you still understand Arabic?

1. Yes
2. No
3. DK, RF

LNR_Q124

Do you still understand Tagalog?

1. Yes
2. No
3. DK, RF

LNR_Q125

Do you still understand Hungarian?

1. Yes
2. No
3. DK, RF

LNR_Q126

Do you still understand ^LNR_S100?

1. Yes
2. No
3. DK, RF

LNR_Q140

What language do you speak most often at home?

1. 11. English
2. 12. French
3. 13. Italian
4. 14. Chinese
5. 15. German
6. 16. Portuguese
7. 17. Polish
8. 18. Ukrainian
9. 19. Spanish
10. 20. Vietnamese
11. 21. Greek
12. 22. Punjabi
13. 23. Arabic
14. 24. Tagalog (Filipino)
15. 25. Hungarian
16. 26. Other - Specify
17. DK, RF

LNR_S140

(What language do you speak most often at home?)

(80 spaces)

(DK, RF not allowed)

LNR_Q210

Can you speak English well enough to conduct a conversation?

1. Yes
2. No
3. DK, RF

LNR_Q220

Can you speak French well enough to conduct a conversation?

1. Yes
2. No
3. DK, RF

Income (INR)

INR_R025

Now, the last set of questions.

INR_Q025

What was your main source of income during the year ending December 31, ^DV_PASTYEAR?

1. 0. No income
2. 1. Employment including wages, salaries, commissions and tips
3. 2. Self-employment such as unincorporated business, professional practice or farm
4. 3. Investment income (dividends, interest or net rents from real estate)
5. 4. RRSPs or RRIFs (registered retirement income funds)
6. 5. Employment Insurance (or Quebec Parental Insurance Plan)
7. 6. Workers' Compensation
8. 7. Benefits from Canada or Quebec Pension Plan
9. 8. Retirement Pensions, Superannuation and Annuities
10. 9. Basic Old Age Security
11. 10. Guaranteed Income Supplement or Survivor's Allowance (from federal government only)
12. 11. Child Tax Benefit or family allowances
13. 12. Provincial, Territorial or Municipal Social Assistance or Welfare
14. 13. Child Support/Alimony
15. 14. Autre revenu - Précisez
16. DK, RF

INR_S025

(What was your main source of income during the year ending December 31, ^DV_PASTYEAR?)

(80 spaces)

DK, RF

INR_Q032

What is your best estimate of your total personal income, before taxes and deductions, from all sources during the year ending December 31, ^DV_PASTYEAR?

(MIN: -9000000) (MAX: 90000000)

DK, RF

INR_Q033

Can you estimate in which of the following groups your total personal income falls for the year ending December 31, ^DV_PASTYEAR? Was it:

1. … less than $30,000 (including income loss)?
2. … $30,000 or more?
3. DK, RF

INR_Q034

Please stop me when I have read the category which applies to you. Was it:

1. … less than $5,000?
2. … $5,000 to less than $10,000?
3. … $10,000 to less than $15,000?
4. … $15,000 to less than $20,000?
5. … $20,000 to less than $25,000?
6. … $25,000 to less than $30,000?
7. DK, RF

INR_Q035

Please stop me when I have read the category which applies to you. Was it:

1. … $30,000 to less than $40,000?
2. … $40,000 to less than $50,000?
3. … $50,000 to less than $60,000?
4. … $60,000 to less than $80,000?
5. … $80,000 to less than $100,000?
6. … $100,000 to less than $150,000?
7. … $150,000 or more?
8. DK, RF

INR_Q040

Not including you, how many other household members received income from any source during that period (the year ending December 31, ^DV_PASTYEAR)?

(MIN: 0) (MAX: 19)

DK, RF

INR_Q110

What is your best estimate of your total household income, received by all household members, from all sources, before taxes and deductions, during the year ending December 31, ^DV_PASTYEAR?

(MIN: -9000000) (MAX: 90000000)

DK, RF

INR_Q120

Can you estimate in which of the following groups your total household income falls for the year ending December 31, ^DV_PASTYEAR? Was it:

1. … less than $50,000 (including income loss)?
2. … $50,000 or more?
3. DK, RF

INR_Q130

Can you estimate in which of the following groups your total household income falls for the year ending December 31, ^DV_PASTYEAR?

Please stop me when I have read the category which applies to your household. Was it:

1. less than $5,000?
2. $5,000 to less than $10,000?
3. $10,000 to less than $15,000?
4. $15,000 to less than $20,000?
5. $20,000 to less than $30,000?
6. $30,000 to less than $40,000?
7. $40,000 to less than $50,000?
8. DK, RF

INR_Q140

Can you estimate in which of the following groups your total household income falls for the year ending December 31, ^DV_PASTYEAR?

Please stop me when I have read the category which applies to your household. Was it:

1. $50,000 to less than $60,000?
2. $60,000 to less than $70,000?
3. $70,000 to less than $80,000?
4. $80,000 to less than $90,000?
5. $90,000 to less than $100,000?
6. $100,000 to less than $150,000?
7. $150,000 or more?
8. DK, RF