EXPLAIN IF NECESSARY: Include help even if it was for a short time or provided by husband/ wife/

another family member.

ASK IF NECESSARY: [^Have/Has] [^you/[^name]] received help from anyone with walking across a

room, in the last month?

01 Yes

02 No

CATKF*

What about bathing or showering?

EXPLAIN IF NECESSARY: Include help even if it was for a short time or provided by husband/ wife/

another family member.

ASK IF NECESSARY: [^Have/Has] [^you/[^name]] received help from anyone with bathing or showering,

in the last month?

01 Yes

02 No

CATKG*

What about eating, such as cutting up food?

EXPLAIN IF NECESSARY: Include help even if it was for a short time or provided by husband/ wife/

another family member.

ASK IF NECESSARY: [^Have/Has] [^you/[^name]] received help from anyone with eating, such as

cutting up food, in the last month?

01 Yes

02 No

CATKH*

What about getting in or out of bed?

EXPLAIN IF NECESSARY: Include help even if it was for a short time or provided by husband/ wife/

another family member.

ASK IF NECESSARY: [^Have/Has] [^you/[^name]] received help from anyone with getting in or out of

bed, in the last month?

01 Yes

02 No

CATKI*

What about using the toilet, including getting up or down?

EXPLAIN IF NECESSARY: Include help even if it was for a short time or provided by husband/ wife/

another family member.

ASK IF NECESSARY: [^Have/Has] [^you/[^name]] received help from anyone with using the toilet,

including getting up or down, in the last month?

01 Yes

02 No

CATKJ*

What about shopping for groceries?

EXPLAIN IF NECESSARY: Include help even if it was for a short time or provided by husband/ wife/

another family member.

ASK IF NECESSARY: [^Have/Has] [^you/[^name]] received help from anyone with shopping for

groceries, in the last month?

01 Yes

02 No

CATKK*

What about taking medications?