Survey Text

1972
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1972
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Please look at this card (Hand respondent Card M)

Card M
Mobility


In terms of health:
1. Must stay in bed all or most of the time.
2. Must stay in the house all or most of the time.
3. Need the help of another person in getting around inside or outside the house.
4. Need the help of some special aid, such as a cane or wheelchair in getting around inside or outside the house.
5. Does not need the help of another person or a special aid but has trouble getting around freely.
6. Does not have trouble getting around freely.


Which one of these statements fits -- best in terms of health? (Circle appropriate number)
[] 1 (24a)
[] 2 (24a)
[] 3 (24a)
[] 4 (24a)
[] 5 (24a)
[] 6 (NP)


If respondent does not understand or is unable to read the card, ask questions 19-23 for each person.


[End section M]


19. In terms of health must -- stay IN BED all or most of the time?
1 [] Y (24a)
[] N


20. In terms of health must -- stay IN THE HOUSE all or most of the time?
2 [] Y (24a)
[] N


21. Does -- need the help of ANOTHER PERSON in getting around inside or outside the house?
3 [] Y (24a)
[] N


22. Does -- need help of some SPECIAL AID, such as a cane or wheelchair in getting around inside or outside the house?
4 [] Y (24a)
[] N


23. Although -- does not need the help of another person or a special aid, does he have trouble getting around freely?
5 [] Y (24a)
6 [] N (NP)


Ask for each person with a limitation reported in item M or in questions 19-23:

24a. About how long has --

(1) had to stay in bed because of health?
(2) had to stay in the house because of health?
(3-4) needed help getting around inside or outside the house?
(5) had trouble getting around freely?

000 [] Less than 1 month
1 ____ Mos.
2 ____ Yrs.