Section EM [ENVIRONMENTAL MODIFICATIONS] Sequence: 10

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1 NHATS Round 6 Section EM [ENVIRONMENTAL MODIFICATIONS] Sequence: 0 BOX EM BOX EM NOT ON FILE If NEW RESIDENCE flag <>, go to BOX EM. Else if (HO <> (COMMON OR SHARED ENTRANCE) and HO3= (YES, RAMP)) or HO8b= (YES, ELEVATOR) or HO8c= (YES, STAIRLIFT) or HOc= (YES, SHOWER GRABBAR) or HOd= (YES, SHOWER SEAT) or HOe= (YES, RAISED TOILET SEAT) or HOf= (YES, TOILET GRABBAR), go to EM. Otherwise, go to. EM em6dmodhere R6 D EM NEW RES ALL ITEMS HERE If HO<> (COMMON OR SHARED ENTRANCE) and HO3= (YES), display a ramp If HO8b= (YES), display an elevator If HO8c= (YES), display a stair lift or stair glide If HOc= (YES), display a grab bar in the shower or tub area If HOd= (YES), display a seat for the shower or tub If HOe= (YES), display a raised toilet or raised toilet seat If HOf= (YES), display grab bars around the toilet If only one item listed, display Was this item and it Otherwise, display Were all these items and any of them You told me that {you have/sp has}: {a ramp} {an elevator} {a stair lift or stair glide} {a grab bar in the shower or tub area} {a seat for the shower or tub} {a raised toilet or raised toilet seat} {grab bars around the toilet} {Was this item/were all these items} here when {you/{he/she}} moved in or did {you{he/she}} add {it/any of them}? ALL ITEMS HERE ADDED ONE OR MORE ITEMS DON T KNOW BOX EM BOX EM NOT ON FILE If (HO <> (COMMON OR SHARED ENTRANCE) and HO3 = (YES, RAMP) ) or HO8b = (YES, ELEVATOR) Page of 6

2 or HO8c = (YES, STAIRLIFT) or HOc = (YES, SHOWER GRABBAR) orhod = (YES, SHOWER SEAT) orhoe = (YES, RAISED TOILET SEAT) or HOf = (YES, TOILET GRABBAR), go to EM. Otherwise, go to. EM em6addlstyr em6addlstyr em6addlstyr3 em6addlstyr4 em6addlstyr5 em6addlstyr6 em6addlstyr7 R6 EMA RAMP ADDED IN LAST YR R6 EMB ELEVATOR ADDED IN LST YR R6 EMC STR LIFT ADDED IN LST YR R6 EMD SHWR GRABBAR ADD LST YR R6 EME BATHSEAT ADDED IN LST YR R6 EMF TOILETSEAT ADD IN LST YR R6 EMG TOILET GRABGARS ADDED YR Use Same Question Stem display If at first question item, do not display question text in brackets. Otherwise, display question text in brackets. If NEW RESIDENCE flag = (YES), display "We'd like to know {if this was/which of these were} added to {your/sp's} current home. Since {you/sp} moved here, did {you/he/she} add the" Display "current" in underlined text. If NEW RESIDENCE flag <>, display "Since the last interview in {LAST INT MONTH AND YEAR}, did {you/sp} add the" If only one item listed at EM, display if this was. Otherwise, display which of these were. If HO <> (COMMON OR SHARED ENTRANCE) and HO3= (YES), display RESPONSE [] and variable text {a} If HO8b= (YES), display RESPONSE [] and variable text {b} If HO8c= (YES), display RESPONSE [3] and variable text {c} If HOd= (YES), display RESPONSE [4] and variable text {d} If HOe= (YES), display RESPONSE [5] and variable text {e} If HOf= (YES), display RESPONSE [6] and variable text {f} If HOg= (YES), display RESPONSE [7] and variable text {g} {[}{We d like to know {if this was/which of these were} added to {your/sp's} current home. Since {you/sp} moved here, did {you/he/she} add the/since the last interview in {LAST INT MONTH AND YEAR}, did {you/sp} add the}{]} {RESPONSE [] a. ramp?} {RESPONSE [] b. elevator?} {RESPONSE [3] c. stair lift or stair glide?} {RESPONSE [4] d. grab bar in the shower or tub area?} {RESPONSE [5] e. seat for the shower or tub?} {RESPONSE [6] f. raised toilet or raised toilet seat?} {RESPONSE [7] g. grab bars around the toilet?} Page of 6

3 YES NO DON T KNOW Display 'variable text' in the a-g sequence until all rows have been displayed. BOX EM3 BOX EM3 NOT ON FILE If EM a-g = (NO), go to. Otherwise, go to EM3. EM3 em6payyufam em6payyufam em6payyufam3 em6payyufam4 em6payyufam5 em6payyufam6 em6payyufam7 R6 EM3A SP PAID FOR RAMP R6 EM3B SP PAID FOR ELEVATOR R6 EM3C SP PAID STAIR LFT GLIDE R6 EM3D SP PAID SHOWER GRABBAR R6 EM3E SP PAID SHOWER SEAT R6 EM3F SP PAID RAISD TOILT SEAT R6 EM3G SP PAID TOILET GRABBARS Use Same Question Stem display If at first question item, do not display question text in brackets. Otherwise, display question text in brackets. If EMa = (YES), display RESPONSE [] and variable text {a} If EMb= (YES), display RESPONSE [] and variable text {b} If EMc= (YES), display RESPONSE [3] and variable text {c} If EMd= (YES), display RESPONSE [4] and variable text {d} If EMe= (YES), display RESPONSE [5] and variable text {e} If EMf= (YES), display RESPONSE [6] and variable text {f} If EMg= (YES), display RESPONSE [7] and variable text {g} {[}Did {you/sp} or {your/{his/her}} family pay any of the cost of adding or getting the{]} {RESPONSE [] a. ramp?} {RESPONSE [] b. elevator?} {RESPONSE [3] c. stair lift or stair glide?} {RESPONSE [4] d. grab bar in the shower or tub area?} {RESPONSE [5] e. seat for the shower or tub?} {RESPONSE [6] f. raised toilet or raised toilet seat?} {RESPONSE [7] g. grab bars around the toilet?} Page 3 of 6

4 YES NO DON T KNOW Display 'variable text' in the a-g sequence until all rows have been displayed. em6paydevce em6paydevce em6paydevce3 em6paydevce4 em6paydevce5 em6paydevce6 em6paydevce7 em6paydevce8 em6paydevce9 R6 A SP PAID FOR VISION AIDS R6 B SP PAID FOR HEARING AID R6 C SP PAID FOR CANE R6 D SP PAID FOR WALKER R6 E SP PAID FOR WHEELCHAIR R6 F SP PAID FOR SCOOTER R6 G SP PAID FOR GRABBER R6 H SP PD SPECIAL DRESS ITM R6 I SP PAID ADAPTED UTENSILS Use Same Question Stem display If at a, do not display question text in brackets. Otherwise, display question text in brackets. Display "pay anything for" in bold underlined text. {[}Here are a few other devices that help with daily activities. Whether or not {you use/sp uses} them now, since the last interview in {LAST INT MONTH AND YEAR}, did {you/{he/she}} or {your/{his/her}} family pay anything for the following items for {you/{him/her}}?[}] {variable text [a-i]} RESPONSE [] a. glasses or other vision aids such as a magnifying glass? RESPONSE [] b. a hearing aid? RESPONSE [3] c. a cane? RESPONSE [4] d. a walker? RESPONSE [5] e. a wheelchair? RESPONSE [6] f. a scooter? RESPONSE [7] g. a reacher or grabber to pick up things more easily? RESPONSE [8] h. special items to help with dressing, such as button hooks or clothes that are designed to get on and off easily? RESPONSE [9] i. adapted utensils to help {you/sp} to eat or cut {your/{his/her}} food? IF NEEDED: Adapted utensils include things like easy-to-grip silverware, knives that rock, and plates with high sides. Page 4 of 6 YES NO

5 DON T KNOW Display 'variable text' in the a-i sequence until all rows have been displayed. EM5 em6payaltgth R6 EM5 PAY FOR THESE ALTOGETHER If EM3a= (YES), display ramp If EM3b= (YES), display elevator If EM3c= (YES), display stair lift or stair glide If EM3d= (YES), display grab bar in the shower or tub area If EM3e= (YES), display seat for the shower or tub If EM3f= (YES), display raised toilet or raised toilet seat If EM3g= (YES), display grab bars around the toilet If a= (YES), display glasses or other vision aids If b= (YES), display hearing aid If c= (YES), display cane If d= (YES), display walker If e= (YES), display wheelchair If f= (YES), display scooter If g= (YES), display reacher or grabber If h= (YES), display special items to help with dressing If i= (YES), display adapted utensils If more than one item displayed, display commas between each one and display "and" before the last display text. Thinking about the {ramp} {elevator} {stair lift or stair glide} {grab bar in the shower or tub area} {seat for the shower or tub} {raised toilet or raised toilet seat} {grab bars around the toilet} {glasses or vision aids} {hearing aid} {cane} {walker} {wheelchair} {scooter} {reacher or grabber} {special items to help with dressing} {adapted utensils} that {you/sp} (and {your/{his/her}} family) paid for since the last interview in {LAST INT MONTH AND YEAR}, about how much was that altogether? Was it more than $500, less than $500, or just about $500? 3 MORE THAN $500 LESS THAN $500 JUST ABOUT $500 DON'T KNOW EM7 Display 'variable text' in the a-i sequence until all rows have been displayed. EM6 em6morls000 R6 EM6 MORE LESS OR ABOUT $000 Was it more than $000, less than $,000, or just about $,000? 3 MORE THAN $,000 LESS THAN $,000 JUST ABOUT $,000 Page 5 of 6

6 DON'T KNOW EM7 em6morls00 R6 EM7 MORE LESS OR ABOUT $00 Was it more than $00, less than $,00, or just about $,00? 3 LESS THAN $00 JUST ABOUT $00 DON'T KNOW Go to Community. Page 6 of 6

Section RH [Rehabilitation] Sequence: 26

NHATS Round 6 Section RH [Rehabilitation] Sequence: 6 RH rh6rehab R6 RH RECEIVED REHAB IN LAST YEAR Display last year in underlined text. Physical rehabilitation or rehab services can help you improve