What kinds of things do you usually do for (NAME OF PERSON CARED FOR)? IF IS IN HOUSEHOLD (over and above what you would normally do for someone living with you/a child of his/her age?)

Personal care ?
(e.g. dressing, bathing, washing, shaving, cutting nails, feeding, using the toilet)
Physical help?
(e.g. with walking, getting up and down stairs, getting into and out of bed)
Helping with dealing with care services and benefits? (e.g. making appointments and phone calls, filling in forms)
Helping with other paperwork or financial matters? (e.g. writing letters, sending cards, filling in forms, dealing with bills, banking)
Other practical help?
(e.g. preparing meals, doing his/her shopping, laundry, housework, gardening, decorating, household repairs, taking to doctor’s or hospital)
Keeping him/her company?
(e.g. visiting, sitting with, reading to, talking to, playing cards or games)
Taking him/her out?
(e.g. taking out for a walk or drive, taking to see friends or relatives)
Giving medicines?
(e.g. making sure he/she takes pills giving injections, changing dressings)
Keeping an eye on him/her to see he/she is all right?
Other help?