Part 1:
Is there anyone who regularly depends on you for help
or support? By that I mean that you do things they
couldn’t manage for themselves?

Part 2:
what relationship do they have to you?

Part 3:
how many hours do you spend helping them in an average week?

Part 4:
how much of a strain is it?

Part 5:
what do you help with?….

Part 1:
yes
no

Part 2:
(**if couple add 10 to code**) them in an average week?….
spouse
parent
parent in law
brother/sister
child
friend
neighbour
other (specify)…

Part 3:
code hours per week

Part 4:
a great strain
quite a strain
a moderate strain
not much of a strain
no strain at all

Part 5:
(code in order mentioned)
personal care (bathing, taking medicine etc.)….1
mobility round house…………………………. 2
household chores (cleaning, cooking etc.)……. 3
transportation outside (take shopping etc.)……. 4
dealing with officials, financial affairs etc.……. 5
companionship…………………………………6
child minding…………………………………. 7
other (specify)………………………………… 8