Deceased Individual 2016 [instrument]


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0 First of all we, the team of “Living in Germany”, want to express our deepest regret for the loss of your family member. For many people it is very hard to talk to stranges about dying and death. Nevertheless because of the inadequate knowledge in the scientific community about this topic we would like to aks a couple of questions. We would like to know more about the last phase of your relatives live. Therefor we ask you kindly - to answer our representative the following questions - or carfully fill out this questionnaire by yourself. intro
1 Please enter according to address protocol. 0
2 Please state the first name, sex, and year of birth of the deceased person: 1
3 What was your family relationship with the person passed away? He / She was … 2
4 How old was your relative when he/she passed away? 3
5 Did the deceased person live in this household? 4
6 Do you know whether he/she ever participated the study “Living in Germany”? 5
7 What was the main home environment the person who died lived in the last years? 6
8 Where did he/she live? 7
9 Within the last 12 month of his/her life: How often did you have personal contact to the deceased person? (personally, by telephone, by writing) 8
10 Where did he/she decease? 9
11 Can you tell me what the cause of death was? 10
12 Had the person who passed away deposited one or some of the following documents? 11
13 Did the person who died had a reduced mental capacity? 12
14 How was the state of health of the person who passed away three month before death? 13
15 Was the deceased in need of assistance or care three months before he/she died? 14
16 For which of the following activities did the deceased Person needed assistence in? The person needed help with: 15
17 Think about the period of time before your relative passed away. How satisfied do you think he/she was with his/her life overall? 16
18 Finally a personal question to you: To which extend did the death of your relative changed your life? 17
19 What is the date today and at what time did you finish filling out the questionnaire? a
Instrument info

Name: soep-core-2016-vp

Label: Deceased Individual 2016

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DDI on Rails, designed and built by Marcel Hebing.
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