No. | Questions |
---|---|
Instrumental Self-Maintenance | |
1 | Can you use public transportation (bus or train) by yourself? |
2 | Are you able to shop for daily necessities by yourself? |
3 | Are you able to prepare meals by yourself? |
4 | Are you able to pay bills? |
5 | Can you handle your own banking? |
Intellectual Activity | |
6 | Are you able to fill out forms for your pension? |
7 | Do you read newspapers or books? |
8 | Are you interested in news stories or programs dealing with health? |
Social Role | |
9 | Do you visit the homes of friends? |
10 | Are you sometimes called on for advice? |
11 | Are you able to visit sick friends? |
12 | Do you ever talk to young people yourself? |