Bathing, dressing or eating without assistance

42. Do you have difficulties in washing or dressing?

2. Instructions for answering questions
A wide variety of questions can help us learn about the country's residents' level of functioning and ability to cope in their daily life. In the population census survey we examine these issues through questions about the level of difficulty a person experiences when performing different activities.
Each question in this part is separate from the others and does not depend on the other questions. Therefore, each question is asked regardless of the answer received for the previous question.
a. The introduction
An introduction sentence appears before the questions, explaining the framework within which the questions are asked. The introduction presents the subject of the questions and explains the type of difficulties that should be addressed. The introduction is read out once and refers to the series of questions that follows.
In the questions, you should refer to difficulties which are the result of a health, physical or mental problem, lasting six months or more. This time frame was determined in order to focus on long-term and permanent difficulties and avoid collecting data on temporary difficulties, such as a person who broke his leg but will fully recover within a short time.

Question 5.40 - Do you experience any difficulty in getting dressed or bathing?

- If the person only experiences difficulties performing one of the actions that appear in the question, respond according to the difficulty in performing that action. For example, if a person experiences little trouble bathing, but does not have any trouble getting dressed, mark 'Yes - little trouble' (answer 2).

5.43 Question 3.7-3.10 General
These questions seek to determine whether the respondent has a physical or mental disability. In order to set the respondent at ease before asking these questions which might be seen as sensitive, begin by saying: "Now I would like to ask you some questions about any difficulty which you (or other members of the household) might have in carrying out every day activities due to mental or physical problems."

Disability - is defined as any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being. Such restriction or lack of ability must be as a result of an impairment. A person has an impairment if he or she has suffered any loss or abnormality of mind or body.

5.45 Question 3.10 Handicap
This question is intended to determine the particular area in which the person is handicapped as a result of the disability. Once the person has any difficulty at all in the area identified he must be included. It is important to note that a person can be handicapped in several areas. In such cases you must indicate for each area in which the handicap exists.

Self-Care - Score this if the person is not able to take care of himself/herself but is dependent on assistance from other people. Such care includes, for e.g. feeding and bathing oneself, and other personal care.

Mobility - This is applicable where the person is not able to move about effectively in his surroundings.

Communication - This refers to cases where the individual is not able to communicate with other persons i.e. he/she is unable to generate and emit messages or to receive and understand messages.

Schooling - This is applicable in cases where the person is not within the normal school system but has to attend a special school.

Employment - This refers to cases where because of his/her handicap, the individual is restricted to certain kinds of work.

None - Score this if the individual indicates that he/she is not handicapped in any area.

5.43 Question 3.7-3.10 General
These questions seek to determine whether the respondent has a physical or mental disability. In order to set the respondent at ease before asking these questions which might be seen as sensitive, begin by saying: "Now I would like to ask you some questions about any difficulty which you (or other members of the household) might have in carrying out every day activities due to mental or physical problems."

Disability - is defined as any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being. Such restriction or lack of ability must be as a result of an impairment. A person has an impairment if he or she has suffered any loss or abnormality of mind or body.

5.44 Question 3.9 Type of Disability
The categories are for the most part self-explanatory.

Physical Disability only - score this if the person's only impairment is the loss of use of parts of the body e.g. arms, legs.

Multiple Disability - score this for any combination of impairments.

Slowness at Learning or Understanding - score this only for persons who have been medically tested and found to be 'slow'.

Mental Retardation - it is very important to distinguish between mental retardation and mental illness. Mental Retardation exists where the person is born with a mental problem. Score this where it has been determined that the disease is one with which the person was born.

Mental Illness - is an illness acquired after birth.

P-37. What type of disability does [person] have?

Columns P37 to P38 contain questions pertaining to disabilities. These questions are to be asked of the head of the household or any other responsible person.

32.1 Introduction

Questions regarding disabilities have to be asked very carefully and with caution. You should not ask "Do you have a disability, or are you disabled, or are you blind, or deaf" nor "are you lame?'. This will generate very low rates of response because you will not get the correct answer. The word "disability" is regarded negatively in most communities particularly in developing countries. People may feel stigmatized or be ashamed to be identified as having a disability. In some cultures, disability is seen as punishment for sins committed in previous lives.
Also, even if people do not feel stigmatized, the word "disability" often implies a very significant condition. Persons who can walk around their homes but are unable to walk to the market may perceive their situation as not severe enough to be considered as having a disability.
Disability is interpreted relative to what is considered normal functioning (or different). This may vary across various cultures, age groups, or social class.

32.2 Definition of disability

The Disability Act 2003 defines disability as: physical, sensory, mental, or other impairment, including a visual, hearing or physical disability, which has a substantial long term adverse effect on a person's ability to carry out usual day to day activities. Disability is, therefore, viewed as a physical, mental, or psychological condition or impairment that substantially affects a person's daily activities or limits a person's ability to perform one or more basic life activities (referred to as activities of daily life? ADL) such as caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, earning a living, or working and interacting with other persons.
In this context, activities refer to a wide range of deliberate actions performed by an individual as opposed to particular body functions or structures. These are basic deliberate actions undertaken in order to accomplish a task such as dressing or feeding oneself.
In the 2009 Kenya Population and Housing Census we will classify one as having a disability if they have any of the following: visual, hearing and speech impairment; physical, mental and other disabilities, and self?care difficulties.

32.3 Types of disabilities

P-37. What type of disability does [person] have?

Columns P37 to P38 contain questions pertaining to disabilities. These questions are to be asked of the head of the household or any other responsible person.

32.1 Introduction

Questions regarding disabilities have to be asked very carefully and with caution. You should not ask "Do you have a disability, or are you disabled, or are you blind, or deaf" nor "are you lame?'. This will generate very low rates of response because you will not get the correct answer. The word "disability" is regarded negatively in most communities particularly in developing countries. People may feel stigmatized or be ashamed to be identified as having a disability. In some cultures, disability is seen as punishment for sins committed in previous lives.
Also, even if people do not feel stigmatized, the word "disability" often implies a very significant condition. Persons who can walk around their homes but are unable to walk to the market may perceive their situation as not severe enough to be considered as having a disability.
Disability is interpreted relative to what is considered normal functioning (or different). This may vary across various cultures, age groups, or social class.

32.2 Definition of disability

The Disability Act 2003 defines disability as: physical, sensory, mental, or other impairment, including a visual, hearing or physical disability, which has a substantial long term adverse effect on a person's ability to carry out usual day to day activities. Disability is, therefore, viewed as a physical, mental, or psychological condition or impairment that substantially affects a person's daily activities or limits a person's ability to perform one or more basic life activities (referred to as activities of daily life? ADL) such as caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, earning a living, or working and interacting with other persons.
In this context, activities refer to a wide range of deliberate actions performed by an individual as opposed to particular body functions or structures. These are basic deliberate actions undertaken in order to accomplish a task such as dressing or feeding oneself.
In the 2009 Kenya Population and Housing Census we will classify one as having a disability if they have any of the following: visual, hearing and speech impairment; physical, mental and other disabilities, and self?care difficulties.

32.3 Types of disabilities

P-37. What type of disability does [person] have?

Columns P37 to P38 contain questions pertaining to disabilities. These questions are to be asked of the head of the household or any other responsible person.

32.1 Introduction

Questions regarding disabilities have to be asked very carefully and with caution. You should not ask "Do you have a disability, or are you disabled, or are you blind, or deaf" nor "are you lame?'. This will generate very low rates of response because you will not get the correct answer. The word "disability" is regarded negatively in most communities particularly in developing countries. People may feel stigmatized or be ashamed to be identified as having a disability. In some cultures, disability is seen as punishment for sins committed in previous lives.
Also, even if people do not feel stigmatized, the word "disability" often implies a very significant condition. Persons who can walk around their homes but are unable to walk to the market may perceive their situation as not severe enough to be considered as having a disability.
Disability is interpreted relative to what is considered normal functioning (or different). This may vary across various cultures, age groups, or social class.

32.2 Definition of disability

The Disability Act 2003 defines disability as: physical, sensory, mental, or other impairment, including a visual, hearing or physical disability, which has a substantial long term adverse effect on a person's ability to carry out usual day to day activities. Disability is, therefore, viewed as a physical, mental, or psychological condition or impairment that substantially affects a person's daily activities or limits a person's ability to perform one or more basic life activities (referred to as activities of daily life? ADL) such as caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, earning a living, or working and interacting with other persons.
In this context, activities refer to a wide range of deliberate actions performed by an individual as opposed to particular body functions or structures. These are basic deliberate actions undertaken in order to accomplish a task such as dressing or feeding oneself.
In the 2009 Kenya Population and Housing Census we will classify one as having a disability if they have any of the following: visual, hearing and speech impairment; physical, mental and other disabilities, and self?care difficulties.

32.3 Types of disabilities

Do you have any difficulty with the following activities?

Q15: Difficulty in self-care
Refers to a person who cannot or has difficulty in cleaning their body or dressing, such as people who are crippled, partially paralyzed, or wholly paralyzed.

11. Disability _ _ _

Column 11 - Disability
Write 'Yes' if the person, because of a long-term physical/mental condition or health problem, experiences any disability, i.e. any limitation to perform any daily-life activity in a manner considered normal for a person of his/her age. Long-term physical/mental condition or health problem is one that has lasted or is expected to last for six months or more.
A long-term disability or handicap is one that has lasted or is expected to last for six months or more.
Then describe the disabilities using the following abbreviations:

If the person has no long-term disability or handicap, write 'No'.

P12B. If [Yes] at P12A, state the severity of all applicable difficulties as follows:

E. Looking after oneself with regard to feeding, personal care and hygiene

P12A and P12B - Disability
The question provides information which is needed for the formulation and implementation of programs in support of the disabled (e.g. special education, employment and social aid).

8. How to fill in the Population Census Questionnaire

P12A and P12B - Disability
[figure omitted]
This question should be asked tactfully to obtain information as to whether the person has any difficulty to perform a daily-life activity (as listed at P12B - A to I) considered normal for his/her age. If the answer is "Yes", ask for the severity of all applicable difficulties as follows:

[figure omitted]
Shade the degree of severity for all applicable difficulties. If a difficulty is not applicable, leave the corresponding boxes blank.
If a person has reported that he/she is experiencing "I - Other difficulties" at P12B, specify the nature of the difficulty in the adjacent boxes.
[figure omitted]

Now I am going to ask you about (name): ________
Copy the name of the person from section II

For all persons
[Questions 1-10 are asked of all persons.]

10. Disability
Does [the respondent] have difficulty doing the following activities in his/her daily life:

In this section the information of the people who inhabit the dwelling, like the sex, age, level of studies, income, among others, is obtained.

Before requesting the information for each person, copy all the names in the spaces designated for them, and for each person start with the phrase: "Now I'm going to ask about (mention the name of the person you previously noted)", so that the informer knows about whom you will be asking the information.

For all persons
[Questions 1-11 are for all persons.]

10. Disabilities
This question identifies the people who have difficulties completing activities in daily life such as walking, seeing, speaking or communicating, listening, learning, or attending to their personal care.

For each question consider the following:

• Ask all the people who live in the dwelling.
• You can circle up to six codes when a person declares more than one difficulty.

• Have difficulties and limitations moving or getting around, going up stairs because of the lack of one or a part of one's leg; this also includes those whose legs are impaired or display movement restrictions, in such a way that they need the help of another person, wheelchair or other apparatus, like walkers or artificial legs.
• Display total loss of vision in one or both eyes, as well as those with weak vision and those who while using glasses can't see very well because of their advanced visual problem.
• Have difficulty communicating with others, due to the speech limitations or because they can't chat or converse in a comprehensible way. Remember to not include small children in this situation because due to their young age they still have natural difficulty speaking because they are still learning to do so.
• Can't hear, as well as those who display difficulties hearing (weak audio), in one or both ears, or those who even while using an audial device have listening difficulties due to the advanced state of the problem.
• Can't attend to their own personal care or display difficulties and limitations completing activities such as bathing themselves, getting dressed, or consuming food.
• Declare limitations or difficulties learning a new task of paying attention for a determined amount of time, as well as limitations remembering information, or performing activities that should be completed in daily life.
• This also includes the people who declare a mental problem like mental retardation or alternative conduct and behavior.

In this section, information is obtained for each of the people living in the housing unit.

Before requesting data for each resident, copy the details from Section II. List people and general data, their names, gender, and age, and write them down in the spaces provided. Do not forget to correct the person number when using more than one questionnaire.

[Figure omitted: image with text]

For the respondent to know who to provide the information about, start with the sentence: "Now I'm going to ask you about...", and mention the name of the person you previously wrote down.

Apply questions 1 through 11 for all the people who are habitual residents, including children, as well as elderly people.

10. Disability
This question identifies the degree of difficulty people have in performing some activities in their daily lives, such as seeing, hearing, walking, remembering or concentrating, providing self-care, speaking, or communicating. Also, if they have any mental problems or conditions.

The question consists of two parts. The first part asks about the degree of difficulty in six activities of daily living. The second part identifies people who have a mental problem or condition.

[p. 309]

[Figure omitted: image with text]

To ask these questions, consider the following:

For all members of the household, specify the degree of difficulty the person has in
[Questions 16 to 21 were asked of all household members]

20. Taking care of him/herself, such as bathing or dressing

For all 5 years old and over.
[Questions P13 to P16 were asked of persons 5 years or over.]

P13. Functional difficulty
Does [the respondent] have any difficulty/problem in ...?

P13-Functional Difficulty
As defined by the International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization, functioning is an umbrella term for body functions, body structures, activities, and participation. It denotes the positive aspects of the interaction between an individual (with a health condition) and that individual's contextual factors (environmental and personal factors). Environmental factors include the physical world and its features, the human-made physical world, other people in different relationships and roles, attitudes and values, social systems and services, and policies, rules and laws. Personal factors are factors that relate to individual such as age, gender, social status, life experiences, and so on.
A person with difficulty in functioning may have activity limitations, which means difficulties an individual may have in executing activities. An activity limitation may range from a slight to a severe deviation in terms of quality or quantity in executing the activity in a manner or to the extent that is expected of people without the health condition. In general, functional difficulties experienced by people may have been due to their health conditions. Health conditions refer to diseases or illnesses, other health problems that may be short
or long lasting injuries, mental or emotional problems, and problems with alcohol or drugs. A health condition may also include other circumstances such as pregnancy, ageing, stress, congenital anomaly, or genetic predisposition. Difficulty is usually manifested when a person is doing an activity with increased effort, discomfort or pain, slowness, or changes in the way he/she does the activity.
[pg. 119]
For the purpose of this census, functional difficulty is classified into six core categories. The concepts and definitions are based on ICF. These difficulties are the following:

Difficulty in self-caring (bathing or dressing)

20. Because of a health condition that has lasted for 6 or more months, does [respondent] have any difficulty --

20b. Taking care of his or her own personal needs, such as bathing, dressing, or getting around inside the home?

17.b. Dressing, bathing, or getting around inside the home?

16. Because of a physical, mental, or emotional condition lasting 6 months or more, does this person have any difficulty in doing any of the following activities:

17. Mark the "Yes" or "No" box for parts 17a. and 17b. of question 17 to indicate if the person has any difficulty doing any of the activities listed.

[Question 18 was asked of persons age 5 and above.]

c) Does this person have difficulty dressing or bathing?

18a-18c. Mark the "Yes" or "No" box to indicate if the person has serious difficulty with any of the activities listed in parts a, b, and c because of a physical, mental, or emotional condition.

18a-18c. Mark the "yes" or "no" box to indicate if the person has serious difficulty with any of the activities listed in parts a, b, and c because of a physical, mental, or emotional condition.

19c. Does this person have difficulty dressing or bathing?

Answer question 19a-c if this person is 5 years old or over. Otherwise skip to the questions for Person 2 on page 19.

P19. Mark the "yes" or "no" box to indicate if the person has serious difficulty with any of the activities listed in parts a, b, and c because of a physical, mental, or emotional condition.

The entire population
[Questions B16 through B28 were asked of all resident persons.]

Population aged 1 year or older.
[Question B21 through B26 were asked of all resident persons age 1 or older.]

B21-B26. The following questions pertain to difficulties which you may have in carrying out certain activities due to a health problem.

B21/26: set of short questions on disability recommended for the censuses (population aged 1 year and over)
The questions about disability issues have been greatly altered in relation to what previous censuses proposed. It is about Senegal aligning itself with the progress made in this area. The United Nations, through their experts on global statistics, created in the 2000s a group of experts, the Washington group, which developed a series of short questions for censuses and surveys according to the Basic Principles of Official Statistics. These questions identify the majority of those most at risk in the general population who have limited or restricted participation in public life. It is not a question of identifying the handicap or the cause of disability, the question is to identify the limitations of the respondent (and/or one of his or her family members) to have/potentially have difficulty in performing actions linked to their lifestyle and related functions: seeing, hearing, walking, having cognitive faculty, taking care of themselves, and communicating. These are the areas the questions included in the census questionnaire concern.
The questions to ask relate to the difficulties that the respondent or a family member may have in fulfilling certain tasks in a sustainable manner (6 months or more, in a recurring manner):

Each question has four response categories:

The severity scale is used in the response categories to identify the full range of functional domains ranging from the most benign to the most severe form. This is very important because we will have a full range of the respondent's capabilities.
NB: This question concerns the population aged at least 1 year.
On the PDA, you will choose the answer on a drop-down list.

P-12 Health and functioning
Does [the person have difficulty in the following?
Write the appropriate code [number from 1 to 6] in the box.

[3.7] Household members

[3.7.3] General health and functioning
Now, I am going to ask you health-related questions.

[3.7.3.7] Does the respondent have difficulty with self-care such as washing, dressing or feeding him/herself?

All persons (health)
[Questions P21a to P23 were asked of all persons about their health.]

P21a. Does this person experience difficulty / problems (with):

Disability

11. Self-care

14. Activities and participation

3.1. Disability

Persons with disabilities are defined here as those persons who are at greater risk than the general population for experiencing restrictions in performing specific tasks or participating in role activities.

[p.12]

Data about impairments (problems at the level of organs and anatomical structures) is different from data about activity limitations (limitations on the capacity of a person to act or behave in a desired manner, because of a health condition), which again is different from data about participation restrictions (limitations in what a person does that result from an interaction between impairments or activity limitations and barriers created by the person's environment).

Short-term disabilities due to temporary conditions such as broken legs and illness are excluded. Only disabilities lasting for at least six months or expected to last for more than six (6) months are to be included.

The following categories focus on whether the individual has any impairments:

Participation restrictions are problems an individual may experience in involvement in life situations. A participation restriction can be determined by comparing an individual's normal and regular involvement in activities with that expected of an individual without a disability.

The following categories focus on whether the individual has any participation/activity limitations:

19b. Taking care of his or her own personal needs, such as bathing, dressing, or getting around inside the home?

17. b. Dressing, bathing, or getting around inside the home?

18.

b) Does this person have serious difficulty walking or climbing stairs?

c) Does this person have difficulty dressing or bathing?

18a-18c. Mark the "Yes" or "No" box to indicate if the person has serious difficulty with any of the activities listed in parts a, b, and c because of a physical, mental, or emotional condition.

19c. Does this person have difficulty dressing or bathing?

Answer question 19a-c if this person is 5 years old or over. Otherwise skip to the questions for Person 2 on page 19.

P19. Mark the "Yes" or "No" box to indicate if the person has serious difficulty with any of the activities listed in parts a, b, and c because of a physical, mental, or emotional condition.

The next questions are about difficulties a person faces when performing certain activities due to health reasons.

13. Does [the respondent] have any difficulty with:

Part 1: Information about members of the household
Part 1 of the Census form consists of 41 questions, numbered sequentially from Question 1 to Question 41.

The respondent is the head of the household or a person knowledgeable about members of the household. For information on employment and birth history of women, DTV needs to interview DTDT face-to-face and collect information. In addition, for other information about members of the household, if the head of the household or the information provider is not knowledgeable, DTV also needs to interview DTDT face-to-face and record the information.

Question 13: Does [the respondent] have any difficulty when [...]?
This question is intended to gather information about difficulties a person may encounter in performing certain activities due to health problems/long term health problems, including difficulties due to the effects of old age, but does not include difficulties due to the children being young or not yet proficient in taking care of themselves (help from adults).

DTV asks about the conditions and level of difficulty of each person and in turn according to each ability, including vision, hearing, walking up the stairs, memory, self-care, and communication. Therein: