Questionnaire Text

Questionnaire form view entire document:  text  image
Census of population (inhabitants)

1. No. of a person _ _

____ Surname
____ Name

24. Is the person fully or seriously unable to perform the tasks typical for his/her age due to disability or chronic illness? (encircle)

[] 1Yes -- fully
[] 2Yes -- seriously
[] 0 No
Questionnaire instructions view entire document:  text  image
Part 4: Rules concerning filling in 2nd and 3rd page of the A Form

42. Is the person fully or seriously unable to perform the tasks typical for his/her age due to disability or chronic illness? (question 24) [p. 38]
The aim of this question is to specify the number of individuals, who evaluate their health conditions as serious -- in a significant part or generally -- and making it impossible to perform their basic activities appropriate for their age, such as professional work, education, household's management, and for kids -- entertainment. Disability in this case does not need to be certified by a medical committee on disability and employment (KIZ). The reverse situation is possible, when an individual with certified inability and obtaining annuities may consider himself as healthy or at least able to perform basic activities for his age.

Two main limitations concerning these disabilities are applied:

- Serious disability, so the partial inability to perform activities or health conditions making it highly problematic
- Full disability

In both cases only long term disabilities must be registered (exceeding 6 months), and must be caused by disablement or a chronic disease.

Basic activities in relation to one's age are:

- For kindergarten children (age 0-6) ability to take part in any entertaining activities with other children, and for newborns to the age of 1 -- ability to react to internal and external stimuli (crying, laughter, appropriate gestures, etc.). Serious disability is defined when the health condition make performing these activities truly problematic. Full disability should be defined in the case of serious disablement or nervous system's disorders.
- In the case of schoolchildren and pre-procreation age teenagers (age 7-17) -- going to a normal school and taking part in all obligatory activities (except PE lessons). Serious disability should be defined, when a child goes (or might have gone) to a school (or class) performed specially for disabled individuals or to a special educational point, as well as while going to traditional school he cannot perform his obligatory, but not psychical activities due to disablement or a chronic disease. Full disability is defined, when a child cannot go to any school, even to a special one. For children and teenagers with serious health disablement, parents -- besides the family pension -- additional nursing pension. Children with such pensions administered should be considered as individuals with limitations concerning performing their basic activities (partially or generally).
- In the case of individuals in the operation age (men aged 18-64, women aged 18-59) -- professional work, women household's management, going to a high school or to university (for individuals up to 25). Serious disability is defined, when an individual works (or might have worked) in a protected work's point or on a specially performed workplace, as well as one can perform only particular activities for a household. Serious disability is also defined in the case, when an individual must have limited his working hours or stops performing some activities, which had been considered as his responsibilities. It also applies to situations in which due to the health conditions an individual must have changed his working tools for specially adjusted ones. Full disability is defined, when an individual cannot perform any of basic activities or must have stopped them.
- In the case of individuals in the post-procreation age (men aged 65 and more, women aged 60 and more) -- possibility to perform basic self-servicing, as: self-dishes making, basic shopping, personal hygienic activities. Serious disability is defined when an individual needs some help to perform these activities. Full disability -- when these activities cannot be performed due to disablement or a chronic disease and a person needs a constant care.

Due to the fact that both asking and answering this question may be rather hard, it is advised to ask all household's members about this issue, providing it in a following way: 'Are there people among you, that have serious problems with performing their basic activities due to disablement or a chronic disease, that is they cannot perform them without problems, such as professional work performing, studying, household management, take part in children entertainment's activities or must be supported and cared about by others?'

If such individuals will be specified, they should be registered as '1.yes- seriously or as '2. yes- fully. Other, healthy individuals should be registered as '0.no'.