Questionnaire Text

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19. Because of a health condition that has lasted for 6 or more months, does this person have any difficulty --

[Consider a person to have difficulty with these activities if any of the following situations apply: (1) it takes extra time or extra effort for the person to perform one or more of the activities, (2) there are times when the person cannot perform one or more of the activities, or (3) the person is completely unable to perform one more of the activities.]


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

[] Yes
[] No