Caregiver’s demographic profile
|
Gender |
|
Geographical Location |
|
|
Male |
|
City/Urban |
|
|
Female |
|
Rural |
|
|
Head of Household Status |
|
Children in the Household (under 18) |
|
|
Yes |
|
Yes |
|
|
No |
|
No |
|
|
Does the person(s) you are looking after live with you? |
|
Have you taken off work to assist this person(s)? |
|
|
Yes |
|
Yes |
|
|
No |
|
No |
|
|
Marital Status |
|
Education Level |
|
|
Married |
|
Less than High School |
|
|
Single |
|
High School Graduate |
|
|
Divorced |
|
Some College |
|
|
Separated |
|
College Graduate |
|
|
Common Law |
|
University Graduate |
|
|
Widowed |
|
Trade School |
|
|
Age of Caregiver |
|
Household Size |
|
|
18-34 |
|
Live alone |
|
|
35-44 |
|
Two people |
|
|
45-54 |
|
Three people |
|
|
55-64 |
|
Four people |
|
|
65 plus |
|
Five or more people |
|
|
Employment Status |
|
Household Income |
|
|
Full-Time Employment |
|
$10,000 to $25,999 |
|
|
Part-Time Employment |
|
$26,000 to $39,999 |
|
|
Seasonal Employment |
|
$40,000 to $54,999 |
|
|
Unemployment |
|
$55,000 to $69,999 |
|
|
Retired |
|
$70,000 to $89,999 |
|
|
Other |
|
$90,000 or more |
|
|
Ethnicity of Caregiver |
|
Do you have access to a vehicle? |
|
|
White |
|
Yes |
|
|
Black |
|
No |
|
|
Coloured |
|
Public transit |
|
|
Other |
|
Borrow |
|
|
No Reply |
|
Other |
|
|
Your own health since being a caregiver |
|
|
|
|
More stress and/or anxiety |
|
|
|
|
Gained or lost weight |
|
|
|
|
Trouble sleeping |
|
|
|
|
Maintained |
|
|
|
Person(s) for who care is provided
|
Number of Care Recipients |
|
Who provides most of the unpaid care? |
|
|
One |
|
You |
|
|
Two |
|
Someone else |
|
|
Three or more |
|
You and someone else |
|
|
Gender |
|
Distance to care recipient if they don’t live with you |
|
|
Male |
|
Less than a mile |
|
|
Female |
|
1 to 10 miles |
|
|
Both (if more than 1) |
|
11 to 20 miles |
|
|
Each |
|
More than 20 miles |
|
|
Age of the person you are providing care |
|
If the care recipient(s) do not live with you to they live in the following |
|
|
35 to 44 |
|
Home or apartment |
|
|
45 to 54 |
|
Retirement community |
|
|
55 to 64 |
|
Assisted living facility |
|
|
65 to 74 |
|
Nursing home |
|
|
75 to 84 |
|
Other |
|
|
85 plus |
|
No Reply |
|
|
Marital Status of Care Recipient |
|
How long have you been giving care |
|
|
Married or common law |
|
1 to 12 months |
|
|
Widowed |
|
13 months to 2 years |
|
|
Divorced |
|
More than 2 years less than 5 years |
|
|
Separated |
|
More than 5 years less than 10 years |
|
|
Single, never married |
|
More than 10 years less than 15 |
|
|
No Reply |
|
More than 15 years |
|
|
Is the person to whom you provide care: |
|
Types of Care provided |
|
|
Friend/neighbour/non relative |
|
Assisting with toileting |
|
|
Grandparent or great grandparent |
|
Bathing |
|
|
Father |
|
Dealing with diapers or ostomies |
|
|
Father-in-law |
|
Getting dressed |
|
|
Brother |
|
Feeding |
|
|
Brother-in-law |
|
Getting dressed |
|
|
Son |
|
Meal preparation |
|
|
Son-in-law |
|
Grocery shopping |
|
|
Husband |
|
Cleaning (dusting, vacuuming) |
|
|
Uncle or great uncle |
|
Managing the household (arranging appointments and services) |
|
|
Wife |
|
Outdoor maintenance |
|
|
Partner |
|
Indoor maintenance |
|
|
Aunt or great aunt |
|
Administering pills and/or injections |
|
|
Mother |
|
Going to medical appointments |
|
|
Mother-in-law |
|
Assisting with therapy and/or exercise |
|
|
Daughter |
|
|
|
|
Dauther-in-law |
|
|
|
Research Questions
What type of job do you have:
|
Administration |
|
Legal profession |
|
|
Advertising, marketing and PR |
|
Leisure, sport and tourism |
|
|
Animal and plant resources |
|
Management and statistics |
|
|
Charity and voluntary work |
|
Media and broadcasting |
|
|
Construction and property |
|
Mining and land surveying |
|
|
Education |
|
Performing arts |
|
|
Engineering, manufacturing and production |
|
Publishing and journalism |
|
|
Environment |
|
Retail, buying and selling |
|
|
Financial management and accountancy |
|
Scientific services |
|
|
Healthcare |
|
Social care and guidance work |
|
|
Hospitality and events management |
|
Transportation, logistics and distribution |
|
|
Information services |
|
Other |
|
|
Information technology |
|
|
|
|
Insurance and pensions |
|
|
|
|
Law enforcement and protection |
|
|
|