Carol Bongiorno Baglady@peoplepc.com says:
I am a student at Cambridge College in Cambridge, MA.. I want to determine if any psychotherapy is used in dealing with the dying and death of an elderly loved one. Also if money and education has any effect. This questionnaire is for anyone involved in the care of the family member or the family member who is terminally ill.
1. Which member of your family is/was terminally ill?
2. Who took care of this family member? Check all that apply: family member friends of family hospice private care provide 2a. If a family member, who specifically? 2b. Other caregiver? Please specify:
3. Who was the most supportive with your family members care?
4. Was any psychotherapy provided? YesNo
5. If yes, who provided the psychotherapy? clergy social worker psychologist psychiatrist family therapist 5a. Other? Please specify:
6. If yes, was psychotherapy provided for... the patient? the family? the patient and family together?
7. Were you able to talk about the impending death? YesNo 7a. If yes, with whom?
8. was the dying member able to discuss his or her fears about dying? YesNo 8a. If yes, with whom?
9. For those of you who used hospice, was psychotherapy recommended by hospice for... the patient? the family? the patient and family together?
10. What would you change about the care and loss of your loved one?
11. what were you the most proud of in dealing with the care and loss of your loved one?
12. For those you had no psychotherapy: do you think it would have made a difference in your experience with the death and dying of your loved one? Please explain
Some personal information about me.
13. Gender MaleFemale
14. Age
15. Income
16. Education
17. Marital status: married single divorced seperated widow or widower
18. Location: town, state, country.
Thank-you. I appreciate you taking the time to answer these questions. Baglady@peoplepc.com
URL: http://www.thesurvey.com/surv/elderterminalillness.shtml
