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Nebraska Hospice and Palliative Care Partnership Community Survey on End of Life 2006 N=324

Nebraska Hospice and Palliative Care Partnership Community Survey on End of Life 2006 N=324. COMFORT ITEMS. How comfortable are you with talking about death?. How comfortable would you be writing your own will if you thought your death would occur soon?.

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Nebraska Hospice and Palliative Care Partnership Community Survey on End of Life 2006 N=324

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  1. Nebraska Hospice and Palliative Care Partnership Community Survey on End of Life 2006 N=324

  2. COMFORT ITEMS

  3. How comfortable are you with talking about death?

  4. How comfortable would you be writing your own will if you thought your death would occur soon?

  5. How comfortable are you with thinking about life after death?

  6. LIKELIHOOD ITEMS

  7. How likely are you to attend funerals or memorial services?

  8. How likely are you to read books, newspaper articles or other information that deal with the subject of death and dying?

  9. How likely are you to watch television programs or movies that deal with the subject of death and dying?

  10. How likely are you to avoid medical checkups because you are afraid the doctor will find something serious?

  11. How likely are you to speak freely with loved ones about death and dying?

  12. How likely are you to visit or telephone a friend or relative who has recently lost a loved one in order to see how they are doing?

  13. How likely are you to preplan the funeral or memorial service of someone you’re caring for?

  14. AFRAID ITEMS

  15. How afraid are you of dying from a long-term illness?

  16. How afraid are you of dying suddenly?

  17. How afraid are you of dying alone?

  18. How afraid are you of dying in an institution such as a nursing home or hospital?

  19. How afraid are you of dying painfully?

  20. VALUE ITEMS

  21. There is a special value in getting old.

  22. Dying is an important part of life.

  23. If someone could tell me that I likely have six months or less to live, I would want to know.

  24. Caring for people who are dying is a rewarding experience.

  25. If I knew I was dying, I would want medical intervention to keep me alive as long as possible.

  26. CONCERN ITEMS

  27. How concerned are you that your (or your spouse/partner’s) money won’t last?

  28. How concerned are you that your family’s money won’t last?

  29. How concerned are you that you will be a burden to your family or friends?

  30. Which of the following problems would be worse than death?

  31. ADVANCE PLANNING ITEMS

  32. Health Care Power of Attorney

  33. Living Will

  34. Last will and testament

  35. Funeral or burial pre-plan

  36. With whom have you talked about your wishes for care at the end of life?

  37. Who would you want to initiate a conversation with you regarding end-of-life issues?

  38. Who would you trust to provide information on end-of-life issues?

  39. IMPORTANCE ITEMS

  40. How important is having family / friends visiting you?

  41. How important is being able to stay in your home?

  42. How important are honest answers from your doctor?

  43. How important is comfort from religious / spiritual services or persons?

  44. How important is knowing medicine would be available to you?

  45. How important is planning your own funeral or memorial service?

  46. How important is being able to complete your own will?

  47. How important is fulfilling personal goals/pleasures?

  48. How important is reviewing your life history with your family?

  49. How important is having health care professionals visit you at your home?

  50. How important is getting your finances in order?

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