Survey Instructions

1. Survey Instructions There are two sides of the survey, Side 1 and Side 2 (reverse side). Please do not complete Side B, until instructed to do so.

2. Side 1 (Front Side)

3. Context Mrs. X is a 76 year old Filipino woman who has been living in an assisted care facility for 12 years. Four years ago, she was diagnosed with Alzheimer’s dementia. Before her retirement, Mrs. X was an insurance executive in charge of a successful business. She had a strong personality and a wry wit. She remains greatly loved by her family. Recently, Mrs. X has displayed some behavioral problems. She has been hitting and kicking the facility staff when they attempt to provide care, particularly during meal times. Some staff have recommended medication, but Mrs. X’s family is resistant to the idea because they say the medication makes her lifeless and unlike the Mrs. X they know.

4. Your Choice If you were the decision maker, how often would you prescribe anti-psychotic medications? (Mark your answer with an X) How often would you prescribe anti-psychotic medications? (Mark your choice with an X) Never Always

5. Example of Completed Response If you were the decision maker, how often would you prescribe anti-psychotic medications? (Mark your answer with an X) How often would you prescribe anti-psychotic medications? (Mark your state with an X) X Never Always

6. Now, you will be presented with two scenarios. Scenario A will present the positive outcomes associated with anti-psychotic medications. Scenario B will present negative outcomes associated with these medications. We would like to know your emotional responses upon reading each scenario. We will ask you to separately rate your response to each scenario based on the questions below: How pleasant or unpleasant do you find the described scenario? How passionate or detached are your feelings towards the described scenario.

7. Scenario A Mrs. X was given Seroquel, an anti-psychotic medication. She is now less agitated and it is much easier to care for her during meal times. Previously, it was a real ordeal giving baths to Mrs. X, but now she does not give the staff any trouble at all. Her roommate who was constantly complaining about her behavior, is happy with the change in Mrs. X. Overall, she seems more calm and more manageable. How pleasant or unpleasant do find this scenario (Mark your state with an X)? Very Unpleasant Very Pleasant How passionate or detached are your feelings towards this scenario (Mark your state with an X)? Detached/ Un-aroused Passionate/ Aroused

8. Scenario B Mrs. X was given Seroquel, an anti-psychotic medication. She is now almost lifeless. She sleeps through most of the day and when she is awake she just sits in her room, staring. Previously, she would occasionally recall stories from her past in a really funny way, but now she does not seem to be herself at all.Her family believes they have completely lost her. Overall, she seems less herself, and less alive. How pleasant or unpleasant do find this scenario (Mark your state with an X)? Very Unpleasant Very Pleasant How passionate or detached are your feelings towards this scenario (Mark your state with an X)? Detached/ Un-aroused Passionate/ Aroused

9. Side 2 (Reverse Side) Please do not complete Side 2, until instructed to do so

10. Side 2 • Side 2 has the identical questions as Side 1. Please complete these question without referring to your earlier answers in Slide 1. • Side 2 has one additional question (bottom of the page). It asks for 1-3 factors that may have changed your attitudes towards prescribing anti-psychotic medications. If applicable, please indicate your answers in a clear print.