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A Global Response to Elder Abuse - page 67 / 149

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PAGE 52

SECTION 1: FAMILY DYNAMICS RELATIONSHIP WITH SPOUSE/PARTNER

10. If married, is this a first marriage? (Apply same questioning if it is a common law commitment or long-term relationship.)

  • 1.

    Yes p

  • 2.

    No p

  • 3.

    Not applicable p

  • 4.

    R/A p

How long?

How long in current relationship?

(Go to question 12)

11. Most couples acknowledge that there are, from time to time, problems that arise in their relationship. How often would you rate problems in yours, whatever your definition of problem is, using the following:

Never p

Occasiona p

Often p

Very often

Explain:

  • Does your spouse or partner have any specific health problem or emotional problem

(include illness, handicap, alcohol or drug or gambling addiction, or mental illness)?

Yes p No p N/A p R/A p

Explain:

If "Yes", describe the impact that it has had on you:

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