Page 248 - QAP Manual 2020

3. PROXY ALLOWED During COVID time, if there were changes in your daily schedule (like if
you stopped getting some services or had to stay home more), did you get to choose

your new daily schedule? Did you choose what you got to do during the day during
COVID time?
Other respondent: During COVID time, if the person had to change his/her daily schedule (for
example, if he/she had to stop getting certain services or had to stay home more), did he/she get to
choose the new daily schedule?
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other

□ 2. Person made the choice

□ 3. Person had help making the choice
□ 1. Someone else made the choice
□ 98. Not applicable – no changes to services/schedule
□ 99. Don’t know, no response, unclear response

4. PERSON ONLY Think of how your life and daily routine changed since
the beginning of COVID time. Have there been any changes that you

liked? [CHECK ALL THAT APPLY]
 1. I liked talking with friends and family more

No proxy response  2. I started a new activity that I liked or did activities I enjoy more
often
permitted
 3. The amount of support I get changed, and I liked it

 4. I liked staying home more
 5. I liked new service(s) I started getting
 6. I liked using technology more
 7. Other___________________

Now I am going to ask you about how you’ve been feeling since the start of COVID time

5. PROXY ALLOWED Since COVID time started, have you been more worried, scared, anxious or sad

than before?
Other respondent: Since COVID time started, has this person been more worried, scared, anxious or sad than
before?
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other
 2. Yes, I’ve felt more worried, scared, anxious or sad than before
 1. No, I haven’t felt more worried, scared, anxious or sad
 99. Don’t know, no response, unclear response