Version 2.78

100308-6 Do you need someone to help you get to the places you need to go, for example do you need someone to drive you to the grocery store, a place of worship, the doctor?

Observation ID in Form

A17

Skip Logic

If 2,3,4 SKIP TO A18

Fully-Specified Name

Component
Need help getting to essential places
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100309-4 Do you have someone who helps you with this? PROBE: Is that just one person or more than one?

Observation ID in Form

A17a

Skip Logic

If 2,3,4 SKIP TO A18

Fully-Specified Name

Component
Activity support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6250-6

Answer Code Score Answer ID
Yes, one person 1 LA33444-3
Yes, more than one person 2 LA33445-0
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 3 LA32-8
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 4 LA12688-0
Refused 5 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100310-2 How reliable would you say (that person / these persons) are? Would you say they are

Observation ID in Form

A17b

Fully-Specified Name

Component
Reliability of support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6249-8

Answer Code Score Answer ID
Not at all reliable 1 LA33440-1
Somewhat reliable 2 LA33441-9
Very reliable 3 LA33442-7
Completely reliable 4 LA33443-5
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 5 LA12688-0
Refused 6 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100311-0 Do you need someone to make sure you have enough food, medicines or any other things you need in your house?

Observation ID in Form

A18

Skip Logic

If 2,3,4 SKIP TO A19

Fully-Specified Name

Component
Need help to make sure there is enough food, medicines or any other things needed in house
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100312-8 Do you have anyone that takes care of this for you? PROBE: Is that just one person or more than one?

Observation ID in Form

A18a

Skip Logic

If 3,4,5 SKIP TO A19

Fully-Specified Name

Component
Person or persons that makes sure there is enough food, medicines or any other things needed in house
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6250-6

Answer Code Score Answer ID
Yes, one person 1 LA33444-3
Yes, more than one person 2 LA33445-0
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 3 LA32-8
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 4 LA12688-0
Refused 5 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100310-2 How reliable would you say (that person / these persons) are? Would you say they are

Observation ID in Form

A18b

Fully-Specified Name

Component
Reliability of support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6249-8

Answer Code Score Answer ID
Not at all reliable 1 LA33440-1
Somewhat reliable 2 LA33441-9
Very reliable 3 LA33442-7
Completely reliable 4 LA33443-5
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 5 LA12688-0
Refused 6 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100313-6 Do you need someone to help you with household things, like cooking meals, helping you eat, or making sure you take the correct medicines each day?

Observation ID in Form

A19

Skip Logic

If 2,3,4 SKIP TO A20

Fully-Specified Name

Component
Need help with household things such as cook meals, help feed, or provide correct medicines each day
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100312-8 Do you have anyone that takes care of this for you? PROBE: Is that just one person or more than one?

Observation ID in Form

A19a

Skip Logic

If 3,4,5 SKIP TO A20

Fully-Specified Name

Component
Person or persons that makes sure there is enough food, medicines or any other things needed in house
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6250-6

Answer Code Score Answer ID
Yes, one person 1 LA33444-3
Yes, more than one person 2 LA33445-0
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 3 LA32-8
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 4 LA12688-0
Refused 5 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100310-2 How reliable would you say (that person / these persons) are? Would you say they are

Observation ID in Form

A19b

Fully-Specified Name

Component
Reliability of support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6249-8

Answer Code Score Answer ID
Not at all reliable 1 LA33440-1
Somewhat reliable 2 LA33441-9
Very reliable 3 LA33442-7
Completely reliable 4 LA33443-5
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 5 LA12688-0
Refused 6 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100314-4 Do you need someone to help you with house cleaning or yard work?

Observation ID in Form

A20

Skip Logic

If 2,3,4 SKIP TO A21

Fully-Specified Name

Component
Need help with house cleaning or yard work
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100312-8 Do you have anyone that takes care of this for you? PROBE: Is that just one person or more than one?

Observation ID in Form

A20a

Skip Logic

If 3,4,5 SKIP TO A21

Fully-Specified Name

Component
Person or persons that makes sure there is enough food, medicines or any other things needed in house
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6250-6

Answer Code Score Answer ID
Yes, one person 1 LA33444-3
Yes, more than one person 2 LA33445-0
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 3 LA32-8
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 4 LA12688-0
Refused 5 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100310-2 How reliable would you say (that person / these persons) are? Would you say they are

Observation ID in Form

A20b

Fully-Specified Name

Component
Reliability of support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6249-8

Answer Code Score Answer ID
Not at all reliable 1 LA33440-1
Somewhat reliable 2 LA33441-9
Very reliable 3 LA33442-7
Completely reliable 4 LA33443-5
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 5 LA12688-0
Refused 6 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100315-1 Do you need someone to help you get out of bed, get showered, or get dressed?

Observation ID in Form

A21

Skip Logic

If 2,3,4 SKIP TO A22

Fully-Specified Name

Component
Need help getting out of bed, showered, or dressed
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100312-8 Do you have anyone that takes care of this for you? PROBE: Is that just one person or more than one?

Observation ID in Form

A21a

Skip Logic

If 3,4,5 SKIP TO A22

Fully-Specified Name

Component
Person or persons that makes sure there is enough food, medicines or any other things needed in house
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6250-6

Answer Code Score Answer ID
Yes, one person 1 LA33444-3
Yes, more than one person 2 LA33445-0
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 3 LA32-8
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 4 LA12688-0
Refused 5 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100310-2 How reliable would you say (that person / these persons) are? Would you say they are

Observation ID in Form

A21b

Fully-Specified Name

Component
Reliability of support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6249-8

Answer Code Score Answer ID
Not at all reliable 1 LA33440-1
Somewhat reliable 2 LA33441-9
Very reliable 3 LA33442-7
Completely reliable 4 LA33443-5
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 5 LA12688-0
Refused 6 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100316-9 Do you need someone to make sure your bills get paid?

Observation ID in Form

A22

Skip Logic

If 2,3,4 SKIP TO A24

Fully-Specified Name

Component
Need help to make sure bills get paid
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100312-8 Do you have anyone that takes care of this for you? PROBE: Is that just one person or more than one?

Observation ID in Form

A22a

Skip Logic

If 3,4,5 SKIP TO A23

Fully-Specified Name

Component
Person or persons that makes sure there is enough food, medicines or any other things needed in house
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6250-6

Answer Code Score Answer ID
Yes, one person 1 LA33444-3
Yes, more than one person 2 LA33445-0
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 3 LA32-8
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 4 LA12688-0
Refused 5 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100310-2 How reliable would you say (that person / these persons) are? Would you say they are

Observation ID in Form

A22b

Fully-Specified Name

Component
Reliability of support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6249-8

Answer Code Score Answer ID
Not at all reliable 1 LA33440-1
Somewhat reliable 2 LA33441-9
Very reliable 3 LA33442-7
Completely reliable 4 LA33443-5
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 5 LA12688-0
Refused 6 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100317-7 Considering all the things that we just talked about, who is the person who is supposed to help you with these things most of the time?

Observation ID in Form

A23

Fully-Specified Name

Component
Relationship of usual support person for daily activities
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6252-2

Answer Code Score Answer ID
Your spouse or partner 1 LA33221-5
Ex spouse or partner 2 LA33447-6
Parent or step-parent 3 LA33448-4
Brother or sister 4 LA15645-7
Child 5 LA9949-4
Other relative 6 LA15640-8
Co-worker 7 LA33449-2
Neighbor 8 LA27179-3
Friend 9 LA6656-8
Other nonrelative 10 LA15649-9
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 11 LA12688-0
Refused 12 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100318-5 Is there someone who helps you take care of your finances, or is there someone other than yourself who makes decisions about your money and your property, either with or without your approval?

Observation ID in Form

A24

Skip Logic

IF 2,3,4 SKIP TO A34

Fully-Specified Name

Component
Have help with finances &or financial decisions
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100319-3 What is that person’s relationship to you?

Observation ID in Form

A25

Skip Logic

IF 11, 12 SKIP TO A34

Fully-Specified Name

Component
Relationship of financial support person
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL6252-2

Answer Code Score Answer ID
Your spouse or partner 1 LA33221-5
Ex spouse or partner 2 LA33447-6
Parent or step-parent 3 LA33448-4
Brother or sister 4 LA15645-7
Child 5 LA9949-4
Other relative 6 LA15640-8
Co-worker 7 LA33449-2
Neighbor 8 LA27179-3
Friend 9 LA6656-8
Other nonrelative 10 LA15649-9
Don't know Copyright http://snomed.info/sct ID:456791000124100 Do not know (qualifier value) 11 LA12688-0
Refused 12 LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100320-1 Does that person usually ask for your permission before deciding to spend your money or sell your property?

Observation ID in Form

A27

Fully-Specified Name

Component
Financial support person usually asks for permission before making decisions
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100321-9 Do you feel like that person usually makes good decisions about your finances?

Observation ID in Form

A28

Fully-Specified Name

Component
Financial support person usually makes good decisions about finances
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100322-7 Do you have the copies of paperwork for the financial decisions they make, or can you get copies if you wanted them?

Observation ID in Form

A29

Fully-Specified Name

Component
Have access to paperwork for financial decisions made
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100323-5 Has that person ever forged your signature without your permission in order to sell your property or to get money from your accounts?

Observation ID in Form

A31

Fully-Specified Name

Component
Financial support person forged signature
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100324-3 Has that person ever forced or tricked you into signing a document so that they would be able to get some of your money or possessions?

Observation ID in Form

A32

Fully-Specified Name

Component
Coercion of financial support person for signing a document in order to get money or possessions
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100325-0 Has that person, or anyone else you are close to, ever stolen your money or take your things for themselves, their friends, or to sell?

Observation ID in Form

A33

Fully-Specified Name

Component
Experienced theft by support person
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100326-8 Has a stranger ever spent your money or sold your property without your permission?

Observation ID in Form

A34

Fully-Specified Name

Component
Money spent or property sold without permission
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100327-6 Has a stranger ever forged your signature in order to get some of your money or sell your property?

Observation ID in Form

A36

Fully-Specified Name

Component
Stranger forged signature for financial gain
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100328-4 Has a stranger ever forced or tricked you into signing a document so that they would be able to get some of your money or possessions?

Observation ID in Form

A37

Fully-Specified Name

Component
Stranger forced document signature for financial gain
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100329-2 Has anyone ever verbally attacked, scolded, or yelled at you so that you felt afraid for your safety, threatened or intimidated?

Observation ID in Form

A39

Skip Logic

IF 2,3,4 SKIP TO A40

Fully-Specified Name

Component
Feared for safety due to verbal attack
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100330-0 Has anyone ever made you feel humiliated or embarrassed by calling you names such as stupid, or telling you that you or your opinion was worthless?

Observation ID in Form

A40

Skip Logic

IF 2,3,4 SKIP TO A41

Fully-Specified Name

Component
Felt humiliated due to ridicule
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100331-8 Has anyone ever forcefully or repeatedly asked you to do something so much that you felt harassed or coerced into doing something against your will?

Observation ID in Form

A41

Skip Logic

IF 2,3,4 SKIP TO A42

Fully-Specified Name

Component
Coerced to do something
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100332-6 Has anyone close to you ever completely refused to talk to you or ignored you for days at a time, even when you wanted to talk to them?

Observation ID in Form

A42

Skip Logic

IF 2,3,4 SKIP TO A55

Fully-Specified Name

Component
Ignored by close friend or relative for extended period
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100333-4 Has anyone ever hit you with their hand or object, slapped you, or threatened you with a weapon?

Observation ID in Form

A55

Skip Logic

IF 2,3,4 SKIP TO A56

Fully-Specified Name

Component
Physically hit or threatened
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100339-1 Has anyone ever tried to restrain you by holding you down, tying you up, or locking you in your room or house?

Observation ID in Form

A56

Skip Logic

IF 2,3,4 SKIP TO A57

Fully-Specified Name

Component
Experienced attempted physical restraint
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100334-2 Has anyone ever physically hurt you so that you suffered some degree of injury, including cuts, bruises, or other marks?

Observation ID in Form

A57

Skip Logic

IF 2,3,4 SKIP TO A70

Fully-Specified Name

Component
Been physically hurt with some degree of injury
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100335-9 Regardless of how long ago it happened or who made the advances, has anyone ever made you have sex or oral sex by using force or threatening to harm you or someone close to you?

Observation ID in Form

A70

Skip Logic

IF 2,3,4 SKIP TO A71

Fully-Specified Name

Component
Coerced sexual activity
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100336-7 (IF FEMALE READ) Has anyone ever touched your breasts or pubic area or made you touch his penis by using force or threat of force? (IF MALE READ) Has anyone ever touched your pubic area or made you touch their pubic area by using force or threat of force?

Observation ID in Form

A71

Skip Logic

IF 2,3,4 SKIP TO A72

Fully-Specified Name

Component
Coerced touching of private body parts of self or others
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100337-5 (IF FEMALE READ) Has anyone ever forced you to undress or expose your breasts or pubic area when you didn’t want to? (IF MALE READ) Has anyone ever forced you to undress or expose your pubic area when you didn’t want to?

Observation ID in Form

A72

Skip Logic

IF 2,3,4 SKIP TO A73

Fully-Specified Name

Component
Coerced to undress or expose private body area
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment

100338-3 Has anyone ever taken pictures of you with your clothes partially or completely taken off when you didn’t want them to?

Observation ID in Form

A73

Skip Logic

IF 2,3,4 SKIP TO D1

Fully-Specified Name

Component
Photographed in any degree of nudity without consent
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.MTLHLTH
Type
Surveys
First Released
Version 2.73
Last Updated
Version 2.73
Order vs. Observation
Observation

Normative Answer List LL4027-0

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Don't know/not sure LA14619-3
Refused LA4389-8

Member of these Panels

LOINC Long Common Name
100307-8 Behavioral screening elder mistreatment