Dear Father Here I am sending the Interview Schedule for correction

1. A study on depression of senior citizens in the
institutions at Wayanad District
INTERVIEW SCHEDULE
1. Name:
2. Age:
a. 55-60
b. 61-65
c. 66-70
d. 71-75
3. Sex:
a. Male
b. Female
4. Education
a. Illiterate
b. 1-5th
c. 6th-PDC
d. Graduation and above
5. Religion
a. Hindu
b. Christian
c. Muslim
d. Any other
6. Marital Status
a. Widow/er
b. Divorced
c. Separated
d. Single
7. No of children
a. No

2. b. 1-2
c. 3-4
d. 5 above
8. How many years you are in this institution
a. 0-1
b. 2-3
c. 4-5
d. More than 5
9. Who brought you to this Institution
a. Self
b. Children
c. Relatives/ Neighbours
d. Police
10. Do you have visitors
a. Never
b. Monthly
c. Once in six months
d. Once in a year
11. Who is your visitors
a. Children
b. Relatives
c. Neighbours
d. Any other person
12. What is the reason of the Institutionalization
a. Adjustment problem with the family
b. Don’t like to be a burden for others
c. No care givers
d. Forced to send by Children / Relatives/ Neighbours/ Police
13. Preference to stay with
a. Children
b. Institution

3. c. Relatives
d. Any other institution
14. Do you have any health problems
a. Diabetic
b. Blood pressure
c. Heart problem
d. Any other
15. Mode of treatment
a. Regular
b. Occasional
c. Sometimes
d. No treatment
Geriatric Depression Scale
1. Are you basically satisfied with your life? YES / NO
2. Have you dropped many of your activities and interests? YES / NO
3. Do you feel that your life is empty? YES / NO
4. Do you often get bored? YES / NO
5. Are you in good spirits most of the time? YES / NO
6. Are you afraid that something bad is going to happen to you? YES / NO
7. Do you feel happy most of the time? YES / NO
8. Do you often feel helpless? YES / NO
9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO
10. Do you feel you have more problems with memory than most? YES / NO
11. Do you think it is wonderful to be alive now? YES / NO
12. Do you feel pretty worthless the way you are now? YES / NO

4. 13. Do you feel full of energy? YES / NO
14. Do you feel that your situation is hopeless? YES / NO
15. Do you think that most people are better off than you are? YES / NO