Table 5.

Questions on final version of instrument validated for Brazilian Portuguese.

Item	Questions
1	How often was your loved one able to feed her/himself?
2	How often did your loved one appear to breathe comfortably?
3	How often did your loved one appear to feel at peace during the process of dying?
4	How often did your loved one appear to be unafraid of dying?
5	How often did your loved one spend time with his/her family or friends?
6	How often did your loved one spend time alone?
7	Was your loved one touched or hugged by his/her loved ones?
8	Were all of your loved one’s health care costs taken care of?
9	Did your loved one say goodbye to loved ones?
10	Did your loved one clear up any bad feelings with others?
11	Did your loved one have one or more visits from a religious or spiritual advisor?
12	Did your loved one have a spiritual service or ceremony before his/her death?
13	Did your loved one receive a mechanical ventilator (respirator) to breathe for him/her?
14	Did your loved one receive dialysis for his/her kidneys?
15	Did your loved one discuss his or her wishes for end-of-life care with his/her doctor -- for example, resuscitation or intensive care?
16	Was any family member present at the moment of your loved one’s death?
17	In the moment before your loved one’s death, was he/she:
18	Overall, how would you rate the quality of your loved one’s dying?