Table 2.

Questions for each item in the MIDAM-LTC

For each item the following two questions can be asked:
a. Does this apply to you? (think about the past 2 days)
	No		Yes
b. If so, to what extent does this influence your sense of dignity?
Not at all		A little	Somewhat		Quite a lot		Very much
1		2	3		4		5
Example:
	a. Does this apply to you?		b. Does this influence your sense of dignity?
			Not at all ← →Very much
I am incontinent	❑ No ↓ (item 2)	❑ Yes → (question b)	1	2	3	4	5
I have little privacy	❑ No ↓	❑ Yes →	1	2	3	4	5