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Following is the wording of an AARP survey received by an 86 year old relative on February 24, 2011
Beware of what your elderly relatives and friends receive in the mail. Don't let them fill out forms they do not understand.


AARP Health
Medicare Supplement Insurance insured by United HeaIthCare Insurance Company

Well-Being Assessment Survey


When complete, please return this survey in the enclosed business reply envelope, for which postage has already been paid. Please do not write your name on either the survey document or the envelope as a precaution to protect your privacy. Additionally, please do not include anything other than the completed survey in the enclosed reply envelope.

Please respond to all questions by filling in the oval using blue or black ink.

Over the last 2 weeks, how often have you been bothered by any of the following problems?

1. Little interest or pleasure in doing things
2. Feeling down, depressed or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down
7. Trouble concentrating on things, such as reading the newspaper or watching television
8. Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual
9. Thoughts that you would be better off dead, or of hurting yourself in some way

Choices given for the above questions are:

Not at all
Several days
More than half the days
Nearly every day

The survey continues:

10. If you checked off any problems - how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

Not difficult at all
Some what difficult
Very difficult
Extremely difficult


Source: AARP survey
received February 26, 2011

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