| | Dimensions | Variables (modalities) |
| | Interpersonal relations (interactions, relationships, support-emotional, physical, financial, feedback) | Living alone (no, yes) | | Marital status (married, unmarried, or not yet married) | | In case of life troubles, my family trust/count on: relatives, friends, neighbors, nonprofit associations, other? (no, yes) | | Home health/social career on behalf of the municipality (no, yes) | | Home worker (no, yes) | | Elderly/handicapped care (no, yes) |
| | Social inclusion (community integration and participation, community roles, social support network, services) | Distance too long between own home and relatives' home (no, yes) | | Do your relatives use a mobile? (yes, no) | | Do you have telephone at home? (yes, no) |
| | Physical well-being (health, activities of daily living, leisure, access to health care) | Physical disability (no, yes) | | Mental disability (no, yes) | | Need to home care services (no, yes) | | Recourse to health-rehabilitation services in the last three months (no, yes) | | Home health career on behalf of local health unit, (no, yes) | Do you ask someone for important decision on own health?
(I ask my GP, I ask a specialist, I ask my private physician, I ask other health professionals, I take final decision by myself) | | Flu vaccination in the last twelve months (yes, no) | | Frequency of blood hypertension check (At least once a year, less than once a year, never) |
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