Long-Term Care Costs Survey
Hi there, we are just a few volunteers working on a tool to help inform people about the costs of providing care to someone who needs care. This recipient of care (care recipient) might be a parent, a relative, or possibly, a dear friend - someone who needs care from others. We wanted to guide people through the care options and the costs involved. To be able to create a tool (in the form of a calculator), we would like you to share with us the costs that you have had to handle in your care for your care recipient.
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1. What condition does your care recipient have? *
2. What activities of daily living is your care recipient able to perform?  (Please select the appropriate boxes) *
Required
3. What type of housing is the care recipient being cared for in? *
4. How much did you pay to retrofit the loved one's living areas? *
4b. Would you accept/receive any donated items? If you would/did, please list down the kind of items. Eg. hospital bed, walking frame, etc.
5. What kind of help did your care recipient need to move around? *
6. Does your care recipient attend external therapy sessions and how much do they cost per mth? (Eg. Physiotherapy, Aquatherapy, etc.  Please add transport cost if it is needed)
7. Does your care recipient need hospice care? *
7a. How much is/was the hospice care? Put NA if you answered ‘No’ previously. You can answer as "$/mth or $/yr". *
8. How much was the hospital bed? Put NA if you are not using a hospital bed. You can answer as "$/one time, $/mth or $/yr". *
9. What supplements are your care recipient taking and how much do they cost? NA if your care recipient is not taking any supplements. You can answer as "$/one time, $/mth or $/yr". *
10. What subsidies/schemes are you receiving/using from government for this caregiving? *
Required
9a. What other schemes have we missed?
10b. Can you estimate how much subsidies you are receiving? You can answer as "$/one time, $/mth or $/yr from this [scheme name]."
11. Could you estimate what is the care recipient's household income received per person? This will be helpful for us as we think about other related projects. *
12. What services are you receiving? *
Required
13. What services would you like to know more about? *
Required
14. If you would like to be contacted via email, please leave your details below. If not, please leave a blank.
15. If you would like to be contacted via mobile, please leave your details below. If not, please leave a blank.
We would also be happy to receive suggestions! Do leave your feedback below.
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