Older Adult Survey
Survey for older adults receiving care to help them stay in their homes
Which of these was most helpful in securing good quality services, when you first began looking?
What is your zip code?
Your answer
When you first started to look for support services, what were the first support services that you brought in?
Which service improves your life the most of all services you use?
Your answer
What are some "red flags" that would make you choose not to work with a service or provider?
Your answer
When you can't find a service or it doesn't fully meet your need, what/how do you deal with it?
Your answer
How long have you been receiving services to help you stay in your home? (Please indicate if your answer is months or years.)
Your answer
Would it be/have been helpful to you to have guidelines about quality or some place you could turn for information from a consumer's point of view?
What factors are most important to you when choosing a provider of any service? Please rank on a scale of 1-3 (1 - less important, 2 - important, 3 - most important)
1 (less important)
2 (important)
3 (most important)
Adequate staffing
Allows the older adult to direct his/her own care needs
Creative problem-solving
Able to meet specific needs of older adult
What gaps in service or lack of services have the biggest impact on you and/or your family? (1 - no impact, 2 - some impact, 3 - highest impact)
1 ( no impact)
2 (some impact)
3 (highest impact)
Knowledge of disease specific information
Geriatric medical specialty assistance (geriatrician, geriatric pharmacists, geriatric nurses)
Case management
Lack of medical specialists (cardiologist, pulmonologist, nephrologist, dermatologist, podiatrist, etc.)
No/limited medical care due to lack of coverage and/or reimbursement
Mental health services (including geriatric specialty)
Home maintenance
Companion care and/or attendant care
Adult day services (out-of-home setting providing activities, supervision, medication management)
Respite care (someone to provide care to allow caregiver to take a break from caregiving)
Attendant care and/or companion care
Home health services
Meals/nutrition (home delivered, meal preparation, special diet, dietician)
Therapies (occupational, speech respiratory, physical)
What services or professionals/providers have done the most to make your health, well-being, or life better?
Your answer
What do you wish you would have known before looking for providers and services? What would you tell others who are just starting to look for help with services or providers?
Your answer
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