Background Information

HAVE YOUR SAY BECAUSE YOUR OPINION MATTERS! 
 
Complete the survey and enter to win a $50 gift certificate from a local supplier. (You must provide your contact info at the end of the survey to enter.)

BC Community Response Networks (BC CRN) is working with Island Health and local communities to raise awareness of health and service issues for LGBTQ2+ seniors. The limited research about LGBTQ2+ seniors tells us:

o   Many LBGTQ2+ seniors do not have the informal support networks of children and extended families that other seniors might have.
o   They have higher rates of disability compared to other older adults.
o   They are resilient and live full lives, building strong communities despite challenges.
o   They feel anxious about increased health care needs related to aging and about how they will be treated by service providers.

Information from the survey and some in-person interviews will be used to plan for health and community services for Vancouver Island LGBTQ2+ seniors. All information you provide is confidential. The information from these surveys will be summarized.  Any information that could potentially identify you will not be disclosed.

Definitions: 

o   Public health services: services or programs you do not pay for directly. They are fully or partially covered by government and MSP premiums.
o   Private health services: services you do pay for directly.
o   Community services: services or programs that are provided by community centres and community (non-profit) organizations. There may or may not be a fee for a program.

If you have completed this survey by hand, you may return it: 
By mail to:  Jane Osborne, c/o Volunteer Cowichan, 200 Craig St, Duncan, BC V9L 5G3
In person to: The project member who contacted you.
 
If you have questions about this survey, please contact: Jane Osborne, Survey Team Lead at 604-363-5370 or jane.osborne@bccrns.ca

1. SECTION 1: General information

Do you consider yourself a member of the Lesbian, Gay, Bisexual, Transgender, Queer, Two-spirited (LGBTQ2+) community? Please check one:

2. How do you identify in terms of gender? Please check one:

3. How do you identify in terms of sexual orientation? Please check one:

4. What is your age? Please check one:

5. Where do you live on Vancouver Island? Please check one:

6. How would you describe your community? Please check one

7. SECTION 2: Using Public Health Services as a member of the LGBTQ2+ community. Think about the times you or someone you support has used public (government or MSP funded) health services and then respond to these questions.

If you have used public home care or home support services to assist you to remain independent in your home, has your experience been positive, negative or mixed? Please check one:

8. Did the people providing the service know you were LGBTQ2+? Please check one:

9. If you used these services in the last 5 years, when was it? Please check one:

10. If you have used publicly subsidised residential care, e.g. hospital, intermediate or long term, palliative, assisted living, was your experience positive, negative or mixed? Please check one:

11. Did the people providing the care and the other residents know you were LGBTQ2+? Please check one:

12. If you used these services in the last 5 years, when was it? Please check one:

13. When you have used primary care, e.g. family doctor, nurse practitioner (physician offices or clinic based) to address a specific medical condition or general health issue, has your experience been positive, negative or mixed? Please check one:

14. Did the people providing the services know you were LGBTQ2+? Please check one:

15. SECTION 3: Using Private Health Care Services as a member of the LGBTQ2+ community. Think about the times you or someone you support have used privately provided health services and then respond to these questions.

If you have used private home care or home support services, was your experience positive, negative or mixed? Please check one:

16. Did the people providing the care know you were LGBTQ2+? Please check one:

17. If you used these services in the last 5 years, when was it? Please check one:

18. If you have used private residential care services, was your experience positive, negative or mixed? Please check one:

19. Did the people providing the care and the other residents know you were LGBTQ2+? Please check one:

20. If you used these services in the last 5 years, when was it? Please check one:

21. SECTION 4: Using Services provided by the Community (not-for-profit) Sector as a member of the LGBTQ2+ community. Think about the times you (or someone you support) have used community-based services to remain living independently in your home and then respond to these questions.

If you have used community-based home support services (supported transportation, meals, grocery-shopping, friendly visiting, minor maintenance, etc.) to assist you to remain independent in your home, has your experience been positive, negative or mixed? Please check one:

22. Did the people providing the service know you were LGBTQ2+? Please check one:

23. If you used these services in the last 5 years, when was it? Please check one:

24. If you have attended community-based programs (meals, exercise, respite, caregiver support, etc.) to support you to remain independent in your home, has your experience been positive, negative or mixed? Please check one:

25. Did the people providing the program and the other attendees know you were LGBTQ2+? Please check one:

26. If you used these services in the last 5 years, when was it? Please check one:

27. SECTION 5: Some final questions about you and your community:

Do you feel part of a community where you live? Please check one:

28. Do you have family or friends in your community who provide you with a support network? (These are people you could turn when you need help) Please check one:

29. Do you feel you are valued and respected as an LGBTQ2+ senior in your community on Vancouver Island? Please check one:

30. Overall, do you feel that there is a high or low level of awareness of the needs of LGBTQ2+ seniors in your community? Please check one:

31. Finally, people have many different cultural backgrounds and characteristics (other than age, gender or sexual orientation), e.g. race, ethnicity, ability/disability, education, income, etc. We know some of these may also be factors in how we are treated by public, private and community service providers or fellow residents/citizens. Please check all that apply to you:

32. What do you need to see, feel or experience to have the sense of being cared for by health care systems/providers and community organizations?:

33. Do you wish to be involved in future working group meetings for the LGBTQ2+ Project?

34. Do you wish to be entered into a draw to receive a $50 gift certificate from a local business?

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