Skip to content

The Area Agency on Aging & Disability of Southwest Washington
2027 - 2030 Area Plan Survey - Individual

The Area Agency on Aging & Disabilities of Southwest Washington (AAADSW) is conducting a survey on the needs of older adults, people with disabilities, and caregivers who live in Clark, Cowlitz, Skamania, Klickitat, and Wahkiakum counties. Every four years AAADSW updates its plan for providing services to the community. Your input on this survey helps us understand which services are needed in the communities we serve.

In years past, responses from surveys like this have helped our agency design new programs to help people in the communities we serve.

The survey will take about 15 minutes. Your responses are anonymous, and you can skip any questions you are not comfortable with.

We thank you for your participation!
1.What is your age?
2.In which county do you live?
3.What is your racial or ethnic identity (select all that apply)
4.What is the primary language you speak at home?
5.Which of the following best describes your living situation? (check all that apply)
6.What is your approximate monthly household income:
7.What is your gender identity?
8.Do you identify as LGBTQ+?
9.How do you describe yourself? (check all that apply)
10.Please identify your level of concern about the following issues:
Major concern
Minor concern
Not a concern
Access to affordable in-home caregiving
Not having enough social support
Alzheimer’s disease, dementia, or memory loss
Access to affordable healthcare
Being able to remain at home
Access to affordable housing
Chronic diseases (such as diabetes, arthritis, etc.)
Crime / fraud / abuse
Falling
Financial security / money to live on
Not being able to drive
Not knowing where to turn for help
Nutrition / not being able to cook
Losing someone you depend on
Concern for someone who depends on you
11.Please feel free to share other thoughts or comments about your concerns.
12.Below are some things that can help make life better for older adults, people with disabilities, or caregivers. Please indicate if you or the person you care for currently has this type of support, need this type of support, or don’t need this type of support.
Have
Need
Don't Need
In home caregiving or personal care (e.g. help with bathing, dressing, etc.)
Opportunities to socialize with others
Medication management (e.g. daily reminders, setting up weekly pill box)
Emergency alert button (e.g. Life Alert pendant)
Meal preparation (e.g. home delivered meals, senior meal sites)
Transportation to medical appointments
Non-medical transportation
Access to enough healthy food
Information & referral services
Case manager or social worker
Help with laundry or housecleaning
Help with yard care (e.g. lawn care, tree limb removal, snow clearing, etc.)
Handyman services (e.g. changing light bulbs or smoke detector batteries)
Home modification (e.g. wheelchair ramp, walk-in shower, etc.)
Paying for supplies or equipment (e.g. grab bars, incontinence briefs, etc.)
Grocery pick-up or delivery
Prescription medication pick-up or delivery
Advance care planning (e.g. power of attorney, advance directive, etc.)
Support for Dementia, Alzheimer’s disease, or memory loss
Access to reliable high-speed internet
Ability to use a computer, tablet, or smartphone
Help understanding Medicare or Medicaid options
Low-income resources
Help with applications for service (e.g. SNAP, Medicaid, etc.)
Fitness or wellness programs
Dental care
Vision care
Hearing care
Access to a primary care provider (e.g. physician, nurse practitioner, etc.)
13.For items marked “need” above in question 12, what are the main reasons you’re not able to access these supports? Please check all that apply.
14.Please feel free to share any other thoughts or comments about barriers you or a loved one are currently experiencing.
15.Do you provide regular care or assistance to someone who has a disability, physical or mental health condition, dementia, or intellectual impairment? If so, please select all that apply:
16.Below are some things that can help make taking care of another person easier. As someone who provides care to another person, I would rate the importance of the following as:
Very important
Moderately important
Not very important
Getting a break from my caregiving duties
Attending a caregiver support group
Getting help with housework or errands
Help understanding options for support
Training in hands-on care
Taking care of my own well-being
Training in behavior management
Education on Alzheimer’s disease or dementia
Legal or Financial planning support
17.Please add any other thoughts or comments you would like to share.
Thank you for completing this survey.