Preparing for the Needs of Older Adults Priority Issues and Challenges Your answers will help local and state leaders allocate resources to help adults as they reach retirement age. Question Title * 1. Hello, how did you find out about this survey? Select all that apply Social media Newspaper or local media Friend, family member, or neighbor GNRC.org website Workshop or other event Other (please specify) Question Title * 2. What is the 5-digit zip code of your primary home or residence? Question Title * 3. What is your affiliation with the Greater Nashville Regional Council (GNRC)? Select all that apply Client or Customer of a Program or Service Government Partner Non-Profit Partner Private Sector Consultant, Vendor, or Service Provider Member of Staff None of the above Question Title * 4. Which of the following describe your reasons for taking this survey? Select all that apply I am an older or disabled adult in need of services I provide care to an older or disabled adult I am preparing for life as an older adult I want my community to be a good place for older adults to live Other (please specify) Question Title * 5. As you grow older, how concerned are you with the following? Extremely Concerned Very Concerned Somewhat Concerned Not Very Concerned Not at all Concerned Finding a place to live Finding a place to live Extremely Concerned Finding a place to live Very Concerned Finding a place to live Somewhat Concerned Finding a place to live Not Very Concerned Finding a place to live Not at all Concerned Paying bills Paying bills Extremely Concerned Paying bills Very Concerned Paying bills Somewhat Concerned Paying bills Not Very Concerned Paying bills Not at all Concerned Staying connected with family and friends Staying connected with family and friends Extremely Concerned Staying connected with family and friends Very Concerned Staying connected with family and friends Somewhat Concerned Staying connected with family and friends Not Very Concerned Staying connected with family and friends Not at all Concerned Getting around town Getting around town Extremely Concerned Getting around town Very Concerned Getting around town Somewhat Concerned Getting around town Not Very Concerned Getting around town Not at all Concerned Ability to take care of your family Ability to take care of your family Extremely Concerned Ability to take care of your family Very Concerned Ability to take care of your family Somewhat Concerned Ability to take care of your family Not Very Concerned Ability to take care of your family Not at all Concerned Having someone to take care of you Having someone to take care of you Extremely Concerned Having someone to take care of you Very Concerned Having someone to take care of you Somewhat Concerned Having someone to take care of you Not Very Concerned Having someone to take care of you Not at all Concerned Question Title * 6. Have you considered moving to a new location as a result age-related issues? Yes, I have already moved for age-related reasons Yes, I plan to move for age-related reasons No, I do not plan to move for age-related reasons I am unsure if I will move for age-related reasons Question Title * 7. How do you rate your home, neighborhood, and city in terms of how well they are equipped to support the needs of older or disabled adults? Excellent Very Good Good Fair Poor Your Personal Residence Your Personal Residence Excellent Your Personal Residence Very Good Your Personal Residence Good Your Personal Residence Fair Your Personal Residence Poor Your Neighborhood Your Neighborhood Excellent Your Neighborhood Very Good Your Neighborhood Good Your Neighborhood Fair Your Neighborhood Poor Your City or Town Your City or Town Excellent Your City or Town Very Good Your City or Town Good Your City or Town Fair Your City or Town Poor Question Title * 8. Please describe how your community could be a better place to live for older or disabled adults. Question Title * 9. How often do you visit a senior center? At least once per week At least once per month A few times a year Hardly ever Never, and I have no plans to do so Never, but I plan to do so in the future Question Title * 10. Do you currently need help with any of the following? Select all that apply Personal care like bathing, dressing, getting around the home Household chores Transportation to places outside of the home Getting groceries or preparing meals Home repairs or modifications Legal assistance Health Insurance, Medicaid, or Medicare Taking care of someone else Other (please specify) None of the above Question Title * 11. How familiar are you with the following organizations? Very Familiar Somewhat Familiar Not Familiar Area Agency on Aging and Disability (Greater Nashville Regional Council) Area Agency on Aging and Disability (Greater Nashville Regional Council) Very Familiar Area Agency on Aging and Disability (Greater Nashville Regional Council) Somewhat Familiar Area Agency on Aging and Disability (Greater Nashville Regional Council) Not Familiar Tennessee Commission on Aging and Disability Services Tennessee Commission on Aging and Disability Services Very Familiar Tennessee Commission on Aging and Disability Services Somewhat Familiar Tennessee Commission on Aging and Disability Services Not Familiar AgeWell Middle Tennessee (formerly the Council on Aging) AgeWell Middle Tennessee (formerly the Council on Aging) Very Familiar AgeWell Middle Tennessee (formerly the Council on Aging) Somewhat Familiar AgeWell Middle Tennessee (formerly the Council on Aging) Not Familiar FiftyForward FiftyForward Very Familiar FiftyForward Somewhat Familiar FiftyForward Not Familiar AARP AARP Very Familiar AARP Somewhat Familiar AARP Not Familiar Question Title * 12. Please list any other organizations that older adults might turn to for support. Question Title * 13. Overall, do you think local government leaders are doing enough to address the day-to-day needs of older adults? Yes No Not sure Question Title * 14. Please describe what community leaders can do to better support older adults. Question Title * 15. Are you interested in receiving more information about any of the following? Select all that apply Affordable Housing Caregiver Support Emergency Preparedness Information Employment for Senior Citizens Home Repair Assistance In-Home Care Assistance Legal Assistance Medicare or Medicaid Options Mental Health Services Nutrition Assistance Prescription Drug Assistance Safety and Crime Prevention Social Opportunities Substance Abuse Assistance Transportation Assistance Question Title * 16. Please share your contact information if you would like to receive additional information about programs and services. Name Phone Email Next
