Your answers will help improve care for people who live with dementia.

This is a short, anonymous and ongoing survey on behaviour, which takes 3 - 4 minutes to complete. Many people say it has made them think differently about the way people who live with dementia behave. You will be able to see the results immediately after you complete the survey by clicking "Done." 
 
If you have a problem seeing the survey, or some of the questions are cut off, please try changing your browser or using a different device. 

Thanks you for participating. I invite you to distribute this survey as widely as possible using any means you wish and to use it as a tool to change minds and create better dementia care .
 

* 1. If a stranger tried to take your clothes off, would you resist?

* 2. Do you ever become upset or lose your temper?

* 3. If you found yourself in a new or unknown environment, might you spontaneously explore it?

* 4. Do you ever wake up in the night?

* 5. Do you ever talk, mutter, or mumble to yourself?

* 6. Do you ever engage in behaviour that might not be in your best interest?

* 7. What would you do if someone tried to make you take drugs you didn't want to take?

* 8. If you were physically threatened, might you hit, slap, kick, bite, or push someone to defend yourself?

* 9. If you had to sit for long periods of time with nothing to do, might you become restless, want to get up or start to fidget?

* 10. Do you ever have difficulty falling asleep?

* 11. Have you ever been unable to find a bathroom and been so desperate to pee that you urinated somewhere you otherwise would not have? (e.g. on the roadside, in the woods)

* 12. Do you ever say things that don't make sense?

* 13. Have you ever damaged, broken or destroyed something on purpose? (if angry, bored, or frustrated for example)

* 14. Have you ever screamed, yelled, or moaned loudly?

* 15. Do you ever argue, threaten, or curse?

* 16. Do you ever do things in an unsafe manner? (For example: stand on a chair to change a light bulb, drive over the speed limit, jaywalk, not wear a seatbelt, ski or hike off marked trails, operate equipment without safety glasses, etc.)

* 17. Do you ever complain about your health?

* 18. Have you ever engaged in what someone else might consider inappropriate sexual behaviour? (Note: some people consider this type of behaviour inappropriate: sex before or outside of marriage, oral sex, masturbation, reading or watching erotic books or movies)

* 19. Have you ever seen or heard things that turn out to be something other than what you thought they were?

* 20. Have you ever woken someone else up in the night?

* 21. If you were confined against your will, would you try to find ways to escape?

* 22. Have you ever mistakenly accused someone of doing something they didn't do?

* 23. Have you ever asked for attention or help?

* 24. Are you ever uncooperative?

* 25. If you were bored, might you try to find something to do?

* 26. If you were physically restrained against your will would you try to get free?

* 27. Do you ever complain?

* 28. Have you ever repeated behaviour other people say doesn't make sense, but that makes sense to you?

* 29. Do you ever do things that others might think is risky, but that you think is safe?

* 30. How long could you sit in a chair with nothing to do before you would feel restless, want to get up or start to fidget?

* 31. Are you male or female?

* 32. What is your age?

* 33. In what country do you currently reside?

* 34. As far as you are aware, do you have any form of dementia? (e.g. Alzheimer disease)

* 35. Do you have or have you had any role in dementia care?

* 36. Additional comments?


As the survey is anonymous, I have no way to communicate directly with respondents. If you wish to see the results of the survey when they are published later in 2017, please go to the link after you click "Done," and contact me using the contact form. Thanks.  

I invite you to follow my blog
MyAlzheimersStory.com;

Or to contact me via this page:
http://myalzheimersstory.com/contact-susan/ 

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