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Fiscal Year 2027-2029 Multi-Year Plan CONSUMER SURVEY
Thank you for taking the time to complete this survey. We value your input on the needs of the community to help you live safely, confidently, and age well in the environment of your choice.
Every three years, Region IV Area Agency on Aging (AAA) develops a Multi-Year Plan to outline the services and activities it will fund, develop, and/or advocate for when accessing federal, state, and local funding. This Community Needs Assessment Survey will assist AAA to focus its resources and energies on the most important needs of the community. In addition, it will help shape the agency’s program development and advocacy efforts.
At the end of the survey there are demographic questions. We’re asking more about you to understand who is taking this survey. Inclusion and representation are crucial to our work. Every person brings unique strengths to our community. Learning more about your identity helps us better understand who we are serving and helps us take actions that meet the unique needs of our neighbors. You may skip any question at any time.
This survey should take 15-20 minutes to complete. All individual responses are confidential. All questions are optional. However, input is encouraged to help inform AAA efforts.
If you have any questions or would like additional information on available services, please contact:
Region IV Area Agency on Aging
800-654-2810
1.
When you have a problem that requires services where do you go to find out about services.
Please check all that apply.
211
Area Agency on Aging/Campus for Creative Aging
Community Newsletter
Doctor
Faith Community
Friend/Neighbor
Internet
Library
Local Health Department
Local Senior Center
Newspaper
Relative
Social Media
Television/Radio
I haven’t needed information or services
Other
2.
What do you believe are the five biggest unmet needs faced by older adults and persons with disabilities in your community?
Please check no more than five.
Adult Day Programming
Affordable Housing
Caregiver Education, Support & Training
Chronic Condition Care
Dementia Education & Support
Elder Abuse Prevention
Emergency Needs (help to pay for goods or services in a personal emergency)
Food or Nutritious Food Options
Help in Applying for Public Benefits
Health and Wellness Classes
Health Insurance Options Counseling
Home Maintenance/Chore Services
Home Repair/Modifications
Information about Senior Services
Legal Assistance
Long-Term Care Options Counseling
Long-Term Care Ombudsman (advocacy and education for nursing home residents of their rights; investigate, resolve and report complaints on behalf of nursing home residents)
Personal Care Assistance (help with daily care and light household tasks)
Respite Services (a break from caregiving)
Senior Centers
Social Engagement/Activities for Older Adults
Support for Adults with Disabilities
Support for Older Adults Raising Children 18 or Younger
Tax Assistance
Transportation
Other
3.
What are your biggest health concerns.
Please check all that apply.
Coping with pain
Fear of falling
Losing independence
Managing a chronic condition
Not being able to do the things you enjoy
Paying for health care (including co-pays)
Paying for medications
No health concerns
Other health concerns
4.
Do you typically eat at least two meals a day?
Yes
No
5.
If no, why do you have less than 2 meals per day?
You don’t always have enough money for food.
You are not always physically able to shop, cook, and/or feed yourself.
You need help with shopping, preparing meals, and/or eating but do not always have someone that can assist you.
You have an illness or condition that made you change the kind and/or amount of food you eat.
You have tooth or mouth problems that make it hard for you to eat.
You are not hungry enough to eat more/more often.
6.
In general, would you say your mental or emotional health is:
Excellent
Very Good
Good
Fair
Poor
7.
Do you have family members or friends living nearby who you can ask for help or support if you need it?
Yes
No
8.
Do you speak to or interact with friends or family outside your home as often as you would like?
Yes
No
9.
Do any of the following prevent you from participating in social activities?
Please check all that apply.
You cannot afford it
You are too sick or your disability is a barrier
You don’t know of such programs in your community
You don’t have a way to get there
You don’t want to be with the people in the programs
You would prefer to be with younger people
You don’t want to go alone
Does not apply
Other
10.
Do you live alone?
Yes
No
11.
Do you have any of the following concerns about the condition of your home environment?
Please check all that apply.
Home in need of major repairs (roof, furnace, sagging floors, bad wiring)
Home in need of minor repairs (leaking pipes, windows and doors not sealed)
Not enough handrails or grab bars
Stairways are unsafe
Need a ramp
Presence of mold
Too cluttered, need to remove items
Unsafe neighborhood
Poor water quality
In need of smoke and carbon monoxide detectors
In need of adaptive or durable medical equipment for daily tasks
No home safety concerns (if checked, skip next question)
Does not apply, I am homeless (if checked, skip next question)
12.
What is the main reason the problem conditions have not been addressed?
Please check one.
Cannot afford to do it
Haven’t gotten around to it
Can’t get help with it
You rent and it’s the landlord’s responsibility
Other
13.
Do you have trouble traveling to the places you need to go?
Yes
No
14.
Have you missed a medical appointment in the past 12 months due to lack of transportation?
Yes
No
15.
Do you have access to the Internet in your home?
Yes
No
16.
How often do you use email?
Every day
Three or four times a week
About once a week
Once a month
I rarely use email
I don’t have an email address
17.
How do you prefer to receive information about services and resources?
Please select one response.
Phone
Email
U.S. Mail
Social Media (Facebook, Instagram, etc.)
18.
Which county do you live in?
Berrien
Cass
Van Buren
19.
What is your zip code?
20.
What is your age?
21.
What is your gender? Please check all that apply.
Female
Male
Non-binary
Prefer not to answer
Prefer to self-describe
22.
How do you describe your sexual orientation or sexual identity? Please check all that apply.
Asexual
Bisexual
Heterosexual/Straight
Homosexual/Gay/Lesbian
Queer
Questioning or Unsure
Prefer not to answer
Prefer to self-describe
23.
Are you Spanish, Hispanic, or Latinx?
Yes
No
24.
Which of the following best describes you? Please check all that apply.
American Indian or Alaska Native
Asian or Asian American
Black or African American
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White or Caucasian
Prefer not to answer
Prefer to self-describe
25.
What is your annual household income? Please check one.
Less than $15,000
$15,000 - $24,999
$25,000 - $34,999
$35,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $149,999
$150,000 - $199,999
$200,000+
Prefer not to answer
Prefer to self-describe
26.
Please provide any additional comments here:
Thank you for completing the survey! We truly appreciate your input!
