Survey for Workforce 2015 Question Title * 1. What is your primary profession? Certified Nurse Aide Home Health Aide Personal Care Aide/Companion Social Worker First Responder Nurse Physician’s Assistant Physician Therapist – PT, OT, SLP Allied Healthcare Provider Mental Health Provider Educator Administrator/Owner Other (please specify) Question Title * 2. In what type of organization do you work? (Choose all that apply) Continuing Care Retirement Community Senior Center Home Care Agency Home Health Agency Home and Community Based Services Skilled Nursing Facility Assisted Living Facility Personal Care Home Adult Day Hospice Hospital Transportation Community Outreach Program Managed Care Organization Special Care /Memory Unit Retirement Community (Market Place/HUD subsidized) Other (please specify) Question Title * 3. How long you have been with this organization? Less than a month 1 month- 1 year 2-5 years 6-10 years 10 plus years Question Title * 4. How long in total have you been working in the aging field (counting your current and previous positions)? Less than a month 1 month- 1 year 2-5 years 6-10 years 10 plus years Question Title * 5. In what setting do you conduct most of your work? Individuals’ homes Facility Community Other (please specify) Question Title * 6. Please specify the organization type. For Profit Not-for-profit Part of a corporate chain Considered a faith-based organization Question Title * 7. In the last week, how many individuals/clients did you serve? 0 1-5 6-10 11-15 16-20 21-25 26-30 31-35 36-40 More than 40 Question Title * 8. What percent of these individuals are living with Alzheimer’s or a related dementia? 0% 1-10% 11-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-99% 100% Don’t know Next