Saginaw County Commission on Aging Older Adult Survey 60+

Dear Saginaw County Resident age 60 or better:

The Commission on Aging, is a department of the County of Saginaw which, provides support services and opportunities to older adults. We are governed by a Board of Directors comprised of eleven members appointed by the Saginaw County Board of Commissioners. We are funded by local Millage Property Taxes, Federal and State Grants, and donations.

By completing this survey, you will assist us in developing a Senior Services Strategic Plan, which will help our agency align resources over the next five years. It is important we hear from you to understand what services you find valuable in the community and if there are any unmet needs that could be provided.

At the end of the survey, enter your name and telephone number for a chance to win a $25 gift card. Thank you for your time and your input.

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* 1. Which township/city/village do you reside?

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* 2. What is your zip code?

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* 3. I identify as:

Male

Female

I prefer not to disclose

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* 4. What is your age?

60-64

65-74

75-84

85+

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* 5. What is the number of people in your household (including you)?

4 or more

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* 6. What is your living situation?

Living alone

Living with spouse

Living with relatives

Other (please specify)

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* 7. What race do you consider yourself?

White/Caucasian

Black or African American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

American Indian or Alaska Native

Asian or Asian American

Another race:

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* 8. What is your monthly income?

Less than $1,000

$1,000-$1,500

$1,500-$2,000

$2,000-$2,500

More than $2,500

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* 9. Do you live in your own home?

Yes

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* 10. If you do NOT live in your own home, where do you live?

Apartment Community

Assisted Living Facility

Adult Care Facility

Retirement Community

Home of Other Family Member

I live in my own home

Other (please specify)

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* 11. Have you utilized Saginaw County Commission on Aging services/programs in the past year?

Yes

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* 12. If yes, select all programs/services you have used in the past year:

Transportation

Home Delivered Meals (Meals on Wheels)

Information & Assistance

Senior Centers

Volunteer

Respite

Minority Outreach

Personal Care

Care Management

Cell Phones for Seniors

Respite

Caregiver/Kinship Support

Foster Grandparent Program

Homemaking

Other (please specify)

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* 13. Overall my health is:

Good

Fair

Poor

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* 14. How often do you have contact with family, friends, or neighbors who do not live with you?

Everyday

Several times a week

Once a week

Once a month

Less than once a month

Never

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* 15. Do you receive assistance or help from another program or person?

Yes (please specify)

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* 16. Are you still driving?

Yes

Yes - but only when I have to

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* 17. Would you be interested in volunteering with the Commission on Aging?

I am already a volunteer

Yes - please include name and telephone number:

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* 18. Do you have any unmet needs you could use assistance with?

Yes (please explain)

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* 19. Are there any special programs/services you would like to see developed by the agency for adults 60 and better? If yes, please specify.

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* 20. I need help with:

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* 21. How important do you think it is for older adults to have access to the following programs or services?

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* 22. If you would like to be included in a drawing for a $25 gift card for completing this survey, please enter your name and telephone number.

Thank you for your time and input!

Name

Phone Number

	Never	Sometimes	Always
Affording energy and utilities (bills)	Affording energy and utilities (bills) Never	Affording energy and utilities (bills) Sometimes	Affording energy and utilities (bills) Always
Keeping up with medical costs	Keeping up with medical costs Never	Keeping up with medical costs Sometimes	Keeping up with medical costs Always
Understanding health insurance / Medicare	Understanding health insurance / Medicare Never	Understanding health insurance / Medicare Sometimes	Understanding health insurance / Medicare Always
Insufficient money for food, shelter, clothes	Insufficient money for food, shelter, clothes Never	Insufficient money for food, shelter, clothes Sometimes	Insufficient money for food, shelter, clothes Always
Legal Assistance	Legal Assistance Never	Legal Assistance Sometimes	Legal Assistance Always
Household chores	Household chores Never	Household chores Sometimes	Household chores Always
Disability or Impaired Mobility	Disability or Impaired Mobility Never	Disability or Impaired Mobility Sometimes	Disability or Impaired Mobility Always
Feeling afraid/unsafe at home because you may fall or get injured	Feeling afraid/unsafe at home because you may fall or get injured Never	Feeling afraid/unsafe at home because you may fall or get injured Sometimes	Feeling afraid/unsafe at home because you may fall or get injured Always
Loneliness, isolation, or depression	Loneliness, isolation, or depression Never	Loneliness, isolation, or depression Sometimes	Loneliness, isolation, or depression Always
Transportation: Grocery Shopping, Recreational, Other	Transportation: Grocery Shopping, Recreational, Other Never	Transportation: Grocery Shopping, Recreational, Other Sometimes	Transportation: Grocery Shopping, Recreational, Other Always
Knowing where to obtain information about services and benefits	Knowing where to obtain information about services and benefits Never	Knowing where to obtain information about services and benefits Sometimes	Knowing where to obtain information about services and benefits Always
Taking care of another adult	Taking care of another adult Never	Taking care of another adult Sometimes	Taking care of another adult Always
Taking care of a grandchild	Taking care of a grandchild Never	Taking care of a grandchild Sometimes	Taking care of a grandchild Always
Taking care of personal needs like bathing, dressing, oral hygiene	Taking care of personal needs like bathing, dressing, oral hygiene Never	Taking care of personal needs like bathing, dressing, oral hygiene Sometimes	Taking care of personal needs like bathing, dressing, oral hygiene Always
Conflicts with others such as family, neighbors, creditors	Conflicts with others such as family, neighbors, creditors Never	Conflicts with others such as family, neighbors, creditors Sometimes	Conflicts with others such as family, neighbors, creditors Always
Setting up or remembering medications	Setting up or remembering medications Never	Setting up or remembering medications Sometimes	Setting up or remembering medications Always
Home repairs or maintenance	Home repairs or maintenance Never	Home repairs or maintenance Sometimes	Home repairs or maintenance Always
Technology needs such as using a phone/internet	Technology needs such as using a phone/internet Never	Technology needs such as using a phone/internet Sometimes	Technology needs such as using a phone/internet Always
Tax Preparation Assistance	Tax Preparation Assistance Never	Tax Preparation Assistance Sometimes	Tax Preparation Assistance Always

	Not Important	Neutral	Somewhat Important	Very Important
Information on programs and services available	Information on programs and services available Not Important	Information on programs and services available Neutral	Information on programs and services available Somewhat Important	Information on programs and services available Very Important
Home Delivered Meals (Meals on Wheels Program)	Home Delivered Meals (Meals on Wheels Program) Not Important	Home Delivered Meals (Meals on Wheels Program) Neutral	Home Delivered Meals (Meals on Wheels Program) Somewhat Important	Home Delivered Meals (Meals on Wheels Program) Very Important
Senior Centers	Senior Centers Not Important	Senior Centers Neutral	Senior Centers Somewhat Important	Senior Centers Very Important
Volunteer programs	Volunteer programs Not Important	Volunteer programs Neutral	Volunteer programs Somewhat Important	Volunteer programs Very Important
Emergency financial assistance for utilities	Emergency financial assistance for utilities Not Important	Emergency financial assistance for utilities Neutral	Emergency financial assistance for utilities Somewhat Important	Emergency financial assistance for utilities Very Important
Transportation: Grocery shopping, recreational, other	Transportation: Grocery shopping, recreational, other Not Important	Transportation: Grocery shopping, recreational, other Neutral	Transportation: Grocery shopping, recreational, other Somewhat Important	Transportation: Grocery shopping, recreational, other Very Important
Transportation: Medical Appointments	Transportation: Medical Appointments Not Important	Transportation: Medical Appointments Neutral	Transportation: Medical Appointments Somewhat Important	Transportation: Medical Appointments Very Important
Legal Services	Legal Services Not Important	Legal Services Neutral	Legal Services Somewhat Important	Legal Services Very Important
Health and wellness programs	Health and wellness programs Not Important	Health and wellness programs Neutral	Health and wellness programs Somewhat Important	Health and wellness programs Very Important
Home repairs or modification services	Home repairs or modification services Not Important	Home repairs or modification services Neutral	Home repairs or modification services Somewhat Important	Home repairs or modification services Very Important
Major home repairs: new floor, roof	Major home repairs: new floor, roof Not Important	Major home repairs: new floor, roof Neutral	Major home repairs: new floor, roof Somewhat Important	Major home repairs: new floor, roof Very Important
Minor home repairs: leaky pipes, windows	Minor home repairs: leaky pipes, windows Not Important	Minor home repairs: leaky pipes, windows Neutral	Minor home repairs: leaky pipes, windows Somewhat Important	Minor home repairs: leaky pipes, windows Very Important
Caregiver support groups	Caregiver support groups Not Important	Caregiver support groups Neutral	Caregiver support groups Somewhat Important	Caregiver support groups Very Important
Help with housekeeping, bathing & respite for caregiver	Help with housekeeping, bathing & respite for caregiver Not Important	Help with housekeeping, bathing & respite for caregiver Neutral	Help with housekeeping, bathing & respite for caregiver Somewhat Important	Help with housekeeping, bathing & respite for caregiver Very Important
Elder abuse prevention education and supports	Elder abuse prevention education and supports Not Important	Elder abuse prevention education and supports Neutral	Elder abuse prevention education and supports Somewhat Important	Elder abuse prevention education and supports Very Important
Incontinence supplies	Incontinence supplies Not Important	Incontinence supplies Neutral	Incontinence supplies Somewhat Important	Incontinence supplies Very Important
Loan Closet ( loan equipment such as a wheelchair, walker, cane	Loan Closet ( loan equipment such as a wheelchair, walker, cane Not Important	Loan Closet ( loan equipment such as a wheelchair, walker, cane Neutral	Loan Closet ( loan equipment such as a wheelchair, walker, cane Somewhat Important	Loan Closet ( loan equipment such as a wheelchair, walker, cane Very Important
Safety Features in the home such as smoke detectors, hand rails, etc.	Safety Features in the home such as smoke detectors, hand rails, etc. Not Important	Safety Features in the home such as smoke detectors, hand rails, etc. Neutral	Safety Features in the home such as smoke detectors, hand rails, etc. Somewhat Important	Safety Features in the home such as smoke detectors, hand rails, etc. Very Important

Saginaw County Commission on Aging Older Adult Survey 60+

Question Title

* 1. Which township/city/village do you reside?

Question Title

* 2. What is your zip code?

Question Title

* 3. I identify as:

Question Title

* 4. What is your age?

Question Title

* 5. What is the number of people in your household (including you)?

Question Title

* 6. What is your living situation?

Question Title

* 7. What race do you consider yourself?

Question Title

* 8. What is your monthly income?

Question Title

* 9. Do you live in your own home?

Question Title

* 10. If you do NOT live in your own home, where do you live?

Question Title

* 11. Have you utilized Saginaw County Commission on Aging services/programs in the past year?

Question Title

* 12. If yes, select all programs/services you have used in the past year:

Question Title

* 13. Overall my health is:

Question Title

* 14. How often do you have contact with family, friends, or neighbors who do not live with you?

Question Title

* 15. Do you receive assistance or help from another program or person?

Question Title

* 16. Are you still driving?

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* 17. Would you be interested in volunteering with the Commission on Aging?

Question Title

* 18. Do you have any unmet needs you could use assistance with?

Question Title

* 19. Are there any special programs/services you would like to see developed by the agency for adults 60 and better? If yes, please specify.

Question Title

* 20. I need help with:

Question Title

* 21. How important do you think it is for older adults to have access to the following programs or services?

Question Title

* 22. If you would like to be included in a drawing for a $25 gift card for completing this survey, please enter your name and telephone number.Thank you for your time and input!

* 22. If you would like to be included in a drawing for a $25 gift card for completing this survey, please enter your name and telephone number.

Thank you for your time and input!