Caregiving Survey Question Title * 1. Are you the person most responsible for caring for an adult, such as your spouse, partner, parent, relative or friend (care recipient)? Are you an unpaid or professional caregiver? Yes; I am the primary caregiver (unpaid) Yes; I am the primary caregiver (professional) No; I am a secondary caregiver (unpaid) - I am involved in caregiving responsibilities part-time, but someone else is the person most responsible for the care. No; I know a caregiver. Comments Question Title * 2. Are you currently a caregiver or were you a caregiver in the past? I am (or someone I know is) currently a caregiver. I (or someone I know) was a caregiver in the past. When? (Please provide approximate year range) Question Title * 3. Do you live with the care recipient? Yes No Question Title * 4. When were you born? 1900-1924 1925-1945 1946-1964 1965-1976 1977-1994 After 1995 Question Title * 5. What is your race/ethnicity? Please select the best option that best describes you. American Indian or Alaska Native Hawaiian or Other Pacific Islander Asian or Asian American Black or African American Hispanic or Latino Non-Hispanic White Question Title * 6. Please describe the health conditions or physical limitations of the care recipient. Long-term physical condition Short-term physical condition Memory problems Alzheimer's or dementia Surgery/wounds Cancer Limited mobility Mental/emotional health issues Other (please specify) Question Title * 7. How many hours per week do you spend on caregiving duties? Less than 5 5-10 10-20 20-30 30-40 More than 40 Comments: Question Title * 8. What kind of assistance do you provide? (Please check all that apply.) Light home maintenance (changing light bulbs, etc.) Heavy home maintenance (fixing plumbing, heavy lifting, etc.) Technical Troubleshooting with entertainment systems, TV, computer, phone, etc. Banking, finances, and bill payment Errands (buying groceries, picking up prescriptions, shopping, etc.) Keeping track of legal documents Health monitoring Providing meals Physical assistance Telephone calls and communication Scheduling appointments Setting up medications Cleaning/laundry Calling service providers Other (please specify) Question Title * 9. During a typical week, what kinds of people are you in contact with regarding the caregiving? (Please check all that apply.) Nurses Doctors Pharmacists Professional Caregivers Family Members Friends Social Workers Physical Therapists Financial Institutions Government Agencies None Other (please specify) Question Title * 10. What are some challenges you face as a caregiver? (Please check all that apply.) Time management Physical and emotional stress Financial implications Impact on career goals Personal sacrifices - interests, hobbies, relationships, travel, etc. Dealing with home maintenance or technical challenges for the care recipient The need for more training/education/knowledge regarding certain caregiving duties Worrying about the safety and comfort of the care recipient Communication with the care recipient Difficulty keeping track of tasks (i.e. remembering medications on time, monitoring regularly, etc.) Other (please specify) Question Title * 11. What kinds of technology are you currently using to help with caregiving duties? Smartphone Apps Services Sensors/Alerts Emergency Calling Devices Wearables GPS Monitor Robots Electric Wheelchairs Voice-Activated Device Smart Home Technology Bluetooth-Enabled Devices Other (please specify) Question Title * 12. Is there a type of technology you wish existed to help make caregiving easier? Yes No Please explain. Done