Dementia Module 4 Survey

Question Title

* 1. What is your role in working with persons with dementia?

Family caregiver

Certified Family Home Provider

Case manager, care coordinator

Direct care worker

Health care provider

First responder

Community business

Other (please specify)

Question Title

* 2. What was your level of awareness of the "Positive Physical " approach for interacting with a person with dementia before and after completing Dementia Module 4?

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree
Before taking the Promoting Communication training, I was aware of the "Positive Physical" approach used for interacting with a person with dementia.	Before taking the Promoting Communication training, I was aware of the "Positive Physical" approach used for interacting with a person with dementia. Strongly Disagree	Before taking the Promoting Communication training, I was aware of the "Positive Physical" approach used for interacting with a person with dementia. Disagree	Before taking the Promoting Communication training, I was aware of the "Positive Physical" approach used for interacting with a person with dementia. Neither	Before taking the Promoting Communication training, I was aware of the "Positive Physical" approach used for interacting with a person with dementia. Agree	Before taking the Promoting Communication training, I was aware of the "Positive Physical" approach used for interacting with a person with dementia. Strongly Agree
After taking the Promoting Communication training, I am aware of the "Positive Physical" approach used for interacting with a person with dementia.	After taking the Promoting Communication training, I am aware of the "Positive Physical" approach used for interacting with a person with dementia. Strongly Disagree	After taking the Promoting Communication training, I am aware of the "Positive Physical" approach used for interacting with a person with dementia. Disagree	After taking the Promoting Communication training, I am aware of the "Positive Physical" approach used for interacting with a person with dementia. Neither	After taking the Promoting Communication training, I am aware of the "Positive Physical" approach used for interacting with a person with dementia. Agree	After taking the Promoting Communication training, I am aware of the "Positive Physical" approach used for interacting with a person with dementia. Strongly Agree

Question Title

* 3. Please rate your understanding the needs of consistently establishing emotional safety, comfort and a friendly connection with a person with dementia Before and After taking Module 4.

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Before taking the Promoting Communication training, I understood that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off.	Before taking the Promoting Communication training, I understood that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Strongly disagree	Before taking the Promoting Communication training, I understood that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Disagree	Before taking the Promoting Communication training, I understood that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Neither agree nor disagree	Before taking the Promoting Communication training, I understood that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Agree	Before taking the Promoting Communication training, I understood that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Strongly agree
After taking the Promoting Communication training, I understand that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off.	After taking the Promoting Communication training, I understand that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Strongly disagree	After taking the Promoting Communication training, I understand that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Disagree	After taking the Promoting Communication training, I understand that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Neither agree nor disagree	After taking the Promoting Communication training, I understand that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Agree	After taking the Promoting Communication training, I understand that consistently establishing emotional safety, comfort and a friendly connection before communicating with a person with dementia will pay off. Strongly agree

Question Title

* 4. How likely are you to use the information presented in this module?

Not likely

Somewhat likely

Likely

Very likely

Not likely

Somewhat likely

Likely

Very likely

Comments?

Question Title

* 5. How likely are you to recommend this module to others?

Not likely

Somewhat likely

Likely

Very likely

Not likely

Somewhat likely

Likely

Very likely

Comments?