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* 1. Are you a person living with a diagnosis of dementia or a family care giver?

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* 2. Which of these should the Dementia Action Alliance focus on in the next two years? Please tick up to three

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* 3. What do you find most difficult in day to day living as a result of your (or your loved one’s) dementia? Please tick up to three

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* 4. Tell us what would help you (or your loved one) to keep having an active life your community

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* 5. What would help you (or your loved one) manage their health conditions better?

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* 6. What would make it easier for you to get benefits or support services?

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* 7. Have you (or your loved one) visited or stayed in a hospital in the last three years?

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* 8. If yes, do you feel that you (they) received care that took account of your (their) dementia..

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* 9. What would have made your experience in hospital better?

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* 10. Please tell us about any particular difficulties you have living from day to day that are made worse because an organisation does not undestand dementia.

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