Cape & Islands Older Adult Needs Assessment

Please review the list below of critical needs of elders and family members/friends and/or others living in the community.  Please check all needs that you believe are unmet or need additional services. 

Select OK to continue
 

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* 1. Caregiver Support

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* 2. Civic Engagement

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* 3. Economic

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* 4. Health Care

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* 5. Housing

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* 6. Learning and Development/Workforce Development

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* 7. Maintain Independence

 

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* 8. Legal Services

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* 9. Leisure and Recreation

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* 10. Mental and Behavioral Health

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* 11. Nutrition

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* 12. Safety and Security

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* 13. Spirituality

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* 14. Transportation

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* 15. Other: Please name any other needs that have not been listed.

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* 16. From the checklist, please list the top three critical needs that you have identified.

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* 17. What is preventing the elders in your family and you, including others living in the community, from receiving the assistance that you need?  Please check all that apply.

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* 18. Please list any programs/services that you are aware of that are successful in meeting the critical needs of the elders in your family and you, including others living in the community.

Please take a moment to tell us a little about yourself

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* 19. AGE

PLEASE CHECK ALL THAT APPLY FOR THE FOLLOWING SECTIONS 

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* 20. Gender Identity

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* 21. ETHNICITY

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* 22. LIVING ARRANGMENTS

Thank you for completing this survey. Your input will assist in the completion of the statewide Needs Assessment Project being conducted by your local Area Agency on Aging and the Executive Office of Elder Affairs.

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