MYP 2020 Survey

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* 1. Check all that apply. I am a/an:

Older adult (age 60+)

Caregiver (providing care for an older adult)

Provider (providing professional services for an older adult)

Person with disability

Grandparent raising grandchild(ren) (age 55+)

Other

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* 2. Please indicate your county of residence

Muskegon

Oceana

Ottawa

Other

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* 3. Your current living situation :

Single family home

Senior Living Facility

Condo

Apartment

Living with family/friend

Other

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* 4. Do you intend to continue living in your current home for the next 5 to 10 years?

Yes

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* 5. Do you plan to make any modifications to your home to help you age in place?

Yes

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* 6. Can you afford to make home the modification necessary to remain in your home?

Yes

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* 7. Does any disability, handicap, or chronic disease keep you and /or your spouse or partner from fully participating in work, housework or other activities? (CHECK ONLY ONE)

Yes, myself

Yes, my spouse or partner

Yes, both me and my spouse or partner

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* 8. In general, how often do you go online to access the Internet for things like sending or receiving email, getting news and information, paying bills or managing finances or buying products or services?

This includes access from home, work, a mobile device (such as a smart phone), or someplace else.

Daily

1-2 days a week

3-6 days a week

Once every few weeks

I never go online

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* 9. Would you be interested in using a web-based system to video chat with friends and family?

Yes

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* 10. How important do you think it is for seniors to have access to adult day services - community based supervised care for older adults?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 11. How important do you think it is for seniors to have access to affordable housing?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 12. How important do you think it is for seniors to have access to caregiver trainings and support groups?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 13. How important do you think it is for seniors to have access to congregate meals - meals offered at community locations?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 14. How important do you think it is for seniors to have access to fitness activities specifically geared to older adults?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 15. How important do you think it is for seniors to have access to health and wellness programs such as classes in areas of nutrition, chronic disease management, weight control, balance, etc.?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 16. How important do you think it is for seniors to have access to home care services like in-home respite, personal care and housekeeping?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 17. How important do you think it is for seniors to have access to home delivered meals - nutritious meals delivered to a homebound seniors home?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 18. How important do you think it is for seniors to have access to home repair services - help with minor home repair?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 19. How important do you think it is for seniors to have access to life enrichment activities such as art, travel and educational opportunities?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 20. How important do you think it is for seniors to have access to seasonal services - lawn maintenance or snow removal?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 21. How important do you think it is for seniors to have access to service navigation - services that fund seniors to find and access health and supportive services?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 22. How important do you think it is for seniors to have access to telephone or home visiting for older adults?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 23. How important do you think it is for seniors to have access to transportation for medical appointments or community involvement?

1. Very important

2. Somewhat important

3. Neutral

4. Not important

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* 24. Are you able to go shopping, visit the doctor, run errands or go to other places?

Yes

If no, why not?

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* 25. If yes,do you

Drive yourself

Have others drive you

Walk

Ride a bike

Use public transportation

Take a taxi/cab

Use a special transportation service such as one for seniors or persons with disabilities

Other (please specify)

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* 26. About how frequently do you interact with friends, family or neighbors in your community? This interaction could be by phone, in person, email or social media such as Facebook.

More than once a day

About once a day

Several times a week

Once a week

Once every 2 or 3 weeks

Once a month

Less than monthly

Never

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* 27. What kind of help do you feel you need to remain in your home to age in place?

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* 28. Do you identify as male or female?

Male

Female

Other

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* 29. What is your age?

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* 30. Which race/ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Multiple ethnicity / Other (please specify)