Santee-Lynches is conducting a region-specific needs assessment to determine the needs of seniors in the Santee-Lynches region. Please take a moment and complete the survey so that we can find ways to better serve seniors in our area.

Section 1: Demographic Information
Are you current receiving services from a senior center or area Agency on Aging?

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* 1. Are you current receiving services from a senior center or area Agency on Aging?

What county do you live in?

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* 2. What county do you live in?

What is your gender?

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* 3. What is your gender?

What is your race?

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* 4. What is your race?

How old are you?

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* 5. How old are you?

What is your marital status?

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* 6. What is your marital status?

What is your monthly income?

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* 7. What is your monthly income?

How many people live in your household?

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* 8. How many people live in your household?

Section 2: Concerns and Challenges at Home
Which of the following items are you currently experiencing? Check all that apply.

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* 9. Which of the following items are you currently experiencing? Check all that apply.

Which of the following items are you concerned about in regards to your ability to remain independent at home?

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* 10. Which of the following items are you concerned about in regards to your ability to remain independent at home?

Section 3: FAMILY CAREGIVERS: Please answer the following questions below if you provide substantial care to a love one over the age of 60 or to anyone who has been diagnosed with dementia.
Do you provide hands-on care for a loved one? If no, skip to Section 4.

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* 11. Do you provide hands-on care for a loved one? If no, skip to Section 4.

How many hours a week do you provide direct hands-on care?

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* 12. How many hours a week do you provide direct hands-on care?

How many people are you currently providing hands-on care for?

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* 13. How many people are you currently providing hands-on care for?

Are you currently receiving funding from the Family Caregiver Support Porgram?

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* 14. Are you currently receiving funding from the Family Caregiver Support Porgram?

If so, would your loved one be able to remain at home without the support of the Family Caregiver Support Program?

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* 15. If so, would your loved one be able to remain at home without the support of the Family Caregiver Support Program?

Section 4: Senior Centers
Does your community have a Senior Center?

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* 16. Does your community have a Senior Center?

If yes, do you attend?

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* 17. If yes, do you attend?

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