Dementia-Friendly WA: Networking & Resource Sharing Opportunities Survey

1.Which statement(s) describe you? (choose all that apply)

I have memory loss / dementia

I have a family member, friend or neighbor with memory loss / dementia

I work with people who have memory loss / dementia

I have no direct connection to someone with memory loss / dementia, but I care about dementia-friendly communities

2.What general questions related to promoting dementia-friendly programs and/or dementia-friendly communities are most relevant to you? (choose all that apply)

What is a dementia-friendly community?

How do you get started building a dementia-friendly community?

What kinds of dementia-friendly programs have worked well in other areas (i.e. Memory Cafes, walking groups), and how do you start them?

What approaches work well in rural communities?

What practices support cultural relevancy?

Other (please specify)

3.If you could talk with others around the state about what they're doing to build dementia-friendly communities, which elements of dementia-friendly communities would you want to discuss? (choose all that apply)

Respect (Challenging stigma, promoting respect)

Participation in community life (Through dementia-awareness training for neighborhoods, congregations, stores, banks, restaurants, libraries, hospitals, etc)

Social engagement, recreation and volunteerism (i.e. Memory Cafes, memory loss walking groups, dementia-inclusive art gallery tours, accessible volunteer options, etc)

Voice and leadership (inclusion of the perspectives and experiences of people with memory loss in community decisions)

Medical care and post-diagnostic supports

Transportation

Housing

Physical environment (Using signs and technology to make neighborhoods easier to navigate)

Other (please specify)

4.What is one "burning question" you would like to ask someone else who is working on dementia-friendly programs or initiatives?

5.What methods of networking / resource sharing would work best for you? (choose all that apply)

Meeting with people face to face, and I would be happy to travel elsewhere in the state to do so

Meeting with people face to face, but only if it was within 30 miles of my location

Phone or Video conferencing

Online forum

Email listserv

Webinar

Other (please specify)

6.If you would like to be notified about future dementia-friendly communities networking or resource-sharing opportunities in Washington State, please complete the following:

Name

Phone

County