Question Title

* 1. Where do you live?  County or City of Residence

Question Title

* 2. Please tell us your age range.

Question Title

* 3. Please tell us your gender.

Question Title

* 4. Please tell us your Race/Ethnicity.

Question Title

* 5. Are you a veteran?

Question Title

* 6. What are the greatest needs of older adults in the Greater Richmond Area?

  Great Need Moderate Need Little Need I Don't Know
Adult Day Care
Advocacy for Long-Term Care Issues
Affordable Housing
Assistance and Support for Caregivers
Assistance with Critical Needs such as Rent and Utilities
Available and Affordable Transportation for Medical Trips
Available and Affordable Transportation for Shopping and Errands
Check Writing and Budget Assistance
Community Engagement Activities for Older Adults
Health and Wellness Classes
Health Insurance Information and Counseling
Help Making Choices about Future Medical Care and End of Life Decisions
Help with Housework and Cleaning
Help with Personal Care
Home Maintenance Services
Job Training and Referral Services
Knowing Services are Available and How to Access Them
Legal Assistance
Maintaining a Healthy Diet
Someone to Call and Check on Older Adults in the Community

Question Title

* 7. Please tell us how important the following Senior Connections Services are for helping older adults remain in their communities.

  Very Important Somewhat Important Not Important I don't know
Adult Day Care
Care Coordination
Care Transitions
Caregiver Education, Support and Training
Chore Services (heavy cleaning, yard clean-up)
Congregate Meals and Activities through Friendship Cafes
Employment Services
Health and Wellness Classes
Home Delivered Meals
Homemaker and Personal Care Services
Information On and Assistance with Services and Resources
Medicare and Insurance Counseling
Legal Assistance Services
Respite Services (Caregivers break from day-to-day responsibilities)
Telephone Reassurance
Transportation
Volunteer Programs

Question Title

* 8. What services do older adults need but are not currently available?

Question Title

* 9. What three sources do you use most often to obtain information about services and program for older adults?

Question Title

* 10. Do you currently or have you ever received services from Senior Connections?

Question Title

* 11. Do you have any additional comments?

0 of 11 answered
 

T