Caregiver Needs & Smart-Home Product Preference Survey

Question Title

* 1. Are you currently an adult child, relative, or paid caregiver for a senior (aged 65 or older?)

Yes, I am an adult child/relative

Yes, I am a paid/professional caregiver

None of the above

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* 2. Which of the following best describes your involvement in the senior's care? (Select all that apply)

I live with the senior.

I visit the senior daily.

I manage the senior's care from a distance (e.g. arrange services, check in by phone).

I am the primary decision-maker for their health and safety.

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* 3. How independent is the senior you care for?

Fully independent; requires no assistance with daily activities.

Mostly independent; requires minimal assistance (e.g. with managing medication or transportation).

Partially dependent; requires help with 1-2 major Activities of Daily Living (ADLs), such as bathing or getting dressed.

Highly dependent, requires assistance with most ADLS.

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* 4. What is the senior's primary living situation?

Lives alone in their own home/apartment.

Lives with me (the caregiver).

Lives in an independent living facility.

Lives in an assisted living or memory care facility.

Lives in a skilled nursing facility.

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* 5. Please rate the level of anxiety or worry you feel regarding the senior's safety on a typical day, when you are not physically present with them.

No Anxiety

Moderate Anxiety

Extreme Anxiety

No Anxiety

Moderate Anxiety

Extreme Anxiety

Question Title

* 6. Please rate the level of anxiety or worry you feel regarding the senior's safety on a typical day, when you are not physically present with them. (Must rank all 6)

Caregiver Needs & Smart-Home Product Preference Survey

Question Title

* 1. Are you currently an adult child, relative, or paid caregiver for a senior (aged 65 or older?)

Question Title

* 2. Which of the following best describes your involvement in the senior's care? (Select all that apply)

Question Title

* 3. How independent is the senior you care for?

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* 4. What is the senior's primary living situation?

Question Title

* 5. Please rate the level of anxiety or worry you feel regarding the senior's safety on a typical day, when you are not physically present with them.

Question Title

* 6. Please rate the level of anxiety or worry you feel regarding the senior's safety on a typical day, when you are not physically present with them. (Must rank all 6)

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* 7. In a few sentences, describe your single biggest day-to-day concern or recurring issue as a caregiver.

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* 8. What are the three most common or immediate issues that prompt you to check in on or worry about the senior?