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Caregiver Survey for Mobile Phone Application Features
Qinektd LLC invites you to complete this anonymous survey in an effort to obtain funding from the National Institutes of Health (NIH) to develop a mobile phone application to assist caregivers and people living with various types of dementia. Your participation and feedback will provide useful information to help identify the features caregivers need and want so we can develop the best product for your use. For more information about Qinektd LLC (
pronounced Connected
) please visit our website at https://www.qinektd.com. We appreciate your time in completing this short survey. It should take less than 5 minutes to complete.
*
1.
Are you a current or former caregiver for someone living with dementia?
(Required.)
Yes - Current
Yes - Former
No
2.
What is your age?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
3.
What is the age of the person you are caring for?
Younger than 45 years old
45-54 years old
55-64 years old
65-74 years old
75 years or older
4.
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)
*
5.
Do you have a mobile cell phone?
(Required.)
Yes
No
*
6.
If you answered Yes to Question 2 - what kind of mobile cell phone do you have?
(Required.)
Android
iPhone
N/A
Other (please specify)
*
7.
Does the person you care for have a mobile cell phone?
(Required.)
Yes
No
*
8.
If you answered Yes to Question 4, what kind of mobile cell phone?
(Required.)
Android
iPhone
N/A
Other (please specify)
*
9.
Would you use a free mobile phone application to help remotely manage care for your loved one?
(Required.)
Yes
No
Maybe
*
10.
If you are interested in using a free mobile phone application to assist with caregiving, which features would you be interested in? Please check all that apply.
(Required.)
GPS locator with walkie-talkie type real time communication with your loved one.
Shared/managed calendar populated by caregiver and shared with other caregivers as well as person you are caring for. Push reminders will be sent to person being cared for that need to be tapped/acknowledged so the caregiver knows the reminder was viewed by their loved one. Examples of calendar reminders are for general scheduling, birthday reminders, medication reminders, and basic daily tasks. Calendar can be viewed by other caregivers.
Non-Paid Caregiver locator to find other people near you caring for someone with dementia. This would create a community of non-paid caregivers with a similar situation to yours. The goal is to help combat caregiver isolation as well as provide a means of additional, non-paid caregiver support in your area. You would also be a person included in the database so other caregivers could reach out to you via the mobile phone application.
Other (please specify)
None of the above
*
11.
Are there any other ideas or topics related to caregiving you would like to see addressed?
(Required.)
Yes
No
Other (please specify)
12.
Would you be willing to pay for a mobile phone application to assist you in caregiving?
Yes
No
13.
If Yes, What features would you pay for?
14.
If yes, how much would you be willing to pay?
15.
Would you pay for a service that allows you to talk to someone who is not a therapist, just a person to speak with about whatever you want to?
Yes
No
16.
If Yes, how much would you be willing to pay per minute?
