The 28 Texas Area Agencies on Aging are conducting this survey to collect your opinions about what matters most to the older adults and caregivers who live in your region. Responses will guide their Area Plans for Aging Services and help determine the programs and services offered. Please answer the following questions, which do not ask for your name or other identifying information. This survey takes approximately 10 minutes to complete.

Thank you for your time and contributions. We value your perspective and greatly appreciate your participation in this important survey effort.

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* 1. Which categories best describe you? (Please select all that apply.)

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* 2. Please select the county in which you live.

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* 3. Please list the zip code in which you live in?

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* 4. If you selected Service Provider in question #1, please select the county or counties in which your organization serves older adults and/or family caregivers. (If you are not a Service Provider, please skip to Question #5.)

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* 5. From the list below of most common services provided by Area Agencies on Aging, how would you RANK the IMPORTANCE of these services to older adults and family caregivers in your community? (1 being most important, 13 being least important)

  1. Transportation
  2. Home Delivered Meals: Pre-prepared & delivered meals for homebound individuals
  3. Congregate Meals: Hot Meals served at Senior Centers, community centers or designated restaurants
  4. Personal Assistance: help with taking a bath, getting dressed, eating, using the toilet, or other personal care tasks
  5. Homemaker Assistance: Housekeeping, light meal preparation, provided for someone who cannot perform these tasks
  6. Residential Repair: Minor home repairs or modifications that are essential for their health and safety
  7. Adult Day Services: Supervision and socialization at an adult day facility
  8. Health Maintenance: Assistance with the purchase of medications, nutritional supplements, glasses, dentures, hearing aids or health-related goods and services
  9. Caregiver Respite: Temporary relief for family caregivers who are caring for someone 60 and older
  10. Caregiver Education, Training and Information: information about available resources, educational topics and support for family members caring for aging loved ones with the focus on helping with their role as caregivers
  11. Evidence Based Programs: Educational programs that are provided to assist older adults improve their health and wellbeing. Examples include: A Matter of Balance Program, Chronic Disease Self-Management program, Diabetes Self-Management program
  12. Legal Assistance: Information and support that protects older adults from challenges with independence, choice and financial security; includes help accessing public benefits
  13. Information, Referral, and Assistance: Information on various programs and services available to older adults and family caregivers in order to connect them to the assistance needed to meet their needs

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* 6. What are the top three needs to be addressed so that older adults can continue to live independently?

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* 7. If you are a family caregiver, what is the greatest challenge encountered in providing care for a loved one? (If you are not a family caregiver, please skip to question #8.)

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* 8. As an older adult, how concerning are each of the following issues? 

  Highly Concerning

Somewhat Concerning Slightly Concerning Not Concerning at all
Health Issues
Finances
Safety
Scams/Fraud
Physical abuse
Lack of transportation
Inability to carry out activities of daily living, such as walking, bathing, dressing, toileting, feeding, and grooming
Information about services that are available for older adults
Food/Nutrition
Public Benefits
Making the home more accessible (examples: handrails, ramps, etc.)
Depression, loneliness, isolation
Medical and Legal Documents, such as Powers of Attorney, Wills, etc.
Safe and affordable housing

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* 9. Where do you get information about services for older adults? Please select all that apply.

Thank you again for participating in this survey. Your opinions are important to the Area Agency on Aging of the Capital Area.
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