Covid-19 Survey – Alberta Council on Aging

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Working to improve the quality of life for older persons through education, advocacy and inclusion
Learn About Ageism

Working to improve the quality of life for older persons through education, advocacy and inclusion
Learn About Ageism

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COVID-19 Survey

The survey is to better understand how older adults are doing during this time. We appreciate your input in completing the COVID-19 Survey.

Step 1 of 3

33%

Select Your Age
Gender
Marital Status
What type of housing do you live in?
How would you describe your overall health before the pandemic?
Poor Fair Good Great
Do you think your physical health has improved or declined during this time (post-March 2020)
Physical Health has declined Physical Health has stayed the same Physical Health has improved
Do you think your mental/emotional health has improved or declined during this time (post-March 2020)
Mental/Emotional Health has declined Mental/Emotional has stayed the same Mental/Emotional has improved
Did you need medical attention during this time?
- Yes
- No
If Yes, what was your experience like?

Did you receive home supports (meals, housekeeping, laundry) from paid workers or family/friends prior to Covid-19?
- Yes
- No
Did these home supports become reduced or discontinued during the pandemic?
Home Supports Discontinued Home Supports Reduced Home Supports Stay the Same Home Supports Increased
Did you receive healthcare services from paid workers or family/friends prior to Covid-19?
- Yes
- No
Did these medical services become reduced or discontinued during the pandemic?
Medical Services Discontinued Medical Services Reduced Medical Services Stay the Same Medical Services Increased
Have you received timely information on the Covid-19 Situation?
- Yes
- No
Have you had extra expenses since Covid-19 restrictions have been put in place?
Expenses Reduced Expenses Stay the Same Expenses Increased
Have you been forced to defer bill payments or other financial obligations to support yourself or other family members?
- Yes
- No
If Yes, were you able to access any support or help to do so?
- Yes
- No

Were you able to obtain needed groceries, medicines, etc. in a timely manner?
- Yes
- No
If you did require help to receive essential services, were you able to receive the help you needed?
- Yes
- No
What methods did you use to communicate with others during the pandemic?
- Landline phone
- Cell Phone
- Email
- Online (Social Media/Computer/iPad
- In Person
Please select all that apply
Are you a caregiver for a family member or friend?
- Yes
- No
Do you have anything you would like to share regarding your personal experience during the pandemic?
Would you like someone to contact you? If so, please include your contact information below.
CAPTCHA

Monday - Thursday 9:00am - 5:00PMPO Box 62099, Edmonton, AB T5M 4B5 info@acaging.ca 1.780.423.7781 or 1.888.423.9666

Concerned about abuse? Call the Family Violence Information Line at 310.1818. Click here for more information.

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