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Working to improve the quality of life for older persons through education, advocacy and inclusion
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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
Under 20
20-40
40-50
50-60
60-70
70-80
Over 90
Gender
Male
Female
Other
Marital Status
Single
Married
Divorced
Widow/Widower
Common Law
What type of housing do you live in?
House/Apartment/Condo
Lodge
Supportive/Assisted Living
Hospital
Long Term Care (Nursing Homes or Auxiliary Hospital
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.
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Working to improve the quality of life for older persons through education, advocacy and inclusion
Home
About
About Us
Strategic Plan
Key Points
Board and Staff
Bylaws
Annual Reports
Membership
Membership
Donate
Programs
Programs
Age Friendly Programs
Living Strong
Volunteer
Age Friendly Tools
Newsletter Archive
Resources
Covid-19 Pandemic
General Support Programs
Writing to Government
Housing
Continuing Care
Finances
Transportation
Health
Blog
Blog
Calendar
Contact
Contact
Advertise with us
My Account
Donate Now
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