The Johnson County Area Agency on Aging (AAA) is asking Best Times readers to take a few moments to complete the survey on the adjacent page.

By taking part in the survey, you will inform us about your needs in such areas as transportation, housing, information, health care, life skills, legal aid, and activities. The AAA can best serve clients and potential clients, and advocate for those who are aging, when its staff understand their situations and their challenges.

Please fill out the survey and return it by Monday, March 28. Simply print the survey, tuck it into an envelope, and mail (affix postage, please) to:

Needs Survey
Johnson County Area Agency on Aging
11811 S. Sunset Drive, Suite 1300
Olathe, KS 66061-7056

You also may take the survey online at http://hsa.jocogov.org.

If you have questions about the survey, call 913-715-8852. Thank you!

 

Survey of Needs for Johnson County Area Agency on Aging

If applicable, please check more than one answer.

I currently live:
 In my own home  With my child in his/her home
 In my own apartment  With my parent/s in their home
 In assisted living  In a housing complex for seniors
 In a retirement community  Other

I live with:
 No one; I live alone  A spouse or partner
 A parent  My adult child
 A relative  A friend or roommate

To remain in my present residence as I grow older, I would need the following:
 Home maintenance or handyman services
 Homemaker services for cleaning, laundry, shopping
 Home health care for bathing or other personal care
 Help with managing my medications
 Transportation
 Home-delivered meals
 Yard care
 Other

When I need extra help with daily tasks such as grocery shopping, cooking, or transportation, I can count on family or friends.
 Yes  No

I receive help from friends or family at least once a week.
 Yes  No  I do not need help

During an average week, I leave home:
 Only for medical appointments  Less than 1 day per week
 1–3 days per week  4–6 days per week
 Every day

This is what keeps me from going out more often:
 Health concerns  Emotional concerns
 Financial concerns  Lack of transportation
 No one to assist me  Accessibility issues
 Other

I participate in community activities or groups such as a community center, social group, religious group, or support group:
 Never or almost never  Once or twice a year
 Once or twice a month  Once a week or more

I receive these services from the Area Agency on Aging:
 Meals on Wheels  Meals at a senior center
 Legal assistance  Case management
 In-home services such as homemaker or personal care
 Respite care for myself or my caregiver
 Other

When I have legal, financial, or care issues, I turn to the following for advice:
 Area Agency on Aging  Paid adviser
 Clergy or faith-based agency  Friends
 Family  Community services such as United Way

As a Johnson County resident, the following issues concern me (for the present or the near future):
 The cost of medicine  Loss of aging services due to budget cuts
 Maintaining a healthful diet  Remaining independent
 Help with house or yard work  Maintaining mental wellness
 Transportation  Economic news  Other

I contact my legislator, congressional representative, or county commissioner:
 Monthly  Yearly
 Never  As needed, when important issues arise

When I am going somewhere beyond walking distance, I:
 Drive myself  Get a ride from friends or family
 Use public transportation  Use a program-sponsored van
 Use Catch-a-Ride  Use a scooter or electric wheelchair
 Other

Problems with transportation make it difficult for me to:
 Go to medical appointments  Take part in community activities
 Go to work or get a job  Socialize or visit friends and family
 Shop or do errands  Other

Regarding Medicare Part D, the prescription drug plan:
 I have never used it.
 I have used it and experienced no problems.
 I have used it and had these problems:

I provide care for a minor child or a senior over the age of 59:
 Full time  4–8 hours per day
 More than one day per week  1–3 hours per day
 9–24 hours per day  Rarely or not at all

During the past year, I have received health care at:
 Emergency room  Pharmacy clinic
 Public health clinic  Urgent care clinic
 Physician's office  Other

My health insurance is issued by:
 Veterans Administration  Long-term insurance
 Medicare  Private
 Medicaid  Other

The Area Agency on Aging has participated in the Senior Quest information fair each year.
 I have not hear of Senior Quest.
 I have attended the event once.
 I have attended multiple times.
 It is of no interest to me.

If you have questions or comments about aging, please list them here:

 

 

ZIP code __________

Age:  Male  Female

Marital status:
 Married  Separated  Divorced
 Never married  Widowed  Living together as married

Monthly household income before taxes $______________

Name and address (optional)

 

 

Thank you so much for sharing your time and valuable insights with us!

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