Alzheimer's Support Network of Naples, Florida

2014 ADRD CAREGIVER SURVEY

  

 The Florida Department of Elder Affairs (DOEA) is conducting a statewide survey of caregivers of persons with

Alzheimer’s disease and related disorders (ADRD), including Mild Cognitive Impairment.

 

As a caregiver of someone with ADRD, your answers will help DOEA better plan for the growing needs of Florida families like yours that are dealing with the challenges of caring for a loved one with a memory disorder.

 

THE SURVEY IS ANONYMOUS. Please be assured that your responses will be kept strictly confidential. The survey may be completed online or in print.

   

ONLINE VERSION OF THIS SURVEY    https://www.surveymonkey.com/s/2014_ADRD_Caregiver_Survey

 

 

                                                       Printed Version of the Survey


INSTRUCTIONS FOR COMPLETING THE PRINT VERSION OF THIS SURVEY

 

1.  Please answer each question as best you can.

2.  There are 3 ways to answer questions. a.  Circle your answer.

b.  Check one box in each row of questions in a table.

c.   Write your answer to questions where there is a line or an empty box. d.  Write your answer to questions that ask you to “please specify.”

3.  You can continue longer answers to questions on another page.

  

 

RETURNING THE PRINT VERSION OF THE SURVEY

 

Please return this survey to the survey partner who gave it to you, or mail it to:

 

Florida Department of Elder Affairs

Planning and Evaluation Unit

4040 Esplanade Way

Tallahassee, FL 32399-7000

 

  

Thank you for taking the time to fill out this survey. Your responses will help efforts to address the impact of

Alzheimer's disease and related disorders on Florida's citizens.

2014 ADRD Caregiver Survey

 

FREQUENTLY ASKED QUESTIONS

 

What is the purpose of the survey?

 

The 2013 Purple Ribbon Task Force Report recommended that the Florida Department of Elder Affairs (DOEA) conduct a statewide survey of caregivers of persons with Alzheimer’s disease and related disorders (ADRD). The purpose of the survey is to describe the following:

 

  •     The status of Florida’s caregivers of individuals with ADRD and their care recipients,
  •     The types of support available to them, and
  •     The ongoing impact of caregiving responsibilities.

 

The State can use this information to better determine the status of its ADRD population; the on‐going impacts of ADRD on caregivers and others; and to identify regions where needs or gaps of services appear to exist or be emerging. This may allow for the better targeting of public information or service resources by the state.

 

Who may respond to the survey?

 

Caregivers of persons with ADRD. We invite all caregivers to complete the survey regardless of whether they currently are receiving support services or not.

 

Who can be a Survey Partner?

 

Persons or organizations that have contact with caregivers of persons with ADRD are invited to partner with DOEA to provide caregivers with information about and access to the survey. This includes Florida universities and Memory Disorder Clinics, as well as public, private, and not‐for‐profit organizations, and businesses that have contact with caregivers of persons with ADRD.

 

What are Survey Partner responsibilities?

 

To identify, motivate, and assist caregivers in taking the survey.

 

How can Survey Partners help?

 

They can assist by providing caregivers with any or all of the following options for completing the survey:

 

Online (Completing the survey online)

 

1.   Caregivers complete the survey online at the Partner’s facility. This may include the following activities:

a.   DOEA emails a link to the survey to the Partner.

b.   Partner provides access to a computer where a caregiver can take the survey.

c.    Partner has a computer linked to the survey so that the caregiver can take the survey. d.   Partner allows the caregiver to complete the survey.

e.   Multiple caregivers can take the survey on the same computer.

 

 

2.   Caregivers complete the survey online at home. This may include the following activities:

a.   DOEA emails a link to the survey to the Partner. b.   Partner provides the link to the caregiver.

i.   Partner provides the link through an email to the caregiver, or

ii.   Partner provides the link to the caregiver through its website, or


iii.   Partner provides the link to the caregiver through other electronic communications such as a newsletter, or

iv.   Partner provides the link through a written communication.

 

Print (Completing the survey on paper)

 

3.   Caregivers complete a printed copy of the survey at the Partner’s facility. This may include the following activities:

a.   DOEA emails a survey in print format to the Partner.

b.   Partner prints the survey for the caregiver to complete at Partner’s facility. c.      Partner collects the completed surveys.

d.   Partner sends copies of the completed surveys to DOEA.

i.   Partner mails completed surveys to DOEA (see address below)

ii.   Partner faxes completed surveys to DOEA to: (850) 414‐2313

iii.   Partner scans and emails surveys to DOEA: allendorffs@elderaffairs.org

 

 

4.   Caregivers complete a printed copy of the survey at home. This may include the following activities:

a.   DOEA emails a survey in print format to the Partner.

b.   Partner prints the survey for the caregiver to complete at home. c.       Caregiver completes the survey.

i.   Caregiver sends completed survey to DOEA (see address below).

ii.   Caregiver returns completed survey to Partner for Partner to return to DOEA.

 

Telephone (Completing the survey over the phone)

 

5.   The Survey Partner will obtain permission from caregivers to provide their contact information to DOEA. a.   Partner asks caregivers if they would be interested in completing a survey by telephone.

b.   Partner prepares a list of interested caregivers with their contact information (phone numbers).

c.    Partner sends list of caregivers who have agreed to participate in the survey via phone call to DOEA. d.   Planning and Evaluation Call Center Interviewers administer the survey via telephone.

 

Whom can I contact if I have questions?

 

You may contact the following persons for further information:

 

 

What is the fax number for returning completed print surveys?

 

(850) 414‐2313

 

What is the mailing address for returning completed print surveys?

 

Florida Department of Elder Affairs

Planning and Evaluation

4040 Esplanade Way

Tallahassee, FL 32399‐7000