2024 Needs Assessment - Young at Heart Resources

1. I have enough healthy food, or can buy enough healthy food to not be hungry each day.*

2. I have never had to choose between paying bills, purchasing medications or visiting a doctor in order to buy food.*

If Yes to question 2, how often in the past 6 months?

3. I have transportation to all of my doctors and medical appointments.*

4. I have transportation to get to the grocery store, senior center or other places I need/want to go.*

If Yes to question 4, who provides the transportation?

5. I am concerned about falling and injuring myself.*

6. I am an active member of my community.*

7. How many times in a month do you visit a senior center?*

8. I have someone to call whenever I need help or just want someone to talk to.*

9. My home is safe and easy for me to get around in and is not in need of repairs.*

10. I know who to contact to find out about services or programs in my area to help me stay safe, healthy and independent in my home.*

11. I, or someone I know, has been a victim of abuse, neglect or financial exploitation.*

12. Outdoor recreation spaces in my community such as sidewalks, parks and walking tails are safe and appropriate for me to use.*

13. I see a dentist for a check-up at least once a year.*

14. I provide care on at least a weekly basis for someone who is elderly, disabled or a minor child to help them stay safe and healthy.*

If Yes to question 14, do you care for a person who is:

If you selected "Other" to question 15, please state what services you personally use.

If you selected "Other" to question 16, please state what services were not available.

If you selected "Other" to question 17, please state what services you feel are needed.

1. What is your age?*

2. What is your gender?*

3. In which of the following counties do you reside?*

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