SHELTERED HOUSING SURVEY

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Randell McLaughlin
6 years ago
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SHELTERED HOUSING SURVEY If you would like to complete this survey over the phone, please call the researchers Siobhan Fox and Lorna Kenny at 087 ******* A. About you 1.

Yes No If No, who are you living with (tick all that may apply): Spouse Parent Sibling Child / Children Aunt / Uncle Other Who? 5. What is your marital status?

1 SHELTERED HOUSING SURVEY If you would like to complete this survey over the phone, please call the researchers Siobhan Fox and Lorna Kenny at 087 ******* A. About you 1. Are you: Male Female Other 2. What age are you? years. 3. How long have you been living in your current home? years. 4. Are you living alone? Yes No If No, who are you living with (tick all that may apply): Spouse Parent Sibling Child / Children Aunt / Uncle Other Who? 5. What is your marital status? Single Married / Living with partner Widowed Divorced / Separated Other 6. With your total household income, do you find it easy or difficult now to make ends meet? Very Easy Fairly Easy Unsure Fairly Difficult Very Difficult For office purposes only. 1 ID:

2 B. Current Home and Support Needs 1. How happy are you with your current home? Very Unhappy A Little Unhappy Neither Happy Or Unhappy A Little Happy Very Happy Do you want to give reasons for your answer? 2. What is the best thing about your present home? 3. What is the worst thing about your present home? 4. Does the design of your home meet the current physical needs of you, and/or anyone else that you may be living with? Meets needs very well Meets most of needs Unsure Do you want to give reasons for your answer? Meets some of needs Home is totally inappropriate to needs 2

3 5. Thinking about the following features of a house: Does your house have any of these? Do you think you would need any of these now? Do you think you would need any of these in the future? My home has this feature This feature is needed in my home now This feature might be needed in my home in the future Toilet on the ground floor Toilet AND shower / bathtub on the ground floor Nonslip floor surfaces Bedroom on the ground floor Wide doorways An entrance without steps Bathroom aids, e.g. walk in shower, grab rails, toilet adaptions Lever door handles Stair lift Adequate storage for walking aids, wheelchair, etc. Parking and charging space for mobility scooter Outside lights Front door spyhole and keychain Intercom (i.e. check who is at the door without opening) N/A 3

4 6. Have you access to private outdoor space in your home? Yes No 7. How easy is it to heat your home? Very Easy Fairly Easy Neither easy or difficult Fairly Difficult Very Difficult If it is difficult to heat your home, why is this? 8. Do any of the following cause difficulty for you, or anyone in the house? Tick any that may apply. Physical access to your home Home not adapted for reduced mobility Poor repair of home Home too big for current needs Home too small for current needs Yes - causes difficulty for me Yes - causes difficulty for someone living with me No 9. How is your health overall? Excellent Good Fair Poor Bad 4

5 10. Do you, or any one in your house, have an illness, disability, or condition that interferes with your daily life? Me Someone else Nobody If yes, Who? 11. Do you, or anyone else in the house, have any mobility problems, or difficulties in moving around? I have mobility problems Someone living with me has mobility problems Who? There are no mobility problems C. Your neighbourhood 1. Do feel your neighbourhood is safe? Very safe Mostly safe Neither safe or unsafe Mostly unsafe Very unsafe 2. Have you ever had an experience that has left you concerned about your personal safety? Yes No If yes, can you tell us a little about that? 3. Is your neighbourhood noisy? Very quiet Mostly quiet Neither quiet or noisy Mostly noisy Very noisy 5

6 4. Do you have the following facilities within walking distance of your home (10 20 minutes?) Service Within walking distance Not within walking distance Don t need/want service Shop Post office Pharmacy GP/medical centre Pub/restaurant Church Gym/leisure centre Social club Library Bus stop Park/green space Other state service here 6

7 5. Thinking about the following services: Have you or someone living with you used these in the last year? Do you think you or someone living with you, needs any of these now? Tick any that apply Public Health Nurse Social Worker I or someone I am living with used this service in the past year I or someone I am living with would benefit from this service Occupational Therapist (OT) Home help Respite care Meals on Wheels General Practitioner (GP) Hospital outpatient centre Physiotherapist Day Centre Community Development Worker 7

8 D. Moving into sheltered housing 1. Looking back, how satisfied are you with your decision to move to sheltered housing? Satisfied Satisfied Neither Satisfied or Unsatisfied Unsatisfied Unsatisfied Do you want to tell us why you feel that way? 2. Which of the following features do you feel apply to living in sheltered housing? Please tick any that apply. Independent living Someone on hand if I need help Improved social contact - companionship/friendship with other residents Communal areas and facilities Outings and organised activities Safe and secure Near facilities/services that I need 24 hour emergency call system Service charge is expensive Less independence than previous home House is too small Took a long time to readjust Miss previous home I don t have the same level of social contact (neighbours, family, friends) I feel isolated even though I live near to others Can t keep pets 8

9 E. Looking to the Future Please indicate how much you agree or disagree with the following statements: 1. I am confident I will get the supports I need to stay living in my own home as I get older. Neither or 2. My home could be easily adapted to my needs as I grow older Neither or 3. I worry about having to move from my home into accommodation such as a nursing home Neither or 4. I am confident that I know all the options available to me with regard to my housing needs as I get older Neither or 9

10 5. Would you like to move from your current home, if you had the option? Yes No Maybe If yes, why do you want to move? House unsuitable How so? Noise Lack of privacy Service charges too expensive Not getting on with other residents Location of scheme Other State reasons here If yes, what kind of house would you like to move to? 6. Are there any adaptions / changes that would make your house more suitable for your current needs? Please explain your answer. 7. Looking to the future, is there any extra support that you would need to stay living where you are now? Please explain your answer. 10

11 F. Social Contact and Meeting People 1. Are there any days during the week when you do not have contact with neighbours/friends? Yes No If so, on how many days during the week do you not have contact with neighbours/friends? days 2. Do you regularly join in the activities of any local social organisations (e.g. community groups, church or religious groups, evening classes, social clubs, sports clubs) Yes No 3. Do you feel like you are a part of your community? Yes No 4. Do you think any of the following would be valuable to you now or in the future? Friendly Call service - someone who calls once a week / twice a month to see how you are doing. Volunteer service - someone to visit your home once a week / month for friendship/social contact Access to information regarding services and initiatives in your area to become better informed Yes - now Possibly in the future No 11

12 G. Technology 1. Do you have a computer/laptop/tablet? Yes No 2. Do you have access to broadband? Yes No 3. Would you consider using technology in your home for: Safety and security? Yes No Health monitoring? Yes No 4. Finally. is there anything else you would like to add about your housing or other support needs that you think would be useful for us to know? Thank you for taking the time to complete this survey. If you would like to add anything else, please feel free to ring us on 087 *******. In the coming weeks, we will be visiting Clúid housing centres across Ireland to speak with some tenants in more detail about the topics covered in this survey. If you would like to take part in this optional interview, please contact the Researchers Siobhán Fox or Lorna Kenny on 087 ******* or s.fox@ucc.ie for more information. 12

All About Me. Self assessment questionnaire. Please complete and bring with you to your next appointment at Papworth Hospital

All About Me. Self assessment questionnaire. Please complete and bring with you to your next appointment at Papworth Hospital Please affix patient label or complete details below. Full name: Hospital number: NHS number: DOB: All About Me Self assessment questionnaire Please complete and bring with you to your next appointment