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Fulton County Office For Aging - Return Home 2010 OFA Survey

Your Opinion is Important to Us!

The Fulton Co. Office for Aging is conducting a study to determine the needs and concerns of our older residents.
Please take a few minutes to complete the survey below.
Or
Download a copy of the survey.

1) Understanding health insurance/Medicare?
Problem

2) Keeping up with medical costs?
Problem

3) Insufficient money for food, shelter, clothes?
Problem

4) Affording energy and utilities?
Problem

5) Managing household bills?
Problem

6) Household chores/maintenance?
Problem

7) Feeling afraid or unsafe at home because you may fall or get injured?
Problem

8) Feeling afraid or unsafe at home because of crime and/or vandalism?
Problem

9) Legal affairs?Problem

10) Loneliness, isolation or depression?
Problem

11) Disability or impaired mobility?
Problem

12) Transportation (includes medical, shopping, recreation, to/from Social Adult Day program)?
Problem

13) Knowing where to get information about services and benefits?
Problem

14) Taking care of another adult?
Problem

15) Taking care of a grandchild or other kin?Problem

16) Taking care of your personal needs: bathing, dressing, preparing meals?
Problem

17) Conflicts with others such as family, neighbors or creditors?
Problem

18) Are there any issues that are important to you that are not on this list?
Please explain:

19) How would you rate your overall health?
Good

20) What is your zip code?

21) Is your age:
60-74 75-89

22) What is your interest in volunteering at the Office for Aging?
Good

23) Are you interested in nay of the following?

- Telephone Caregiver Support: Yes
- Safety Programs for Seniors: Yes
- Information about the OFA Budget: Yes
- Nutrition Counseling: Yes
- Chronic Disease Management: Yes
- Farmer’s Market Coupons: Yes

24) If you currently receive services from the Office for Aging,
please rate the service(s):
 Excellent Good

25) Please check your ethnic group:
White African American/Black

26) Is your household *low income?
Yes

*Low income is defined as:
1 person household - no more than $16,245 a year
2 person household - no more than $21,855 a year
3 person household - no more than $27,465 a year
4 person household - no more than $33,075 a year
5 person household - no more than $38,685 a year

27) What else would you like the Fulton Co. Office for Aging to know?:

28) If you would like someone to contact you about your needs please enter your telephone number here:

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2010 OFA Survey

 

Andrea Fettinger, BA, MEd, Director
Fulton County Office for Aging
19 North William Street, Johnstown, NY 12095
Phone: (518)736-5650, Fax: (518)762-0698
E-mail: fcofa@co.fulton.ny.us

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