Surveys
2014
September
S
Survey I

Survey I

Why Is It So Hard to Ask for Help?

Hello:
You are invited to participate in our survey "Asking for Help". There are 7 questions, and it will take approximately 7 - 15 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. If you have questions at any time about the survey or the procedures, you may contact the American Association of Caregiving Youth at 561.391.7401 or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

I Agree

* What is your current age?

* Please select your gender.

Female

Male

* Please enter your current zip code.

* Are you or have you been a family caregiver who needs or needed to take a break?

Yes, I am currently a family caregiver and need to take a break.

Yes, I am a former family caregiver and needed to take a break.

No, I am not a family caregiver.

* If you are seeking or have previously sought relief from your caregiving responsibilities, which of the following options have you explored? Please select all that apply.

Help from an immediate family member

Help from a relative

Help from a friend

Volunteer caregiver

Paid professional caregiver

Adult daycare programs

Residential care home services

I have not asked for help.

* If you are or were reluctant to ask for help, why? Please select all that apply.

In-Home care is or was too costly

Out-of-home care is or was too costly

I feel or felt guilty

I feel or felt ashamed

I am or was afraid my loved one will not/would not receive appropriate care

I feel or felt it is/was an invasion of privacy to have a care provider in my home

I am or was apprehensive of cultural, religious, and/or personality barriers with the care provider

My loved one only wants or wanted me to care for him/her

My family and/or friends do not or did not support me

I do not or did not know about care services available in my area

I do not or did not feel supported by my healthcare provider and/or by my loved one's healthcare provider(s)

I am or was afraid other agencies will/would become involved through a care provider

I feel or felt it is/was a hassle to schedule and/or prepare my home for a care provider

I fear or feared legal issues may arise

Other

* Would you like to offer any other insight or comments concerning respite?

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