Questionnaires
Questionnaire for Friends and Relations
A Better Future for YOU
Questions for YOU
Shops & Restaurants Questionnaire
Events
About Us
Contact
Questions for YOU
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About You
1. About You: Your Full Name
2. Age Range
18 to 35
36 to 55
56 to 75
75+
3. Where do you live?
At home
In a care home
Other
Going Out in the Community
4. Do you go out into the community? (Shops, park, cafés, groups, etc.)
Yes, often
Sometimes
Not much
Never
5. When you go out, who do you usually go with?
On my own
With family
With friends
With support staff/carer
6. How do you feel when you go out? (You can select as many as you like)
Select All
Happy
Excited
Calm
Interested
Other
Other
7. What is something you enjoy about being out in the community?
8. Do you ever feel any of these challenges when you are out? (Tick as many as you like)
Tired
Confused
Nervous or worried
Rushed
Other
Other
Support
What helps you most when you go out? Is there something that would make going out easier or more enjoyable for you?
Thank you. Your Voice Matters Is there anything else you want to say about going out in the community? Thank you for sharing your thoughts. Your answers will help make the community more welcoming for everyone. Especially those with Dementia
