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Agewhale Elder Care Needs Survey

We are Agewhale, a Hong Kong social enterprise. In partnership with BCT, we are launching the "Caregiver Support Pilot Program" to assist colleagues who care for elderly family members. We sincerely invite you to take 5 minutes to fill out the following anonymous questionnaire to share your situation and needs. All information will be handled directly by our Agewhale team and kept strictly confidential, so please feel at ease completing it. Your valuable feedback will directly help us design support solutions that are better suited to your needs.

Email: [email protected] Website: www.agewhale.com

Which of the following best describes your current eldercare (adults over 60) situation? (Please select one)

Which of the following best describes your current eldercare (adults over 60) situation? (Please select one)
A
B
C
D
E
F

2. What caregiving tasks do you handle? (Check all that apply)

2. What caregiving tasks do you handle? (Check all that apply)
A
B
C
D
E
F
G
H
I

3. Which of the following best describes the current health status of the adult(s) over 60 you expect to care for? (If there is more than one care recipient, you may select multiple options for different situations)

3. Which of the following best describes the current health status of the adult(s) over 60 you expect to care for? (If there is more than one care recipient, you may select multiple options for different situations)
A
B
C
D
E
F

4. Do you have siblings or other people who you expect could share future elder care responsibilities? (Select one)

4. Do you have siblings or other people who you expect could share future elder care responsibilities? (Select one)
A
B
C

5. In what areas of your life has elder care had an impact? (Check all that apply)

5. In what areas of your life has elder care had an impact? (Check all that apply)
A
B
C
D
E
F

6. How does elder care affect your work? (Select all that apply)

6. How does elder care affect your work? (Select all that apply)
A
B
C
D
E
F
G
H
I
J

7. What are your biggest challenges with elder care? (Check all that apply)

7. What are your biggest challenges with elder care? (Check all that apply)
A
B
C
D
E
F
G

8. What elder care topics would you like to learn more about? (Check all that apply)


8. What elder care topics would you like to learn more about? (Check all that apply)
A
B
C
D
E
F
G
H
I
J
K

How comfortable are you talking to your manager about your elder care needs? (1 - Not comfortable at all to 5 - Very comfortable)

How comfortable are you talking to your manager about your elder care needs? (1 - Not comfortable at all to 5 - Very comfortable)

10. Do you feel supported by your workplace in managing elder care?

10. Do you feel supported by your workplace in managing elder care?
A
B
C
D
E

Which work benefits or resources have you used for elder care? (Open response)

Any additional comments or suggestions about your elder care needs or how your workplace can support you? (Open response)

Your gender

Your gender
A
B
C

Your age

Your age
A
B
C
D
E
F