2023 Elder Needs Questionnaire


Where do you live?Required
Buchanan    Dickenson    Russell    Tazewell   

What is your age?Required
0 - 29    30 - 59    60 and older   

Do you rent or own your home?
Rent    Own   

Please answer the following questions as to how important you feel these services are to area residents.

Assistance in coordinating services among all providers, such as homemaker, meals, transportation, food stamps, housing, fuel assistance, etc.
Not Important    Slightly Important    Important    Most Important    N/A   

Prevention programs: Medicare fraud and abuse, identity theft, etc.
Not Important    Slightly Important    Important    Most Important    N/A   

Specialized transportation for disabled individuals, including lift-equipped vehicles for wheelchair transport. Medical transportation for appointments, dialysis, chemotherapy, etc.
Not Important    Slightly Important    Important    Most Important    N/A   

Educational Programs: Power of attorney, durable medical power of attorney & guardianship. Information on estate planning (wills, trusts and living wills). Live Well workshops: Living with illnesses.
Not Important    Slightly Important    Important    Most Important    N/A   

Minor home repair (plumbing, roof repair, electrical, and flooring). Funding for wheelchair ramps, widening doorways, installing grab bars, etc.
Not Important    Slightly Important    Important    Most Important    N/A   

Assistance with home heating, cooling and utilities.
Not Important    Slightly Important    Important    Most Important    N/A   

Personal care services (assistance with bathing, dressing, eating, toileting, and walking).
Not Important    Slightly Important    Important    Most Important    N/A   

Homemaker services (light housekeeping, laundry, and meal preparation). Chore services (lawn care, window cleaning, heavy housekeeping, and painting).
Not Important    Slightly Important    Important    Most Important    N/A   

Home-Delivered meals (Meals on Wheels) for home bound, frail elderly
Not Important    Slightly Important    Important    Most Important    N/A   

Meal supplement services for frail elderly (Ensure, Resource, etc.)
Not Important    Slightly Important    Important    Most Important    N/A   

Need for assisted living facilities, retirement communities, rest homes.
Not Important    Slightly Important    Important    Most Important    N/A   

Access to affordable rental housing, public or temporary housing options.
Not Important    Slightly Important    Important    Most Important    N/A   

Assistance in locating, filing or qualifying for public housing programs.
Not Important    Slightly Important    Important    Most Important    N/A   

Additional Feedback

Please list any areas in which our service could be improved.


Please share any additional comments.


This web-based survey is powered by Empliant