Consideration of Needs A consideration of your needs. This questionnaire helps us understand your current situation better. Please choose the option that best describes your experience. There are no right or wrong answers – we just want to know how you feel. How would you describe your overall health right now? Please select I think i'm in great shape I have one health issue I'm managing I'm juggling a couple of health challenges I have a few health issues to keep an eye on I'm dealing with several health conditions My health is quite complex with multiple conditions How often do you need to check in with healthcare professionals? Please select Rarely, not even for routine check-ups Only when I'm not feeling my best Regularly, to keep things in check Often, I need quite a bit of medical attention Very frequently, I need a lot of medical support Almost constantly, my health needs close monitoring How do you manage with everyday tasks like dressing or preparing meals? Please select I can do everything on my own, no problem I manage most things, but sometimes it's nice to have a hand I can do quite a bit, but I often need some help I need help with many day-to-day tasks I rely on others for most daily activities I need assistance with pretty much everything How would you describe your mood and emotional wellbeing lately? Please select I feel great emotionally, no concerns I have my ups and downs, but generally I'm okay I sometimes struggle, but I can usually manage I often find it hard to cope with my emotions I'm really struggling emotionally most of the time I'm having a very tough time emotionally and need a lot of support How's your memory and thinking these days? Please select Sharp as a tack, no problems at all I forget little things now and then, but who doesn't? I'm a bit forgetful, it can be frustrating sometimes I often have trouble remembering things or thinking clearly I struggle a lot with memory and clear thinking I have significant difficulty with memory and cognitive tasks How much emotional support do you feel you need in your daily life? Please select I'm pretty self-sufficient emotionally A little encouragement now and then is nice I appreciate having someone to talk to regularly I often need someone to lean on emotionally I need quite a bit of emotional support most days I rely heavily on others for emotional support How well does your current living situation meet your needs? Please select It's perfect, couldn't ask for better It's good, just a few minor things could be improved It's okay, but there are some issues I'd like to address It's not great, there are several problems It's really not suitable, lots of issues to deal with It's unsafe or inadequate for my needs How would you describe the support you get from your family? Please select They're always there for me, couldn't ask for more They're very supportive most of the time They help out when they can They try, but I often need more support than they can give I get very little support from my family I don't have any family support How would you describe your social life and connections with others? Please select I have a bustling social life with lots of friends I have a good circle of friends I see regularly I have some friends, but we don't meet up as often as I'd like I have a few friends, but I often feel lonely I rarely socialize or see friends I feel very isolated and don't have social connections How involved do you like to be in managing your health and care? Please select I'm very proactive and like to manage everything myself I like to be involved in most decisions about my care I'm interested and try to stay involved when I can I sometimes find it overwhelming and prefer others to take the lead I struggle to stay involved and often rely on others I prefer to let others handle my care completely How often do you need help from nurses or other healthcare professionals? Please select Rarely, just for check-ups or occasional needs Sometimes, but not too often Regularly, like once a week Often, several times a week Very frequently, almost daily I need constant care and medical attention What kind of equipment or resources do you need for your health? Please select Just the basics, like a first aid kit A few simple things, like a blood pressure monitor Some specialised equipment that I use regularly Quite a bit of equipment, it takes some managing A lot of equipment, my home feels a bit like a clinic Extensive equipment, almost like a hospital room How safe and comfortable do you feel in your home environment? Please select Completely safe and comfortable, no worries at all Generally safe, just a few minor concerns Mostly okay, but there are some issues I'd like to address I have some significant concerns about safety or comfort I often feel unsafe or uncomfortable in my home My home environment feels very unsafe or unsuitable Calculate my score
