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Dementia Care Action Plan Public Questionnaire

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Demographic Information

1. I am a ____________ (select all that apply): *

person living with dementia

care partner

family member

friend

home support worker

health care provider

private service provider

representative from a community organization

other

If other, please describe: *

2. I access health care in ____________ region: *

Eastern Health

Central Health

Western Health

Labrador-Grenfell Health

unsure

Click here to view a map of health regions

Awareness and Education

Knowledge of dementia may support early diagnosis and earlier access to supports and services. Education and awareness may also help reduce the stigma associated with dementia.

3. I would rate my current level of understanding of dementia as: *

excellent

good

moderate

poor

unsure how to rate my level of knowledge

4. I would like to know more about ____________ (select all that apply): *

potential causes of dementia and early signs of dementia

how to get help for you or someone else who may be having issues with memory loss

how to access services and supports once a diagnosis has been confirmed

how to talk with your doctor about dementia

how to talk with your family and friends about dementia

advance care planning (making decisions now about your care in the event you cannot make decisions in the future)

the rights of people with dementia regarding decision making relating to legal and health care issues

the Adult Protection Act (legislation respecting abuse and neglect of adults - see below for a link of the Act)

end of life care

other

unsure

Click here to view the Adult Protection Act

If other, please describe: *

5. I suggest the following actions to increase awareness and knowledge of dementia:

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