Norwich City Dementia Survey, 2017

The Norwich City Dementia Action Alliance would like to hear your views on living with dementia and your local area. This survey is for anyone living with dementia, their carers or family who live in the city, its suburbs or who regularly visit. The closing date for the survey is 22nd October 2017.

2. When out in your local area, what sort of things do you do? Choose all that apply.

3. Are there things that you used to do, but have stopped doing?

4. What might help you start doing them again?

5. How important are the things below, so you feel able to go out in your local area?

	Not important	Neutral	Very important
People who understand me	People who understand me Not important	People who understand me Neutral	People who understand me Very important
Friends, family or carers	Friends, family or carers Not important	Friends, family or carers Neutral	Friends, family or carers Very important
Easy to read signs	Easy to read signs Not important	Easy to read signs Neutral	Easy to read signs Very important
Public toilets	Public toilets Not important	Public toilets Neutral	Public toilets Very important
Public transport	Public transport Not important	Public transport Neutral	Public transport Very important
Accessible buildings	Accessible buildings Not important	Accessible buildings Neutral	Accessible buildings Very important
Parking	Parking Not important	Parking Neutral	Parking Very important
Safe pavements, pathways and roads	Safe pavements, pathways and roads Not important	Safe pavements, pathways and roads Neutral	Safe pavements, pathways and roads Very important

If you would like to tell us more about your answers or list other things, fill in the box below,

6. Do you feel you live well with dementia? (as a carer, family member or person with dementia)

Yes, most of the time
Yes, sometimes
No, I struggle
No, I feel I need help

Norwich City Dementia Survey, 2017

2. When out in your local area, what sort of things do you do? Choose all that apply.

3. Are there things that you used to do, but have stopped doing?

4. What might help you start doing them again?

5. How important are the things below, so you feel able to go out in your local area?

6. Do you feel you live well with dementia? (as a carer, family member or person with dementia)

7. What makes you feel that way?

8. In your local area, how would you rate public awareness of dementia?

9. What examples can you share of living with dementia in your local area?

Norwich City Dementia Survey, 2017

1. So we know what part of the city you are from, please select your post code from the list.

2. When out in your local area, what sort of things do you do? Choose all that apply.

3. Are there things that you used to do, but have stopped doing?

4. What might help you start doing them again?

5. How important are the things below, so you feel able to go out in your local area?

6. Do you feel you live well with dementia? (as a carer, family member or person with dementia)

7. What makes you feel that way?

8. In your local area, how would you rate public awareness of dementia?

9. What examples can you share of living with dementia in your local area?