Questions for the people of Anglesey that currently don’t receive any care or support services to inform a population assessment

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In order to provide a better future for and best serve the people of Anglesey, public services must understand the current and future care and support needs of the people of Anglesey and what people feel could prevent a care and support need developing.

To understand all of this a joint population assessment between the Health Board and Isle of Anglesey County Council must be produced. To do this we would like your help by completing this questionnaire by considering the following:

Do you have concerns about maintaining your present lifestyle in the future?

Put yourself in the situation where something has gone wrong – life changing health issue e.g. stroke, or you are involved in a car accident. What from your current lifestyle is most important to you? What is most important to maintain? What are your immediate concerns? What if you no longer had choice and control over your daily life as you used to?

This questionnaire needs to be completed by the end of July.

Who do think realistically could support you to maintain your independence?
On a scale of 1-5 (1 = less likely 5 = most likely)

	1	2	3	4	5
Friends and family	Friends and family 1	Friends and family 2	Friends and family 3	Friends and family 4	Friends and family 5
Health professionals	Health professionals 1	Health professionals 2	Health professionals 3	Health professionals 4	Health professionals 5
Social care professionals	Social care professionals 1	Social care professionals 2	Social care professionals 3	Social care professionals 4	Social care professionals 5
Wider community	Wider community 1	Wider community 2	Wider community 3	Wider community 4	Wider community 5

Would you have any concerns on how these changes might affect you? What if you were no longer able to work?
On a scale of 1-5 (1 = not at all concerned -5 = extremely worried)

	1	2	3	4	5
Work: maintaining your current work situation	Work: maintaining your current work situation 1	Work: maintaining your current work situation 2	Work: maintaining your current work situation 3	Work: maintaining your current work situation 4	Work: maintaining your current work situation 5
Finance: concerns to maintaining your current income	Finance: concerns to maintaining your current income 1	Finance: concerns to maintaining your current income 2	Finance: concerns to maintaining your current income 3	Finance: concerns to maintaining your current income 4	Finance: concerns to maintaining your current income 5
Mental stimulation	Mental stimulation 1	Mental stimulation 2	Mental stimulation 3	Mental stimulation 4	Mental stimulation 5
Physical wellbeing – keeping active	Physical wellbeing – keeping active 1	Physical wellbeing – keeping active 2	Physical wellbeing – keeping active 3	Physical wellbeing – keeping active 4	Physical wellbeing – keeping active 5
Feeling safe at home	Feeling safe at home 1	Feeling safe at home 2	Feeling safe at home 3	Feeling safe at home 4	Feeling safe at home 5
Getting out and about	Getting out and about 1	Getting out and about 2	Getting out and about 3	Getting out and about 4	Getting out and about 5
Learning	Learning 1	Learning 2	Learning 3	Learning 4	Learning 5

Who do you support? Any dependents? How could any changes to your situation affect them and what help do you think you would need?

How would you find out what support is available to you? Do you know where to go?

What would help you make any transition to a better way of life?

What do you think could prevent care and support needs from developing?

What if a close family member needs significant care and support?
How would this affect you? How much support would you be willing / able to provide?
Do you know where you would go for support?
What are your immediate concerns? What immediate decisions do you need to make?

Who do think realistically could support you to maintain your independence?On a scale of 1-5 (1 = less likely 5 = most likely)

Would you have any concerns on how these changes might affect you? What if you were no longer able to work?On a scale of 1-5 (1 = not at all concerned -5 = extremely worried)