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Yes |
Indifferent |
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I want to remain independent. |
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I have concerns about my health. |
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Emergency medical help is important to me. |
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Housekeeping assistance would be helpful. |
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I would like transportation service available. |
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I would like meals prepared for me. |
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I am willing to move from where I live now. |
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I would feel safer if I moved somewhere else. |
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I would like assistance with home maintenance and repairs. |
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I would enjoy the opportunity to meet new people in a social setting. |
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I would like planned social and recreational activities. |
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I am willing to have less living space in order to receive service such as prepared meals, maintenance, and housekeeping. |
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