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