Questionnaire on the current situation of family ageing and attitudes towards community ageing in China - 问卷调查调研模板

Questionnaire on the current situation of family ageing and attitudes towards community ageing in China

This questionnaire is anonymous in order to protect the privacy of participants

Q1:1. Please tell me your age range？

A.Under 30 years old

B.30-40 years old

C.40-50 years old

D.Over 50

Q2:2. What is the age range of your parents?

A.Under 60 years old

B.60-70 years old

C.70-80 years old

D. 80 years old or above

Q3:3. What is the health status of your parents?

A.Good

B.Fair

C.Poor

Q4:4. Family income:

A.very good，Net monthly household income of 40,000RMB (£4,700) or more

B.Good，Net monthly household income of RMB20,000 (£2,300) or more

C.Fair，Net monthly household income of RMB10,000 (£1,200) or more

D.Poor，Net monthly household income of RMB10,000 (£1,200) or less

Q5:5. The way of supporting parents:

A. children take turns to take care of them

B. living at their children's home

C.Living alone

D.Nursing home or third party institution

E.If you have any others, please specify below

Q6:6. Your attitude towards institutions for the elderly

A.Very positive

B.Generally positive

C. Neither positive nor negative

D. Generally negative

E. Very negative

F. Prefer not to answer.

Q7:7. Are you willing to send your parents to an institution for the elderly?

A. Yes

B. No

C. Undecided

D. Prefer not to answer.

Q8:8. Are you familiar with Chinas current pension system?

A. Yes

B. Somewhat

C. No

D. Prefer not to answer.

Q9:9. How do you feel about the community-based elderly care system?

A.Very positive

B.Generally positive

C. Neither positive nor negative

D. Generally negative

E. Very negative

F. Prefer not to answer

Q10:10. From your point of view, what kind of elderly care model would you like to implement?

A. A model of old age where the elderly live with their children

B. A model in which the elderly live alone and the community provides assistance

C. A model where the elderly are cared for by a nursing home

D. Other elderly care models

Q11:11.What are the current dilemmas you face in supporting your parents in their old age?

A. financial pressure

B.Not enough time to take care of the elderly

C.Lack of professional elderly care institutions

D.Inconsistency with the elderly's wish to age

E.Others

Q12:12. Are you aware of the community model of ageing?

A.Yes

B.No

Q13:13. What kind of services would you prefer the community-based model to provide? (Choose three)

A.To provide daily care for the elderly

B.To help the elderly with psychological counselling

C. Provide more options for the elderly to develop their hobbies and interests

D. provide professional education for the elderly

E. providing services for the elderly to communicate with each other

F. provide legal assistance and shelter for the elderly