Post-Home Caregiver Training Class Survey Post-Home Caregiver Training Class Survey **STOP** This survey should be completed ONLY on or after the last day of your training class. What is today’s date? * (MM/DD/YYYY) Enter your birthday * (MM/DD/YYYY) What best describes your reason for taking this class? * I plan to work as a paid caregiver I am caring for a friend or family member OtherOther Based on your current knowledge of this class, do you believe that the class content will enable you to fulfill your role as a paid or family caregiver? * Yes No Cannot judge at this time OtherOther Next Which answer best describes your current level of confidence caring for an older adult? * Very High High Average Low Very Low How would you rate your current knowledge of caregiving topics? * Very High High Average Low Very Low How would you rate your current understanding about aging topics? * Very High High Average Low Very Low Next How confident are you using a gait belt? * Very High High Average Low Very Low No confidence How confident are you giving a bath to an immobile person? * Very High High Average Low Very Low No confidence Rate your current skill level in transferring a dependent person? * Very High High Average Low Very Low No skill Rate your current ability to care for a person with memory impairment? * Very High High Average Low Very Low No ability How confident are you providing person-centered care for an older adult? * Very High High Average Low Very Low No confidence Rate your ability to dress a person who requires assistance? * Very High High Average Low Very Low No ability How would you rate your current understanding of chronic disease? * Very High High Average Low Very Low Next Do you have comments, questions, or suggestions about the registration process for this class? Please begin on a new line and number each new item. Are there other aging education topics you suggest for our program? Please begin on a new line and number each new item. Are there other comments, questions, or suggestions you would like to share? Begin on a new line and number each new item. Submit
