Keeping Fit at Home Survey

Question Title

* 1. Please select to which category you belong

Person living with dementia

family member/ supporter/carer

professional

Other (please specify)

Question Title

* 2. What physical activities are you currently doing?

Walking

Yoga

Tai Chi

Gardening

Cycling

No physical activity

Other (please specify)

Question Title

* 3. How could we help you to start or continue your physical activity?

participating in regular online meeting to talk with other people living with dementia and families about activities

receiving gardening seeds

participate with a trainer to learn simple exercises you can do at home

watching and doing easy fitness videos in weekly meetings

uploading pictures and short videos of walks on a Facebook page

receiving a free step counter

taking part in an annual 1000 Miles initiative to receive a medal

Other (please specify)

Question Title

* 4. What might hinder you from starting or continuing a physical activity?

current pandemic

surgery

chronic pulmonary disease

no access to transportation

Other (please specify)

Question Title

* 5. What things are you interested to do in this current pandemic and that you need help to do them?

chatting with someone over the phone

Having an online peer support group that meets regularly

Having an online group for family members of people living with dementia

Having weekly Quiz nights

Receiving postcards with inspirational message

Other (please specify)

Keeping Fit at Home

Question Title

* 1. Please select to which category you belong

Question Title

* 2. What physical activities are you currently doing?

Question Title

* 3. How could we help you to start or continue your physical activity?

Question Title

* 4. What might hinder you from starting or continuing a physical activity?

Question Title

* 5. What things are you interested to do in this current pandemic and that you need help to do them?

Question Title

* 6. If you would like to receive information about our activities and events, please feel free to leave your contact info (email or phone number).