Reasons for Survey• Provide baseline data

– What percent of seniors have health care proxies?

• Provide program guidance– Learn what encourages or discourages people from

completing health care proxies (e.g., Are the forms confusing? How worrisome is it to talk to relatives?)

• Serves as a program announcement and an intervention– Asking questions about health care proxies causes people to

think about them, and perhaps act to complete one - just based on this prompting. The current survey (conducted in August ‘05) will also make them more likely to be receptive to the pilots taking place this fall, and the county-wide program to be kicked-off in the spring of ’06.

Survey Distribution and Response RatesSurvey Conducted through the Health Association of Niagara County, Inc.

(HANCI) in August ‘ 05

• Foster Grandparent Program- 73 hand distributed to volunteers– 84% returns (n = 61)

• Senior Companion Program - 220 hand distributed to volunteers and clients– 18% (N = 39)

• RSVP- 800 in quarterly newsletter– no return  envelope included– 5% returns (n = 42)

• Council on Aging-   300 in newsletter–  return addressed envelope included– 8% returns (n = 24)

• Golden Age Program -   300 in newsletter – return addressed envelope included– 6% returns (n = 18)

Age Distribution of Survey Respondents

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Under 55 55-64 65-74 75-85 85+

Age Distribution

Under 55

55-64

65-74

75-85

85+

Factors in Survey Design

• Validity– Do the questions really measure what they appear to?

• Reliability– Will the question be answered the same way each time it is

asked?

• Sampling– Are the responses representative of the people you want to

measure?

• Power– Do you have a large enough number of responses so that

statistical tests can detect trends and associations

A total of 184 responses is large enough that the survey is worthwhile considering, since we have enough statistical power to learn a lot about what those 184 people think about Health Care Proxies (e.g., Does the process seem confusing? Is it easy to find forms? Is it worrisome to talk to loved ones about this?). However, because response rates were so low, caution should be used in generalizing responses to all seniors in Niagara County. For example, it is possible that seniors who have already completed HCP forms were more likely to return surveys because of “social desirability” (i.e., they were proud that they filled out a HCP). Also, it should be noted that the seniors in these “convenience” samples, may not be typical of Niagara County seniors. For example, it is likely that members the Council of Aging, as well as those who participate in the other programs (i.e., RSVP, Golden Age, Senior Companions) are more knowledgeable and active than others their age. Still, the survey provides useful information and baseline data about these “subpopulations.” A two-sided Chi-square test of significance was used to explore the relationship between age category and responses to each survey item.

Interpreting Survey Results

Have you completed a Health Care Proxy (HCP) Form?

0%

10%

20%

30%

40%

50%

60%

70%

No plans tocomplete HCP

See need, buthaven'tstarted

Started, butnot finished

HCP

Filled out, and reflects

wishes

Filled out, butneedschange

No significant differences found between age groups.

Have you completed a Health Care Proxy (HCP) Form?

0%

10%

20%

30%

40%

50%

60%

70%

80%

No plans tocomplete HCP

See need, buthaven'tstarted

Started, butnot finished

HCP

Filled out, and reflects

wishes

Filled out, butneeds change

No significant differences found between age groups.

The steps to complete a HCP and living will are complicated and confusing

0%

5%

10%

15%

20%

25%

30%

35%

40%

StronglyAgree

Agree Not Sure Disagree StronglyDisagree

Younger respondents were more likely to agree. p = .014

The steps to complete a HCP and living will are complicated and confusing

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

StronglyAgree

Agree Not Sure Disagree StronglyDisagree

Younger respondents were more likely to agree. p = .014

I don’t know where to get the necessary forms.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

StronglyAgree

Agree Not Sure Disagree StronglyDisagree

Younger respondents were more likely to agree. p = .07

Talking to loved ones about end of life just makes them worry without doing much good.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

StronglyAgree

Agree Not Sure Disagree StronglyDisagree

No significant differences found between age groups.

Talking to loved ones about end of life just makes them worry without doing much good.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

StronglyAgree

Agree Not Sure Disagree StronglyDisagree

No significant differences found between age groups.

Other people who are important to me think I should fill out a health care proxy.

0%

10%

20%

30%

40%

50%

60%

StronglyAgree

Agree Not Sure Disagree StronglyDisagree

Younger people were less likely to agree. P = .003

I need to see a lawyer in order to fill out a health care proxy.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

StronglyAgree

Agree Not Sure Disagree StronglyDisagree

Younger people were less likely to agree. P = .003

Importance of Emotional and Spiritual Needs

0%

10%

20%

30%

40%

50%

60%

StronglyAgree

Not Sure StronglyDisagree

Spiritual needs are asimportant as medicalneeds

Emotional needs areas important asmedical needs

Younger respondents were less likely to agree that emotional needs are important. p = .003

How often do you care for an older adult?

0%

10%

20%

30%

40%

50%

60%

Never A fewhrs/week

1-2 days/wk Almost everyday

Every day

Older respondents were more likely to be caregivers p = .02