Need your help for building a survey for those Under 65

Michael Ellenbogen

 I am trying to build a survey that impacts those under 65. What does it mean to their families and kids not to mention financially once they have cognitive issues in the job. It is so much worse than those over 65.

Do you have any other ideas I should us or remove or reword. I hope to pass this on to an organization to do this. Thanks

 

 

Are you a caregivers or a person living with cognitive issues

 

At what age did you start experiencing cognitive issues?

 

Did you inform your work or did they know before you told them that you had cognitive issues that were impacting your performance?

 

Were you forced to Quit, Leave, Fired or Retire.

 

Did you have a medical diagnose when you left work?  

 

Did you have work disability insurance at work?

What did they offer you? Stocks, life insurance, medical insurance,  part of your salary.

What was the value for any of the above items if they say yes?

Was this short term, long term?

 

Were you able to qualify for the disability insurance you paid for or did you lose it.

Did you have any disability plan out side of you existing company?

 

Did you apply for SSDI?

How many months went by before approved?

If not approved what was the reason?

 

What is your sex?

How old are you?

Are you a minority?

How many people are in your immediate family. What are the ages?

Did you lose insurance to you during this time.

Did the family lose insurance because of you during this time?

How long after leaving the work force are you doing this survey?

Has this had any impact on your spouses or partners financial that effects the household?

Do you expect it to have an impact to your spouse or partner in the future? If yes what kind of impact?