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StateArizona
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What is/ are your personal experiences with dementia: (check all that apply)
  • I know someone who is living with dementia.
HTML BlockPlease select true or false for the follow statements below:
Dementia is a typical/ normal part of aging.False
Dementia is caused by diseases of the brain.True
Dementia is not just about having memory problems. It may affect thinking, communication, and ability to carry out everyday tasks.True
There are healthy habits you can adopt to reduce your risk of dementia.True
HTML BlockAfter this Dementia Friends session, on a scale from Strongly Disagree to Strongly Agree, please select the response you feel reflects your feelings about each statement.
I am confident interacting and communicating with people living with dementia.Agree
It is possible to live well and be engaged with your community with a dementia diagnosis.Agree
People living with dementia need to feel safe, respected, and included, just like anyone else.Agree
I am motivated to connect with people living with dementia.Agree
I am aware of tools and resources in my community to support people living with dementia.Agree
Which of the following personal actions will you take to create a more dementia friendly and welcoming community for people living with dementia and their care partners? Place a check next to each action you will take. Select as many as you like.
  • Offer support to care partners of people living with dementia in your community.
  • Connect with someone I know who is living with dementia.
  • Incorporate dementia friendly practices into my next interaction with a person living with dementia.
  • Ask my doctor for a cognitive assessment at my next physical exam.
  • Incorporate more brain healthy activities into my daily life.
Please list three words that you associate with the word “dementia.”Forgetting, confused, brain
Please list any comments or feedback about the Dementia Friends Session that you would like to share.

The video and answering questions were a little difficult on my iPhone. It would occasionally skip a part so I would have to start over.

Do we have permission to contact you for a 3-month follow-up survey?No