Reaching East Kent’s Carers Survey - Carers' Support East Kent

About you

1. How old are you? *

2. Please indicate your gender: *

Please indicate your gender. I use another term: (please specify) *

3. Do you identify as trans? *

Yes
No
I prefer not to say

4. What is your ethnicity? *

Asian/Asian British *

Mixed/Multiple *

White and Asian
White and Black African
White and Black Caribbean
Any other Mixed/Multiple ethnic background

Other *

Arab

Black/African/Caribbean *

Black/African/Caribbean
Black British
African
Caribbean

White *

Any other ethnic group (please specify) *

5. What is your sexual orientation? *

What is your sexual orientation? I use another term: (please specify) *

6. Do you have any disabilities or long-term health problems? A disability or long-term health condition is a physical or mental impairment that impacts negatively on your ability to carry out day-to-day activities. *

Yes
No
Not sure
I prefer not to say

7. Your employment, are you? *

Your employment, are you? Other (please specify) *

8. Where you live, please give your hometown *

My home town is
I prefer not to say

My home town is *

About your caring role

9. Who are you caring for, what’s the relationship? *

Who are you caring for, what’s the relationship? Other (please specify) *

10. What condition does the person you care for have: *

I prefer not to say

10. What condition does the person you care for have: *

Physical illness (please specify)
Mental health condition (please specify)
Age-related difficulties (please specify)
Disability (please specify)
An addiction (please specify)

Physical illness (please specify) *

Mental health condition (please specify) *

Age-related difficulties (please specify) *

Disability (please specify) *

An addiction (please specify) *

11. How many hours do you spend caring on average per week? *

How many hours do you spend caring on average per week? Is there anything else you wish to add? *

12. How would you describe what you do for the person you care for? *

I think of myself as a Carer
I help my family / friend
It is my duty to look after my loved one(s)
I prefer not to say

How would you describe what you do for the person you care for? Other (please specify) *

How would you describe what you do for the person you care for? Is there anything else you wish to add?

13. How does your caring role affect you? *

My life is the same as it was before
I have had to make some adjustment (please give some details)
I have had to change my work
I cannot do the things I used to
My life is not my own
I prefer not to say

I have had to make some adjustment (please give some details) *

I have had to change my work (please give some details) *

I cannot do the things I used to (please give some details) *

My life is not my own (please give some details) *

I feel overwhelmed
I feel isolated and lonely
I find it difficult to take a break
I don’t know where to get support

14. Are you aware of Carers' Support East Kent? *

Yes
No

Are you aware of Carers' Support East Kent? If yes, can you detail what support you have received? *

15. Are you aware of Carers allowance? (a benefit for people who are giving regular and substantial care to people who cannot manage without support) *

Yes
No

Are you aware of Carers allowance? If yes, are you claiming it? *

Yes
No
I prefer not to say

Are you aware of Carers allowance? If you know about it but aren’t claiming it please tell us why below: *

16. Are there support / services would help you in your caring role? *

Yes
No

What support / services would help you in your caring role? *

17. Are there challenges / barriers that prevent you from accessing support? *

Yes
No

What challenges / barriers prevent you from accessing support? *

18. Is there anything else you’d like to say: *

Yes
No

What else would you like to say? *

Privacy notice

Please tick to confirm that you have read and understood our privacy notice *

I have read and understand the privacy notice.

Read our privacy notice here (this will open in a new window to avoid losing data already filled in) - https://carersek.org.uk/privacy-notice/