What REALLY Matters to Women in Midlife
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1. What matters to YOU?

Welcome!
I'm very grateful to you for taking a few minutes to complete this short survey. The purpose of the 10 questions is to help me get an accurate sense of the challenges and experiences of the people I like to work with - modern midlife women.
This is TOTALLY confidential and anonymous (no name or email address is collected) so please, say it as it is for you. Many thanks.

Karen Knott - Midlife Transition Coach
www.midlifematters.co.uk
karen@midlifematters.co.uk

If you would like to discuss your experience in greater detail please email me - I would be delighted to hear from you.

1. Which age group do you belong in?

Which age group do you belong in? 25-34

35-44

45-54

55-64

Other

2. How old would you say you feel?

How old would you say you feel? More than 10 years younger

Up to 10 years younger

More than 10 years older

Up to 10 years older

Feel my age

Can you tell me more about your above choice?

3. What would you say are your favourite/best years so far?

What would you say are your favourite/best years so far? 15-24	25-34	35-44	45-54	55-64	Other
Please give reasons for your choice.

4. Have you experienced any of the following? Please select all that apply.

	Within the last 12 months	Within the last 2 years	Within the last 3 years
Child starting school (including secondary)	*Have you experienced any of the following? Please select all that apply. Child starting school (including secondary) Within the last 12 months	Child starting school (including secondary) Within the last 2 years	Child starting school (including secondary) Within the last 3 years
Empty nest - child leaving home	Empty nest - child leaving home Within the last 12 months	Empty nest - child leaving home Within the last 2 years	Empty nest - child leaving home Within the last 3 years
Child returning home to live	Child returning home to live Within the last 12 months	Child returning home to live Within the last 2 years	Child returning home to live Within the last 3 years
Moved house/downsized	Moved house/downsized Within the last 12 months	Moved house/downsized Within the last 2 years	Moved house/downsized Within the last 3 years
Bereavement	Bereavement Within the last 12 months	Bereavement Within the last 2 years	Bereavement Within the last 3 years
Major illness of parent	Major illness of parent Within the last 12 months	Major illness of parent Within the last 2 years	Major illness of parent Within the last 3 years
Divorce or separation	Divorce or separation Within the last 12 months	Divorce or separation Within the last 2 years	Divorce or separation Within the last 3 years
Career change	Career change Within the last 12 months	Career change Within the last 2 years	Career change Within the last 3 years
Lost job	Lost job Within the last 12 months	Lost job Within the last 2 years	Lost job Within the last 3 years
Redundancy	Redundancy Within the last 12 months	Redundancy Within the last 2 years	Redundancy Within the last 3 years
Retirement	Retirement Within the last 12 months	Retirement Within the last 2 years	Retirement Within the last 3 years
Survived a major illness	Survived a major illness Within the last 12 months	Survived a major illness Within the last 2 years	Survived a major illness Within the last 3 years
Been diagnosed with a medical condition	Been diagnosed with a medical condition Within the last 12 months	Been diagnosed with a medical condition Within the last 2 years	Been diagnosed with a medical condition Within the last 3 years
Midlife crisis	Midlife crisis Within the last 12 months	Midlife crisis Within the last 2 years	Midlife crisis Within the last 3 years

5. On a scale of 1-10 (where 10 is best) how satisfied are you with the way things are going in your life today?

	1	2	3	4	5	6	7	8	9	10
Family	*On a scale of 1-10 (where 10 is best) how satisfied are you with the way things are going in your life today? Family 1	Family 2	Family 3	Family 4	Family 5	Family 6	Family 7	Family 8	Family 9	Family 10
Friends	Friends 1	Friends 2	Friends 3	Friends 4	Friends 5	Friends 6	Friends 7	Friends 8	Friends 9	Friends 10
Relationship with significant other	Relationship with significant other 1	Relationship with significant other 2	Relationship with significant other 3	Relationship with significant other 4	Relationship with significant other 5	Relationship with significant other 6	Relationship with significant other 7	Relationship with significant other 8	Relationship with significant other 9	Relationship with significant other 10
Work/career	Work/career 1	Work/career 2	Work/career 3	Work/career 4	Work/career 5	Work/career 6	Work/career 7	Work/career 8	Work/career 9	Work/career 10
Home environment	Home environment 1	Home environment 2	Home environment 3	Home environment 4	Home environment 5	Home environment 6	Home environment 7	Home environment 8	Home environment 9	Home environment 10
Overall quality of life	Overall quality of life 1	Overall quality of life 2	Overall quality of life 3	Overall quality of life 4	Overall quality of life 5	Overall quality of life 6	Overall quality of life 7	Overall quality of life 8	Overall quality of life 9	Overall quality of life 10
Health/wellbeing	Health/wellbeing 1	Health/wellbeing 2	Health/wellbeing 3	Health/wellbeing 4	Health/wellbeing 5	Health/wellbeing 6	Health/wellbeing 7	Health/wellbeing 8	Health/wellbeing 9	Health/wellbeing 10
Religion/spirituality	Religion/spirituality 1	Religion/spirituality 2	Religion/spirituality 3	Religion/spirituality 4	Religion/spirituality 5	Religion/spirituality 6	Religion/spirituality 7	Religion/spirituality 8	Religion/spirituality 9	Religion/spirituality 10
Personal development	Personal development 1	Personal development 2	Personal development 3	Personal development 4	Personal development 5	Personal development 6	Personal development 7	Personal development 8	Personal development 9	Personal development 10
Education	Education 1	Education 2	Education 3	Education 4	Education 5	Education 6	Education 7	Education 8	Education 9	Education 10
Finances	Finances 1	Finances 2	Finances 3	Finances 4	Finances 5	Finances 6	Finances 7	Finances 8	Finances 9	Finances 10
Leisure	Leisure 1	Leisure 2	Leisure 3	Leisure 4	Leisure 5	Leisure 6	Leisure 7	Leisure 8	Leisure 9	Leisure 10

Which of the above areas would you most like to improve?

6. Please rate the frequency of the following thoughts and feelings.

	Constantly	Often	Sometimes	Rarely	Never
I feel restless	*Please rate the frequency of the following thoughts and feelings. I feel restless Constantly	I feel restless Often	I feel restless Sometimes	I feel restless Rarely	I feel restless Never
I feel negative about the future	I feel negative about the future Constantly	I feel negative about the future Often	I feel negative about the future Sometimes	I feel negative about the future Rarely	I feel negative about the future Never
I lack a sense of purpose	I lack a sense of purpose Constantly	I lack a sense of purpose Often	I lack a sense of purpose Sometimes	I lack a sense of purpose Rarely	I lack a sense of purpose Never
I feel tired & lack energy	I feel tired & lack energy Constantly	I feel tired & lack energy Often	I feel tired & lack energy Sometimes	I feel tired & lack energy Rarely	I feel tired & lack energy Never
I feel life is escaping me	I feel life is escaping me Constantly	I feel life is escaping me Often	I feel life is escaping me Sometimes	I feel life is escaping me Rarely	I feel life is escaping me Never
I feel dissatisfied with my life at present	I feel dissatisfied with my life at present Constantly	I feel dissatisfied with my life at present Often	I feel dissatisfied with my life at present Sometimes	I feel dissatisfied with my life at present Rarely	I feel dissatisfied with my life at present Never
I feel overwhelmed by current decisions	I feel overwhelmed by current decisions Constantly	I feel overwhelmed by current decisions Often	I feel overwhelmed by current decisions Sometimes	I feel overwhelmed by current decisions Rarely	I feel overwhelmed by current decisions Never
I think about making big changes but never DO anything about it	I think about making big changes but never DO anything about it Constantly	I think about making big changes but never DO anything about it Often	I think about making big changes but never DO anything about it Sometimes	I think about making big changes but never DO anything about it Rarely	I think about making big changes but never DO anything about it Never
I feel guilty for wanting more	I feel guilty for wanting more Constantly	I feel guilty for wanting more Often	I feel guilty for wanting more Sometimes	I feel guilty for wanting more Rarely	I feel guilty for wanting more Never

Which of these concerns you most?

7. Please turn your attention to the future now and consider the following statements..

	Agree strongly	Agree	Neither agree or disagree	Disagree	Disagree strongly
I expect life to be better in 5 years' time	*Please turn your attention to the future now and consider the following statements.. I expect life to be better in 5 years' time Agree strongly	I expect life to be better in 5 years' time Agree	I expect life to be better in 5 years' time Neither agree or disagree	I expect life to be better in 5 years' time Disagree	I expect life to be better in 5 years' time Disagree strongly
I plan a lot for my future	I plan a lot for my future Agree strongly	I plan a lot for my future Agree	I plan a lot for my future Neither agree or disagree	I plan a lot for my future Disagree	I plan a lot for my future Disagree strongly
There is little I can do to change important things in my life	There is little I can do to change important things in my life Agree strongly	There is little I can do to change important things in my life Agree	There is little I can do to change important things in my life Neither agree or disagree	There is little I can do to change important things in my life Disagree	There is little I can do to change important things in my life Disagree strongly
What happens to me in the future mostly depends on me	What happens to me in the future mostly depends on me Agree strongly	What happens to me in the future mostly depends on me Agree	What happens to me in the future mostly depends on me Neither agree or disagree	What happens to me in the future mostly depends on me Disagree	What happens to me in the future mostly depends on me Disagree strongly
At this point in my life I’ve done all the planning I need to do	At this point in my life I’ve done all the planning I need to do Agree strongly	At this point in my life I’ve done all the planning I need to do Agree	At this point in my life I’ve done all the planning I need to do Neither agree or disagree	At this point in my life I’ve done all the planning I need to do Disagree	At this point in my life I’ve done all the planning I need to do Disagree strongly
I would benefit from making changes to my life	I would benefit from making changes to my life Agree strongly	I would benefit from making changes to my life Agree	I would benefit from making changes to my life Neither agree or disagree	I would benefit from making changes to my life Disagree	I would benefit from making changes to my life Disagree strongly
I am likely to make them in the next 5 years	I am likely to make them in the next 5 years Agree strongly	I am likely to make them in the next 5 years Agree	I am likely to make them in the next 5 years Neither agree or disagree	I am likely to make them in the next 5 years Disagree	I am likely to make them in the next 5 years Disagree strongly

8. What if anything, is keeping you from achieving what you really want in life?

What if anything, is keeping you from achieving what you really want in life? finances lack of motivation/laziness lack of confidence fear of failure health	family friends/other people time age work	education overwhelm not knowing what I really want nothing other
Which of these is the major thing stopping you?

9. How important do you think the following elements are to making a successful midlife transition?

	Essential	Important	Unimportant	N/A
Becoming clear on your core values	*How important do you think the following elements are to making a successful midlife transition? Becoming clear on your core values Essential	Becoming clear on your core values Important	Becoming clear on your core values Unimportant	Becoming clear on your core values N/A
Letting go of your younger self	Letting go of your younger self Essential	Letting go of your younger self Important	Letting go of your younger self Unimportant	Letting go of your younger self N/A
Finding out who you really are now	Finding out who you really are now Essential	Finding out who you really are now Important	Finding out who you really are now Unimportant	Finding out who you really are now N/A
Accepting yourself completely, warts and all	Accepting yourself completely, warts and all Essential	Accepting yourself completely, warts and all Important	Accepting yourself completely, warts and all Unimportant	Accepting yourself completely, warts and all N/A
Reassessing what is important to you now	Reassessing what is important to you now Essential	Reassessing what is important to you now Important	Reassessing what is important to you now Unimportant	Reassessing what is important to you now N/A
Learning to take responsibility for what you want	Learning to take responsibility for what you want Essential	Learning to take responsibility for what you want Important	Learning to take responsibility for what you want Unimportant	Learning to take responsibility for what you want N/A
Being proactive rather than reactive	Being proactive rather than reactive Essential	Being proactive rather than reactive Important	Being proactive rather than reactive Unimportant	Being proactive rather than reactive N/A
Discovering your true passion and purpose in life	Discovering your true passion and purpose in life Essential	Discovering your true passion and purpose in life Important	Discovering your true passion and purpose in life Unimportant	Discovering your true passion and purpose in life N/A
Having a plan to turn intentions into actions	Having a plan to turn intentions into actions Essential	Having a plan to turn intentions into actions Important	Having a plan to turn intentions into actions Unimportant	Having a plan to turn intentions into actions N/A
Having unconditional support	Having unconditional support Essential	Having unconditional support Important	Having unconditional support Unimportant	Having unconditional support N/A

Please specify anything else you consider important

10. Is there anything else you'd like to share, that hasn't been covered by this survey?

Is there anything else you'd like to share, that hasn't been covered by this survey?

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What REALLY Matters to Women in MidlifeExit this survey >>