Let's Talk About an Age-Friendly Community

Thank you for your time in completing this survey

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* 1. Age:

18 - 29

30 - 39

40 - 49

50 - 59

60 - 69

70 -79

80+

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* 2. Gender

Male

Female

Gender Diverse

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* 3. Ethnicity

New Zealand European

Maori

Samoan

Cook Island Maori

Tongan

Niuean

Chinese

Indian

Other (such as British, Dutch, Philippine, Japanese)

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* 4. Where do you live:

Kaiapoi

Oxford

Pegasus

Rangiora

Woodend

A small settlement (e.g. Cust, Waikuku)

Rural

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* 5. Do you:

Own your own home

Rent privately

Board

Live with family

Resthome

Other

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* 6. How do you rate the Waimakariri District as a place to retire? (Tick which applies)

Excellent

Very good

Good

Poor

Very poor

Don't know

Excellent

Very good

Good

Poor

Very poor

Don't know

Comments below:

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* 7. Please rate each of the following in our District (Choose which applies)

	Excellent	Very good	Good	Poor	Very Poor	Don't know
Opportunities to volunteer	Opportunities to volunteer Excellent	Opportunities to volunteer Very good	Opportunities to volunteer Good	Opportunities to volunteer Poor	Opportunities to volunteer Very Poor	Opportunities to volunteer Don't know
Employment opportunities for older adults	Employment opportunities for older adults Excellent	Employment opportunities for older adults Very good	Employment opportunities for older adults Good	Employment opportunities for older adults Poor	Employment opportunities for older adults Very Poor	Employment opportunities for older adults Don't know
Opportunities to enrol in skill-building or person development classes	Opportunities to enrol in skill-building or person development classes Excellent	Opportunities to enrol in skill-building or person development classes Very good	Opportunities to enrol in skill-building or person development classes Good	Opportunities to enrol in skill-building or person development classes Poor	Opportunities to enrol in skill-building or person development classes Very Poor	Opportunities to enrol in skill-building or person development classes Don't know
Recreational opportunities (including games, arts, library services etc)	Recreational opportunities (including games, arts, library services etc) Excellent	Recreational opportunities (including games, arts, library services etc) Very good	Recreational opportunities (including games, arts, library services etc) Good	Recreational opportunities (including games, arts, library services etc) Poor	Recreational opportunities (including games, arts, library services etc) Very Poor	Recreational opportunities (including games, arts, library services etc) Don't know
Fitness opportunities (including exercise classes, paths, cycle paths etc)	Fitness opportunities (including exercise classes, paths, cycle paths etc) Excellent	Fitness opportunities (including exercise classes, paths, cycle paths etc) Very good	Fitness opportunities (including exercise classes, paths, cycle paths etc) Good	Fitness opportunities (including exercise classes, paths, cycle paths etc) Poor	Fitness opportunities (including exercise classes, paths, cycle paths etc) Very Poor	Fitness opportunities (including exercise classes, paths, cycle paths etc) Don't know
Opportunities to attend social events or spiritual activities	Opportunities to attend social events or spiritual activities Excellent	Opportunities to attend social events or spiritual activities Very good	Opportunities to attend social events or spiritual activities Good	Opportunities to attend social events or spiritual activities Poor	Opportunities to attend social events or spiritual activities Very Poor	Opportunities to attend social events or spiritual activities Don't know
Opportunities to attend and/or participate in meetings about local government or community matters	Opportunities to attend and/or participate in meetings about local government or community matters Excellent	Opportunities to attend and/or participate in meetings about local government or community matters Very good	Opportunities to attend and/or participate in meetings about local government or community matters Good	Opportunities to attend and/or participate in meetings about local government or community matters Poor	Opportunities to attend and/or participate in meetings about local government or community matters Very Poor	Opportunities to attend and/or participate in meetings about local government or community matters Don't know
Openness and acceptance of the community towards older residents	Openness and acceptance of the community towards older residents Excellent	Openness and acceptance of the community towards older residents Very good	Openness and acceptance of the community towards older residents Good	Openness and acceptance of the community towards older residents Poor	Openness and acceptance of the community towards older residents Very Poor	Openness and acceptance of the community towards older residents Don't know
Ease of getting to the places you usually have to visit (supermarket, doctor’s office, pharmacy)	Ease of getting to the places you usually have to visit (supermarket, doctor’s office, pharmacy) Excellent	Ease of getting to the places you usually have to visit (supermarket, doctor’s office, pharmacy) Very good	Ease of getting to the places you usually have to visit (supermarket, doctor’s office, pharmacy) Good	Ease of getting to the places you usually have to visit (supermarket, doctor’s office, pharmacy) Poor	Ease of getting to the places you usually have to visit (supermarket, doctor’s office, pharmacy) Very Poor	Ease of getting to the places you usually have to visit (supermarket, doctor’s office, pharmacy) Don't know
Overall feeling of safety in the Waimakariri District	Overall feeling of safety in the Waimakariri District Excellent	Overall feeling of safety in the Waimakariri District Very good	Overall feeling of safety in the Waimakariri District Good	Overall feeling of safety in the Waimakariri District Poor	Overall feeling of safety in the Waimakariri District Very Poor	Overall feeling of safety in the Waimakariri District Don't know
Older residents being valued in the Waimakariri District	Older residents being valued in the Waimakariri District Excellent	Older residents being valued in the Waimakariri District Very good	Older residents being valued in the Waimakariri District Good	Older residents being valued in the Waimakariri District Poor	Older residents being valued in the Waimakariri District Very Poor	Older residents being valued in the Waimakariri District Don't know
Openness and acceptance of the community towards older residents of diverse backgrounds	Openness and acceptance of the community towards older residents of diverse backgrounds Excellent	Openness and acceptance of the community towards older residents of diverse backgrounds Very good	Openness and acceptance of the community towards older residents of diverse backgrounds Good	Openness and acceptance of the community towards older residents of diverse backgrounds Poor	Openness and acceptance of the community towards older residents of diverse backgrounds Very Poor	Openness and acceptance of the community towards older residents of diverse backgrounds Don't know

Please add any comments:

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* 8. Please rate the overall health services provided for older adults in the Waimakariri District

Excellent

Very good

Good

Poor

Very poor

Don't know

Excellent

Very good

Good

Poor

Very poor

Don't know

Comments below:

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* 9. How informed are you about services and activities available to older adults in the Waimakariri District? (Choose which applies)

Very informed

Informed

Uninformed

Don't know

Very informed

Informed

Uninformed

Don't know

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* 10. How do you currently get information on programmes and services for older adults in the Waimakariri District? (Tick all that apply)

Advertisement at community facility

Advertisement at a Council library or service centre

Chatter newsletter

Church newsletters or bulletins

Citizens Advice Bureau, North Canterbury

Community associations (e.g. residents’ groups, Grey Power)

Email newsletters

Local newspapers

Friend, neighbour or family member

Internet on a personal computer

Internet on a public computer

Residential home/facility

Other

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* 11. If you have had problems in the last 12 months (Tick which applies)

	Yes	No
a) Do you have support?	a) Do you have support? Yes	a) Do you have support? No
b) Do you know where to get help?	b) Do you know where to get help? Yes	b) Do you know where to get help? No

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* 12. Please indicate which of the following transportation options you use on a
regular basis: (Tick all that apply)

Bicycle

Car – I drive myself

Car – someone else drives me

Blue Bus (public transport)

Mobility scooter

North Canterbury Mini-bus Trust

Commercial Transport operators (Uber, taxis, Driving Miss Daisy etc)

St John Health Shuttle Service

Volunteer transportation services (eg: Cancer Society)

Walking

Other

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* 13. Please rate each of the following in our District (Choose which applies)

	Excellent	Very good	Good	Poor	Very Poor	Don't know
Availability of affordable housing	Availability of affordable housing Excellent	Availability of affordable housing Very good	Availability of affordable housing Good	Availability of affordable housing Poor	Availability of affordable housing Very Poor	Availability of affordable housing Don't know
Variety of housing options for older people	Variety of housing options for older people Excellent	Variety of housing options for older people Very good	Variety of housing options for older people Good	Variety of housing options for older people Poor	Variety of housing options for older people Very Poor	Variety of housing options for older people Don't know
Availability of housing for low income seniors	Availability of housing for low income seniors Excellent	Availability of housing for low income seniors Very good	Availability of housing for low income seniors Good	Availability of housing for low income seniors Poor	Availability of housing for low income seniors Very Poor	Availability of housing for low income seniors Don't know
Housing options that are safe and accessible	Housing options that are safe and accessible Excellent	Housing options that are safe and accessible Very good	Housing options that are safe and accessible Good	Housing options that are safe and accessible Poor	Housing options that are safe and accessible Very Poor	Housing options that are safe and accessible Don't know

Comments below:

Let's Talk About an Age-Friendly Community

Thank you for your time in completing this survey

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* 1. Age:

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* 2. Gender

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* 3. Ethnicity

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* 4. Where do you live:

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* 5. Do you:

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* 6. How do you rate the Waimakariri District as a place to retire? (Tick which applies)

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* 7. Please rate each of the following in our District (Choose which applies)

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* 8. Please rate the overall health services provided for older adults in the Waimakariri District

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* 9. How informed are you about services and activities available to older adults in the Waimakariri District? (Choose which applies)

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* 10. How do you currently get information on programmes and services for older adults in the Waimakariri District? (Tick all that apply)

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* 11. If you have had problems in the last 12 months (Tick which applies)

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* 12. Please indicate which of the following transportation options you use on a
regular basis: (Tick all that apply)

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* 13. Please rate each of the following in our District (Choose which applies)

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* 14. Where are the gaps and opportunities to be more age-friendly in our District?
Please refer to the themes in the Age-friendly symbol below.

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* 15. What is your top priority for an age–friendly plan for our District?
Please refer to the themes in the Age-friendly symbol below.

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* 16. Are there any other comments you would like to make?

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* 1. Age:

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* 2. Gender

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* 3. Ethnicity

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* 4. Where do you live:

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* 5. Do you:

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* 6. How do you rate the Waimakariri District as a place to retire? (Tick which applies)

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* 7. Please rate each of the following in our District (Choose which applies)

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* 8. Please rate the overall health services provided for older adults in the Waimakariri District

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* 9. How informed are you about services and activities available to older adults in the Waimakariri District? (Choose which applies)

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* 10. How do you currently get information on programmes and services for older adults in the Waimakariri District? (Tick all that apply)

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* 11. If you have had problems in the last 12 months (Tick which applies)

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* 12. Please indicate which of the following transportation options you use on aregular basis: (Tick all that apply)

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* 13. Please rate each of the following in our District (Choose which applies)

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* 14. Where are the gaps and opportunities to be more age-friendly in our District?Please refer to the themes in the Age-friendly symbol below.

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* 15. What is your top priority for an age–friendly plan for our District?Please refer to the themes in the Age-friendly symbol below.

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* 16. Are there any other comments you would like to make?

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* 12. Please indicate which of the following transportation options you use on a
regular basis: (Tick all that apply)

* 14. Where are the gaps and opportunities to be more age-friendly in our District?
Please refer to the themes in the Age-friendly symbol below.

* 15. What is your top priority for an age–friendly plan for our District?
Please refer to the themes in the Age-friendly symbol below.