November 2018

Dear Neighbor,

We enjoy living in Georgetown and many of us would like to remain here as our lives change. To help us plan, Georgetown’s Age Friendly Community committee has prepared this survey which we invite you to complete. It is absolutely private, anonymous and confidential. We can’t do this without you.

Thank you,
Georgetown Age Friendly Committee
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* 1. What is most important to you about living in Georgetown?

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* 2. What is the best way to reach you to announce community events or resources? Check all that apply.

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* 3. Are there times you need assistance with transportation either within or outside of Georgetown?

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* 3a. Where would assistance in travel be most important?

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* 4. Please rate the kinds of services that would make it easier for you to live in Georgetown.

  Essential Important Nice to have
Assistance getting the food I need
Daily phone calls
Caregiver support
Support groups
Assistance with chores in my home
Wellness classes or programs
Health care services
Help keeping my home warm in the winter
Assistance with general home maintenance
Assistance with transportation
Opportunities to socialize
Help in event of a power failure
Other

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* 5. Are there specific things that would enable you to remain in your home as you age?

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* 6. Do you always feel safe in your home?

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* 6a. Do you have a working smoke detector?

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* 6b. Do you have a working carbon monoxide detector?

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* 6c. Do you have house numbers (at least 4 inch reflective) posted where they can be seen from the street at night?

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* 6d. If you answered "No" to any of the above, are you interested in help in obtaining and installing detectors and or house numbers?

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* 6e. Might you be interested in a lock box so in an emergency the fire department could enter your home for a rescue? (only the Fire Department/Ambulance service would have access to your lock box key.)

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* 7. Now or looking ahead, what obstacles are there in Georgetown that might prevent you from enjoying your life here?

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* 8. What would you like to have in Georgetown for outdoor community space (or modifications to an existing outdoor community space?)
(e.g. Reid State Park, Ipcar preserve, children’s school playground, 5 islands wharf, Higgins Mountain etc.)

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* 9. What activities would you like to see offered in town?

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* 10. Do you have a skill, resource or some expertise you would like to share with others in the community?
(e.g. carpenter, driving, teaching etc.)

Are you willing to volunteer (the above-mentioned skill, resource or expertise)?

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* 11. Some people are reluctant to ask for or accept assistance. Any suggestions how we might reach out?

12.  Tell us about yourself (remember this is completely confidential).

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* 12a. Are you answering this survey:

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* 12b. Are you:

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* 12c. What is your age?

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* 12d. If you don’t live in Georgetown year round, do you plan to someday?

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* We invite your input and ideas!

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* Would you like to join our efforts to help make Georgetown a community in which people of all ages can thrive?

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* Please complete this If you would you like us to contact you for more information, volunteering, services etc.

Please visit our website at www.http://www.agefriendlygeorgetown.org or click here to email us.

Thank you!

Your Age-Friendly Committee:
Patty Kimball, Co-Chair, Jim Peavey, Co-Chair, Juliana Cliffe, Secretary, Bob Arledge, Roger Bogart, Bill Chafe, Lorna Chafe, Rick Cliffe, Cindi Compton, Don Cowing, Joyce DeVito, Richard DeVito, John Evans. Bob Gravino, Kathy Gravino, Rosemary Hentz, Ken Hoffman, Chester Horne, Sandy Jaeger, Ole Jaeger, Peggy Kapisovsky, Georgia Kennett, Stephen Mace, Karen MacGillivary, Sheila McCandless, Fred
Randall, Sharon Randall, Ebbe Stevens, Mary Swain, Janet Thatcher, Patty Thibodeau, Jane Whittaker

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