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Nassau County Department of Human Services, Office for the Aging

Age Friendly Adapted Survey

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* 1. How would you rate your community as a place for people to live and grow as they age? (A community can be located within a city or town or county.)

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* 2. What is the name of your community? 

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* 3. What is your 5-digit zip code? 

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* 4. How long have you lived in this community?

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* 5. How important is it for you to remain in your community as you age?

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* 6. Thinking about your retirement years when you do not work at all for pay, how likely is it that you will move to a different home outside of your community?

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* 7. Do you own your home? 

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* 8. Do you rent your home? 

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* 9. What type of home is your primary home? 

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* 10. How important is it for you to be able to live independently in your home as your age? 

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* 11. As you age, do you anticipate needing to modify your home with a ramp, chairlift, wider doorways or elevator? 

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* 12. As you age, do you anticipate the need to modify your bathroom with grab bars, handrails, a higher toilet or non-slip tiles? 

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* 13. As you age, do you anticipate the need to move your bedroom, bathroom or kitchen to the main level of your home? 

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* 14. Is it important to have home repair contractors who are trustworthy, do quality work and are affordable in your community?

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* 15. Is it important to have well-maintained homes and properties in your community? 

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* 16. Is it important to have affordable housing options for adults of varying incomes levels in your community? 

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* 17. Is it important to have well-maintained and safe parks that are within walking distance of your home? 

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* 18. Is it important that sidewalks are in good condition, free from obstruction and are safe for pedestrian use and accessible for wheelchairs and other assistive devices?

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* 19. Is it important to have separate pathways for bicyclists and pedestrians? 

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* 20. Is it easy for you to get around and do things like shopping, visiting the doctor or running errands? 

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* 21. Is it important to have accessible and convenient public transportation in your community? 

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* 22. Is it important to have special transportation services for people with disabilities and older adults in your community? 

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* 23. Is it important to have easy to read traffic signs in your community?

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* 24. Is it important to have well-maintained streets in your community? 

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* 25. Is it important to have public parking lots, spaces and areas to park in your community?

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* 26. Is it important to have well-lit, safe streets, and intersections for all users (pedestrians, bicyclists, drivers) in your community?

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* 27. Does the community you live in have affordable and accessible public transportation?

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* 28. How often to you engage in some form of physical activity?

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* 29. In general, when compared to most people your age, how would you rate your health?

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* 30. How important is it to have health an wellness programs and classes in areas such as healthy eating, smoking cessation and exercise in your community?

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* 31. How important is it to have conveniently located health care and social services in your community?

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* 32. How frequently do you interact with your family, friends or neighbors? (This could be in person, by phone, e-mail, social media, etc.)

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* 33. Is it important for your community to have volunteer opportunities for older adults to participate in decision making bodies, such as community councils or committees?

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* 34. Do you know how to access human and social services within your community? 

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* 35. Please identify your gender below:

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* 36. Please select your age range below

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* 37. Do you identify as:

Thank you for taking the time to complete the Nassau County Age Friendly 37 question survey.  The completion time is approximately 7:00 minutes.  Your responses will assist in guiding Age Friendly policy moving forward.  
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