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* 1. What is your postal code?
Please Note:  This question must be answered for your survey to be included.  Your postal code will be kept separate and will not be used to identify you in any way.

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* 2. Have any of the following kept you from using public outdoor spaces in the 
community?

  NO My Neighbourhood Downtown Parks Trails
Worries about crime.
Poor lighting at night
Not enough public washrooms.
Not enough sidewalks.
Not enough crosswalks
Not enough public seating/shelters
Not enough public transit.

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* 3. Have any of the following kept you from using public buildings in the 
community?

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* 4. Please share your opinion about each of the following statements.

  Disagree/Agree/Unsure
There are enough police patrols in my community to make me feel safe.
Police respond quickly to calls.
I live in a community that is safe from vandalism and crime.
I live in a community that is safe from abuse.

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* 5. As far as you know , does your community have the following?

  No/Yes/Unsure
Information, courses, and programs about crime prevention.
A program for police to check your home for safety and crime prevention.
A Neighbourhood watch program in you neighbourhood.

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* 6. How do you usually travel around the community? (Check the one(1) you do most often)

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* 7. If you have a vehicle(car,truck or motorcycle): Have any of the following kept you from using your vehicle as much as you would like for getting around the community?

  No/Yes
Not enough parking.
Parking is too expensive.
Problems with traffic(hard-to-read signs, lane markers, stop lights, stop signs, too much traffic)
Snow Removal
Roads and streets are in poor condition.

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* 8. Have any of the following kept you from walking, running, jogging or biking to get around in the community? (Check all that apply)

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* 9. Have any of the following kept you from using buses to get around in the 
community? (Check all that apply)

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* 10. Have any of the following kept you from using taxis to get around in the 
community? (Check all that apply)

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* 11. Answer only if you use a wheelchair: Have any of the following kept you from using buses that are made for wheelchairs? (Check all that apply)

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* 12. In your opinion, does your community have the following?

  No/Yes/Unsure
Different types of housing for seniors (at all income levels) that are affordable, in good condition and safe.
Housing that is made for aging adults (easy to get in, built for safety and ease of use, with items such as grab bars and lowered cupboards)
Low-cost services such as lawn mowing or snow removal for low-income and older adults.
Support (financial or other) for older adults that helps with home repairs and upkeep.
Support (financial or other) for older adults to install safety features (such as grab bars in bathrooms).

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* 13. How important is it for you to be able to live in your own home without
special help as you age?

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* 14. What type of housing are you living in now? (Check one(1) answer that is closest to being right)

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* 15. Do you rent or do you own the place where you are living?

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* 16. Do you plan to move to a different type of housing in the future? (Check one(1))

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* 17. If you do plan to move:
What type of housing would you look for?  (Check one(1) answer that is the most likely one)

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* 18. If you expect to move: Where would your future home most likely be located? (Check one(1))

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* 19. If you had to move, and you had your choice: Would you want to stay in the same neighbourhood where you are living now?

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* 20. If you currently live in your home:

Do you expect that any of the following might stop you from being able to stay in your home in the coming years? (Check up to three(3) of the most important items)

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* 21. Do you think you will need to make any of the following changes to your home so that you can stay there as you age?

  No/Yes/Unsure
Improving your ability to get around (such as a ramp, chairlift, elevator, or wider doorways.)
Making changes to the bathroom for safety (such as grab bars, handrails, a higher toilet or non-slip tiles).
Putting a bedroom, bathroom and kitchen on the first floor

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* 22. As far as you know, are the following cost-saving programs available for seniors in your community?

  No/Yes/Unsure
Help with the cost of rent.
Help with the cost of property taxes.
Help with the cost of power bills.
Help with the cost of home heating (such as oil, propane or wood)
Lower prices for public transit (such as buses)

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* 23. In the last 3 months, have you gone to any of the following? (Check all that apply)

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* 24. Do any of the following stop you from taking part in social, cultural and recreational activities?

  No/Yes/Unsure
The cost is too high
Poor location
No transportation
My health, vision, hearing or ability to get around
Care giving responsibility (having to care for someone else)
Facilities are hard to get into or move around in
Events are scheduled at a poor time
There is no one to go with.

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* 25. How much do you feel you know about the following activities for adults aged 50+ in your community?

  Nothing/A Bit/ A lot
General recreation, fitness, health, and wellness programs.
Recreation, fitness, health and wellness programs that are for people with disabilities.
Creative programs (such as art, writing, crafts, hobbies, music, theatre)
Technology training (such as computers and smart phones)
Learning (such as college or university courses, talks, lectures, presentations).
Social activities that involve recreation (such as tennis, cross-country skiing, walking, curling, bicycling, golf)
Organized games (such as cards, bingo, bridge)
Community events (such as concerts, plays, movies, special events).

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* 26. Just for those things which you said you know "A lot" about:
Please say whether or not you are satisfied with them.
(You do not need to have taken part in them in order to answer this question)

  Not Satisfied/Satisfied/Unsure
General recreation , fitness, health, and wellness programs.
Recreation, fitness, health and wellness programs that are for people with disabilities
Creative programs(such as art, writing, crafts, hobbies, music, theatre).
Technology training (such as computers and smart phones).
Learning ( such as college or university courses, talks, lectures, presentations)
Social activities that involve recreation (such as tennis, cross country skiing, walking, curling, bicycling , golf, etc)
Organized games (such as cards, bingo, bridge)
Community Events (such as concerts, plays, movies, special events, etc)

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* 27. How does your community usually make you feel?

  No/Yes/Unsure
I feel welcomed and valued by the community for my wisdom and for what I have to offer.
I feel connected to my community.
I feel included and welcome in community activities for "families"

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* 28. Do you feel the following statements are usually true in your community?

  No/Yes/Unsure
There are activities in the community that welcome people of all ages to take part together.
Seniors are asked by public (municipal) staff, voluntary groups, and businesses about how to serve them better.
Seniors are able to take part in activities that include people from other cultures or countries
There is a general awareness of the needs of seniors in Miramichi
The Community offers a welcoming environment for Older Adults

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* 29. Do the following groups regularly treat you with respect in your community?

  No/Yes/Unsure
Business/shop staff
City Staff
Children under (12)
Youth aged (12-20)
Family Members
Neighbours
Other adults in the community (outside your neighbourhood)
Province of NB Staff
Government of Canada Staff
Health Care Providers

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* 30. Have any of the following made you feel that you do not belong in your community?

  No/Sometimes/Often/Unsure
Your Age
Your Race
Your Gender
Your culture
Your language
Being a newcomer
Your class or social status
Your sexual orientation
Having a disability
Your Faith

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* 31. In the last 6 months, have you volunteered to help with a community group or event?

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* 32. As far as you know, does your community have the following?

  No/Yes/Unsure
Support for volunteers (such as training, help with expenses).
Transportation to and from volunteer activities for those who need it.
A wide range of volunteer activities to choose from.
Training to help people perform better as volunteers.
Ways for older adults to take part in community councils, committees, boards, etc.
Easy-to-find information about local volunteer activities.

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* 33. If you were given the chance to volunteer for something you enjoy, would you volunteer?

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* 34. If you answered 'Yes' or 'Unsure' to the last question:
Do any of the following keep you from volunteering?

  No/Yes/Unsure
My health or my ability to get around
Not enough time
It costs too much
No transportation
Not enough thanks
Not enough chances to volunteer
Not at the right time of the day
Can't find the right kind of volunteer activities for my skills
No training for what I want to do.
No easy ways to find information about volunteering

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* 35. Only answer if you are still working now: 
Are you thinking about delaying your retirement (for any reasons)?

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* 36. As far as you know, does your community have the following?

  No/Yes/Unsure
A range of jobs for older adults
Job training for older adults who want to learn new job skills or get training in a new field of work
Jobs that are suited to the needs of seniors (such as flex time, part time, help for people with disabilities).

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* 37. In the last 6 months, have you visited a public library?

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* 38. In the last 12 months, how did you usually get the information you needed about your community? (Check all that apply)

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* 39. As far as you know, does your community have the following?

  No/Yes/Unsure
Easy-to-find information from Government about all types of programs and services for seniors.
An easy-to-use , person-to-person telephone service with information about programs and services for seniors.
A description (on paper) of programs and services for seniors , with large print and plain language.

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* 40. As far as you know, does your community have any groups or organizations that help seniors find and use the following?

  No/Yes/Unsure
Health care services
Home support services (such as foot care, meals, housekeeping)
Help with preparing for emergencies (such as floods or ice storms).
An emergency hotline.
End-of-life support (such as a hospice or home care for the dying).

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* 41. In your opinion, does your community have the following?

  No/Yes/Unsure
Food that is safe.
Food that is healthy.
Food that is affordable.
Community Gardens.

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* 42. Do you use any of the following low-cost food programs? 
(Check all that apply)

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* 43. Where do you go when you need health care?

  No/Almost Never/Some of the Time/Most of the time
Family Doctor.
Nurse Practioneer.
A team Practice (Doctor, Nurse, Dietition, Social work all working in the same office)
Community Health Center
Walk-in clinic or after-hours clinic.
Non Traditional health care workers (such as naturopaths, chiropractors, acupuncturists).
Emergency Room
Other

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* 44. In the last 12 months have you needed help with any of the following tasks? (Check all that apply)

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* 45. Just for the things that you said you needed help with in the last question:
Were you able to get the help you needed?

  No/Yes/Unsure
Getting information about services that are available
Filling out or understanding forms
Preparing your income tax
Banking
Grocery Shopping
Getting transportation to and from events
Having groceries delivered
Having meals delivered
Preparing meals
Taking medication or pills
Housekeeping and laundry
Yard care or gardening
Home repair and upkeep
Snow removal
Garbage Removal

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* 46. How do you feel about the following statement?

  Disagree/Agree/Unsure
I am satisfied with my life in general
I am satisfied with my physical health
I am satisfied with my mental health
I am satisfied with my family life
I am satisfied with my social relationships (friends and neighbours)

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* 47. As you think about your future senior years, are you worried or anxious about any of the following?

  No/A bit/A lot/Unsure
Not having enough money
Having trouble getting around physically.
No one to care for me.
Losing my driver's license
Being able to get services in my language
Having to depend on others/losing my independence
Losing my health
Falling and getting badly hurt
Finding the right type of care as I age
Being able to move into housing that is the right kind for me
Having to move into a nursing home
Growing old alone/being alone
Death and Dying

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* 48. How long have you lived in Miramichi? ( in years)

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* 49. How long have you lived in the neighbourhood where you are now? (in years)

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* 50. What is your age group? (Check one)

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* 51. What is your gender?

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* 52. What language(s) do you speak? (Check all that apply)

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* 53. What is your first language (your mother tongue) ? 

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* 54. In what language do you like to get your services and information? 

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* 55. What is your marital status? (Check One)

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* 56. Who do you live with? (Check one)

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* 57. Are you a care-giver for someone who lives with you? (Check all that apply)

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* 58. Does someone else care for you on a regular basis? (Check all that apply)

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* 59. Which of the following best describes your working situation? (Check one(1) answer that is closest to being right)

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* 60. What was the total income last year, for all people living in your home, before taxes and deductions?

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* 61. What is your highest level of education? (Check one)

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* 62. If you have any additional comments that may not have been covered in this survey, please feel free to comment below:

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