Town of Wenham Survey of Residents Age 50 and Over

The Town of Wenham and Council on Aging request that residents age 50 and over share their views in order to assess the needs of the Town’s older population and improve programs and services. All of your responses will be kept confidential. Please do not include your name or other identifying information on this survey. If you would prefer to respond via a paper copy, there will be one available to you through mail or at three locations across town: the Hamilton-Wenham Public Library, the Wenham Council on Aging, and the Wenham Town Hall.  

If you would like assistance completing this survey, please call the COA at 978-468-5534 to arrange a time. We thank you in advance for your participation.

PLEASE COMPLETE THIS SURVEY BY OCTOBER 15th, 2018

How long have you lived in Wenham?
(Check only one)

Question Title

* 1. How long have you lived in Wenham?
(Check only one)

How important is it to you to remain living in Wenham? (Check only one)

Question Title

* 2. How important is it to you to remain living in Wenham? (Check only one)

How would you rate your community as a place for people to live as they age? (Check only one)

Question Title

* 3. How would you rate your community as a place for people to live as they age? (Check only one)

What are your greatest concerns about your ability to remain living in Wenham as you get older? 

Question Title

* 4. What are your greatest concerns about your ability to remain living in Wenham as you get older? 

Do you feel that you are encouraged and able to participate in the development of policies relevant to your life? (Check only one

Question Title

* 5. Do you feel that you are encouraged and able to participate in the development of policies relevant to your life? (Check only one

Which of the following best describes your current place of residence? (Check only one)

Question Title

* 6. Which of the following best describes your current place of residence? (Check only one)

Do you rent or own your current place of residence? (Check only one)

Question Title

* 7. Do you rent or own your current place of residence? (Check only one)

Who do you live with? (Check all that apply)

Question Title

* 8. Who do you live with? (Check all that apply)

Does your current residence need home modifications (e.g., grab bars in showers or railings on stairs) to improve your ability to live in it over the next 5 years? (Check only one

Question Title

* 9. Does your current residence need home modifications (e.g., grab bars in showers or railings on stairs) to improve your ability to live in it over the next 5 years? (Check only one

Have you found someone available to do home maintenance and repairs? (Check only one)

Question Title

* 10. Have you found someone available to do home maintenance and repairs? (Check only one)

Do you feel as if the home maintenance and repair services are affordable enough for you? (Check only one

Question Title

* 11. Do you feel as if the home maintenance and repair services are affordable enough for you? (Check only one

Which activities do you currently enjoy doing? (Check all that apply)

Question Title

* 12. Which activities do you currently enjoy doing? (Check all that apply)

What types of intergenerational opportunities would you participate in if they were available? (Check all that apply)

Question Title

* 13. What types of intergenerational opportunities would you participate in if they were available? (Check all that apply)

Do you now or have you in the past 5 years provided care or assistance to a person who has a disability or in need of assistance (e.g., a spouse, parent, relative, or friend)?

Question Title

* 14. Do you now or have you in the past 5 years provided care or assistance to a person who has a disability or in need of assistance (e.g., a spouse, parent, relative, or friend)?

If Yes on question 14: Are/were you ever paid to provide this care?

Question Title

* 15. If Yes on question 14: Are/were you ever paid to provide this care?

If Yes on question 14: How challenging is/was it for you to care for this person(s) and meet your other responsibilities with family and/or work? (Check only one)

Question Title

* 16. If Yes on question 14: How challenging is/was it for you to care for this person(s) and meet your other responsibilities with family and/or work? (Check only one)

How would you rate your overall physical health? (Check only one)

Question Title

* 17. How would you rate your overall physical health? (Check only one)

How would you rate your overall emotional health? (Check only one

Question Title

* 18. How would you rate your overall emotional health? (Check only one

Due to a health issue, do you require help with activities around the house (e.g., doing routine chores like cleaning or yard work)? (Check only one

Question Title

* 19. Due to a health issue, do you require help with activities around the house (e.g., doing routine chores like cleaning or yard work)? (Check only one

Due to a health issue, do you require help with personal care (e.g., taking a bath or shower, or getting dressed)? (Check only one

Question Title

* 20. Due to a health issue, do you require help with personal care (e.g., taking a bath or shower, or getting dressed)? (Check only one

Due to a health issue, do you require help doing errands outside the home (e.g., food shopping, picking up prescriptions, or going to appointments)? (Check only one

Question Title

* 21. Due to a health issue, do you require help doing errands outside the home (e.g., food shopping, picking up prescriptions, or going to appointments)? (Check only one

If you require help with any of these activities, who helps you? (Check all that apply)

Question Title

* 22. If you require help with any of these activities, who helps you? (Check all that apply)

How many times did you visit a medical doctor or other health care professional for any reason in the last 12 months? (Check only one)

Question Title

* 23. How many times did you visit a medical doctor or other health care professional for any reason in the last 12 months? (Check only one)

How do you meet your transportation needs? (Check all that apply)

Question Title

* 24. How do you meet your transportation needs? (Check all that apply)

Which of the following challenges have you experienced while getting around locally? (Check all that apply)

Question Title

* 25. Which of the following challenges have you experienced while getting around locally? (Check all that apply)

How satisfied are you with the transportation options available to you in Wenham (Check only one)

Question Title

* 26. How satisfied are you with the transportation options available to you in Wenham (Check only one)

What is your employment status? (Check all that apply)

Question Title

* 27. What is your employment status? (Check all that apply)

When do you plan to fully retire (Check only one)

Question Title

* 28. When do you plan to fully retire (Check only one)

Was there any time in the past 12 months when you did not have money for the following necessities? (Check all that apply

Question Title

* 29. Was there any time in the past 12 months when you did not have money for the following necessities? (Check all that apply

Please indicate your level of agreement with the following statement: "During my retirement, I expect to have adequate resources to meet my financial needs, including home maintenance, real estate taxes, healthcare, and other expenses."  (Check only one)

Question Title

* 30. Please indicate your level of agreement with the following statement: "During my retirement, I expect to have adequate resources to meet my financial needs, including home maintenance, real estate taxes, healthcare, and other expenses."  (Check only one)

Are you aware of activities in your community that are directed toward all generations or older adults? (Check only one

Question Title

* 31. Are you aware of activities in your community that are directed toward all generations or older adults? (Check only one

Do you feel the activities in your community appeal to a diverse population of older adults? (Check only one)

Question Title

* 32. Do you feel the activities in your community appeal to a diverse population of older adults? (Check only one)

If no, what types of activities or events would you like to see available?

Question Title

* 33. If no, what types of activities or events would you like to see available?

Do you currently use the programs or services offered by the Council on Aging? (Check only one

Question Title

* 34. Do you currently use the programs or services offered by the Council on Aging? (Check only one

Below is a list of problems one could encounter when accessing the Council on Aging or its programs. Which of these problems have you or someone you know experienced? (Check all that apply)

Question Title

* 35. Below is a list of problems one could encounter when accessing the Council on Aging or its programs. Which of these problems have you or someone you know experienced? (Check all that apply)

The following items refer to programs and services that are currently offered through the Wenham Council on Aging. Please rate how important each program/service is to you and/or your family. (Check only one box per item)

Question Title

* 36. The following items refer to programs and services that are currently offered through the Wenham Council on Aging. Please rate how important each program/service is to you and/or your family. (Check only one box per item)

  Very Important Somewhat Important Neutral Somewhat Not Important Not at All Important
Assistance with local or state programs (e.g., financial, fuel)
Educational opportunities
Fitness activities
Health and wellness
Health insurance counseling (SHINE counselor) 
Information, referral & outreach
Nutrition/Meals on Wheels
Professional services (e.g., tax, legal & financial resource list) 
Social activities
Support groups
Transportation
Trips/Outings
Volunteer opportunities
How satisfied are you with the programs and services offered through the Council on Aging? (Check only one)

Question Title

* 37. How satisfied are you with the programs and services offered through the Council on Aging? (Check only one)

How satisfied are you with the Council on Aging programs and services that you received or participated in? (Check only one

Question Title

* 38. How satisfied are you with the Council on Aging programs and services that you received or participated in? (Check only one

What is the best, most effective way for your town to get information to you?

Question Title

* 39. What is the best, most effective way for your town to get information to you?

How important do you think it is to have the following in your community? (Check only one for each item)

Question Title

* 40. How important do you think it is to have the following in your community? (Check only one for each item)

  Very Important Somewhat Important Neutral Somewhat Not Important Not At All Important
Access to community information in one central source
Clearly displayed, printed community information with large lettering
Assistive listening devices (to aid the hearing impaired) available for community meets and events
An automated community information source that is easy to understand like a toll-free number or information kiosk
What is your age range? (Check only one)

Question Title

* 41. What is your age range? (Check only one)

What is your marital status? (Check only one)

Question Title

* 42. What is your marital status? (Check only one)

Which of the following best describes your race/ethnicity? (Check all that apply)

Question Title

* 43. Which of the following best describes your race/ethnicity? (Check all that apply)

What is the primary language spoken in your home?

Question Title

* 44. What is the primary language spoken in your home?

What is your gender?

Question Title

* 45. What is your gender?

Please use this space to specify any services or other items you think are important to have in your community as you age, or any other concerns or suggestions you would like planners to think about to help make Wenham more friendly for older adults.

Question Title

* 46. Please use this space to specify any services or other items you think are important to have in your community as you age, or any other concerns or suggestions you would like planners to think about to help make Wenham more friendly for older adults.

Have you heard anything about the creation of age and dementia-friendly communities? (Check only one

Question Title

* 47. Have you heard anything about the creation of age and dementia-friendly communities? (Check only one

If yes or some on question 47: What have you heard about the creation of age and dementia-friendly communities?

Question Title

* 48. If yes or some on question 47: What have you heard about the creation of age and dementia-friendly communities?

Would you be interested in attending a program on age and dementia-friendly initiatives? (Check only one)

Question Title

* 49. Would you be interested in attending a program on age and dementia-friendly initiatives? (Check only one)

T