Broome Age-Friendly Project Survey of Adults Age 55+
1.
How would you rate your community as a place to live as people age? (select one)
Excellent
Very Good
Good
Fair
Poor
2.
What about your community makes it a good place for people to live as they age? (select two)
Housing options
Cultural opportunities
Activities for older adults
Low crime/safety
Hospitals/health services
Parks and recreation
Services for older adults
Cost of living
Learning opportunities
Transportation options
Other:
3.
What would make the community a better place for people to live as they age?
4.
How confident are you that you will be able to continue living in your current residence for as long as you would like? (select one)
Very confident
Somewhat confident
Not too confident
Not confident at all
5.
What are some reasons you might consider moving from your current home
(check all that apply)
I don't plan on moving
To be closer to family or friends
Reduce living costs
Lower crime/more safety
Needing more services for older adults
More access to parks and recreation
More activities for older adults
No longer able to maintain my home
Need for more accessible housing
Different climate
Better transportation options
Better access to hospitals/health services
More access to cultural opportunities
Other:
6.
Do you feel that there are enough social activities in your community for older adults?
Yes
No
I don't know
7.
What activities would you like to see that are not currently available?
8.
If you don’t currently go to a senior center, that is because…
9.
Do you currently volunteer?
Yes
No, because I don't know where to look for volunteer opportunities.
No, because I only want a paid position.
No, because I am not interested in volunteering.
No, because I am interested in volunteering but don't like the opportunities available.
No, because I am interested in volunteering but don't like the time expectations of opportunities offered.
No, because I don't have time.
I would prefer to volunteer in this way:
10.
Do you have internet at home?
Yes
No
If no, why not? Please explain:
11.
Is there anything else you would like to share about making your community a better place to age in place?
12.
Where do you live? (City/Town/Village)
13.
How old are you?
14.
How do you identify?
Male
Female
Other:
15.
What is your race and/or ethnicity?
African American
Asian
Native American
White
Mixed Race
I prefer not to answer
Other:
16.
Are you of Hispanic or Latino/a origin?
Yes
No