Seniors Issues Questionaire – Draft



Seniors Issues Survey – January/February 2009

Enabling seniors to continue to live and be supported in Revelstoke is a high priority for planning and action. Your opinions and feedback are important and will determine the direction of community initiatives in the near future.

In addition to the survey questions, there is space for you to comment & identify other issues that are not listed.

|1. Firstly, what year were you born? | |

|2. How long do you plan to stay in Revelstoke? |0 to 5 years |More than 5 years | |

| | | |Don’t Know |

| | | | |

Other:

________________________________________________________________________________________________________________________________________________________________

|3. Accessible transportation |Yes |No |

|Do you have difficulty getting in and out of a vehicle? | | |

|3a. Transportation |Very Important | |Not Important |Not Applicable |

| | |Important | | |

|Reliable taxi service | | | | |

|Getting to and from out-of-town appointments | | | | |

|Continuing to drive myself | | | | |

|Regular public transit (bus) service | | | | |

|Wheelchair accessible door-to-door (taxi) service for mobility-challenged | | | | |

|residents | | | | |

|Wheelchair accessible door-to-door service for mobility-challenged residents who| | | | |

|cannot transfer to a car | | | | |

Other: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|4. Home care support |Yes |No |

|I would like to have, or am on the waiting list for, home care support services | | |

|4a. Health and Community Care |Very Important | |Not Important |Not Applicable |

| | |Important | | |

|Flu shots offered at a downtown location | | | | |

|Knowing what local health and community care services are available & how to | | | | |

|access them | | | | |

|Meals on wheels (in your home) | | | | |

|Wheels to meals (Dining with others) | | | | |

|Telephone support calls from volunteers | | | | |

|Personal support visits from volunteers | | | | |

Other: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|5. Housing to meet my needs |Yes |No |

|I own my home | | |

|I am renting my home | | |

|I am having difficulty finding a place to live that is suitable for me (for example – size or location) | | |

|I am having difficulty finding a place to live that is affordable for me | | |

Other: ________________________________________________________________________________________________________________________________________________________________

| |Very Important | |Not Important |Not Applicable |

|6. Getting around | |Important | | |

|Snow removal/sanding on sidewalks | | | | |

|Wider corridors in stores | | | | |

|More electric doors on public buildings | | | | |

|More sloping curbs at intersections | | | | |

|More benches and/or resting places… | | | | |

|…where (benches)? | |

Other: ________________________________________________________________________________

| |Very Important | |Not Important |Not Applicable |

|7. Personal well-being | |Important | | |

|Learning about volunteer opportunities | | | | |

|Help with shopping and getting to appointments | | | | |

|Help with yard work, home repairs, and snow shoveling | | | | |

|Help with housework & cooking meals | | | | |

|Learning how to use a computer | | | | |

|Help navigating computer websites and getting information online | | | | |

|Help with and/or more information about government services | | | | |

|Educational opportunities | | | | |

|Recreational and social activities | | | | |

Other: ________________________________________________________________________________

Suggestions for recreational and social activities:

________________________________________________________________________________________________________________________________________________________________

|7a. Personal safety |Yes |No |

|I feel safe in my home | | |

|I feel safe when I go for a walk | | |

|I feel safe in the place where I work or volunteer | | |

|I know who to call if I feel unsafe | | |

Other: ________________________________________________________________________________________________________________________________________________________________

|7b. Personal income |Yes |No |

|My income is adequate to meet my needs | | |

|If the cost of living increases much more, my income will not be sufficient to meet my needs | | |

|I know where to obtain financial or legal advice when I need it | | |

Other: ________________________________________________________________________________

If there is anything else you would like us to know, please write it on the back of this page. Please drop the survey off at the community centre by Feb 20th, 2009. Any questions, call Jill Zacharias, Social Development Coordinator, at 250-814-3875. THANK YOU!

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