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This survey is prepared by Western Canada Accessibility and Enablement Consulting. For more information, please
contact Jessica E. Blewett at (phone) 250-562-2390 or (email) blewettj@unbc.ca.


Houston Age Friendly Survey



An age friendly community is a place that enables older adults to live healthy, active
and independent lives into old age. Promoting age friendliness is one of the most
effective strategies to create sustainable and healthy communities. This survey will
provide information about the needs, challenges and supports of older residents in
Houston. The information you provide will help decision makers and community groups
make informed decisions about how to improve Houston. Your input is integral to
ensure that future changes reflect the needs of community members like yourself.
Please note:
One survey per household please make your survey decisions together.*
Participation is VOLUNTARY ideally we would like you to fill out all questions,
but feel free to skip any questions you would rather not answer.
Your answers are completely CONFIDENTIAL no results will be presented in
any way that could identify you and we will not ask for your name or address.
Please return all surveys by June 5
th
2014. Drop box locations can be found at:
o The District of Houston Office
o The Seniors Centre
o The Houston Leisure Centre
o Pharmasave

*Which category does your household fall into: (please check any which apply)
Older residents (65 and older)
Near older residents (50-64 years)
People experienced with the needs of older adults (e.g. care takers, family
members, service workers, etc.). PLEASE NOTE: If you are filling this survey out
based on your knowledge of older adults, please treat all instances of you or your
in sections B to F as older adults in your community.





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General Information
These questions help us create a profile of Houston respondents. All of your answers are
completely confidential.

A1) Please list the age and gender for yourself and everyone in your household:
Age Gender
Yourself
Person 2
Person 3
Person 4
Person 5
Person 6

A2) How long have you lived in Houston? __________________year(s)
A3) What is your marital status? (please check one)
Married Single never married Divorced
Live-in or common-law partner Separated Widowed
A4) What is your total household income for the past year, before taxes and
deductions? (please check one)
$0 - $16,999 $17,000 - $26,999 $27,000 - $36,999
$37,000 - $46,999 $47,000 - $56,999 $57,000 or more
A5) Please describe your employment status. (check any that apply)
Employed/Self-employed full-time Retired Contract worker
Employed/Self-employed part-time Homemaker Volunteer
Not employed Other
A6) What is your ethnicity?________________________________________________
Outdoor Spaces, Buildings, and Safety
The following questions assess the age friendly features and safety of outdoor spaces and
buildings in Houston. (Please check any that apply).

B1) Do you feel safe walking in your community during the day? (please check one)
Not sure Yes No
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B2) Do you feel safe walking in your community at night?
Not sure Yes No
B3) Do you feel safe driving in your community during the day?
Not sure Yes No
B4) Do you feel safe driving in your community at night?
Not sure Yes No
B5) If you answered NO to ANY of the above four questions please explain
why:_______________________________________________________________
___________________________________________________________________
___________________________________________________________________
B6) Are crime or vandalism problems in your community?
Not sure Yes No
B7) Are roadways well maintained in Houston?
Not sure Yes No
B8) Are walking routes/sidewalks well maintained in Houston?
Not sure Yes No
B9) What kind of barriers impede your ability to walk around the community? (Check
any that apply)
Puddles Snow/Ice in walking areas
Foliage in walking areas Gravel on sidewalks or roadways
Concerns over safety Concerns over wildlife
Distance between destinations Lack of sidewalks
Lack of lighting in the evening Lack of designated paths
Lack of crosswalks Lack of or poor curbcuts on sidewalks
Inadequate road maintenance Inadequate benches for resting
Personal mobility issues No yellow stripes on walking areas
Lack of connections between routes None
Other, please explain: ______________________________________________
___________________________________________________________________
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B10) What are the top three walking paths or streets in need of improvement?
1. ___________________________________________________________________
2. ___________________________________________________________________
3. ___________________________________________________________________

B11) Do vehicles stop for pedestrians at crossing areas in Houston?
Not sure Yes Usually Rarely No
B12) Are you able to access most businesses and services in Houston?
Not sure Yes No
B13) What kind of barriers impede your ability to access businesses or services?
Lack of parking for seniors Lack of accessible parking spaces
Heavy doors Lack of parking near entrances
Inaccessible entrance ways Lack of automatic doors
Lack of elevators Lack of wheelchair ramps
Lack of covered entranceways Lack of interior space for mobility
Lack of adequate public washrooms Lack of accessible washrooms
Uneven walking surfaces Mats askew
Stairs or steps Lack of transportation
None
Other, please explain: ______________________________________________
___________________________________________________________________
___________________________________________________________________

B14) What is the most important improvement to buildings, outdoor areas, or safety
needed in order to enhance Houston for older adults?_________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


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Transportation and Mobility
This section tells us about how you get around in your community and what kind of
improvements could be made.

C1) How do you travel around Houston right now, and how do you think you will
travel around the community in the next 5 to 10 years? (Check any that apply)
Type of transportation Now In the next 5 years In the next 10 years
Driving

Carpool

Walking

HandyDART

Taxi

Friends/Family

Bicycle

Transit

Other, please explain:




C2) Which services are important for improving transportation and mobility in
Houston? (Check any that apply)
Transportation for local medical appointments Reliable taxi service
Transportation for regional medical appointments Regular local public transit
Accessible door-to-door pickup service Ride-share program
Other, please specify: _________________________________________________
_______________________________________________________________________
C3) Do you have difficulties getting in or out of vehicles?
Yes or No
C4) Do you know how to obtain a handi-capped parking permit?
Yes or No
C5) On the map on the following page:
1. Circle the top three service/business areas that you travel to the most,
AND
2. Draw a line representing your most used route to access services and
businesses in Houston.

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Shopping
Centre
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Housing
The following questions tell us about housing availability, needs, and challenges for older
adults in Houston.

D1) Do you plan on staying in Houston for retirement? (Please check one)
Not sure Yes No
D1i) If no, please explain why:_________________________________________
___________________________________________________________________
___________________________________________________________________
D2) Do you plan on staying in your current home for retirement?
Not sure Yes No
D3) What type of home do you live in? (Please select from the following)
Single detached dwelling Apartment
Townhouse/rowhouse Mobile home on property
Mobile home in mobile home park Modular home
55+ independent living complex Other, please specify: ________
___________________________________________________________________
D4) Is this home:
Owned (even if its still being paid for) Rented
D5) How many stairs are at the entrance of this home (inside or outside)?
Not sure None 1 3 4 or more
D6) Is your home too large or too small for your households needs?
Too large Too small The right size
D7) Are there other houses in your community that could meet your needs and
lifestyle if you were to leave your current home?
Not sure Yes, many Yes, a small amount Very few No
D7i) If you answered NO or VERY FEW, please explain why (e.g. no houses with
wheelchair ramps): ___________________________________________________
___________________________________________________________________
___________________________________________________________________
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D8) Are there other houses in your community that you could afford to buy/rent if
you were to leave or sell your current home?
Not sure Yes, many Yes, a small amount Very few No
D9) Is your home in need of any repairs?
No, only regular maintenance is needed (i.e. painting, cleaning, etc.)
Yes, minor repairs are needed (i.e. missing/loose floor tiles, defective steps, etc)
Yes, major repairs are needed (i.e. defective plumbing, structural repairs, etc.)

D10) What kind of seniors housing, if any, are you looking for: (Please check any that
apply)
Kind of Seniors Housing
Right
now?
In the next
5 years?
In the next
10 years?
Seniors market independent living units
(optional meals, and housekeeping)

Seniors subsidized independent living units
(optional meals, and housekeeping)

Seniors market supportive housing (24-hour
response, light housekeeping, meals, and
activities)

Seniors subsidized supportive housing (24-
hour response, light housekeeping, meals, and
activities)

Seniors registered assisted living units (24-
hour response, housekeeping, meals, activities,
and personal care such as grooming and
medication assistance)

Seniors Residential/Complex Care (i.e.
nursing home)

Other, please specify:

_____________________________________
_____________________________________


I am not looking for housing:


D11) How much would you be willing to pay for seniors accommodation?
$_____________ per month to rent or $_____________ purchase price
D12) How many bedrooms would you like to have in your home in the future? #____
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D13) What type of building would you prefer to live in: (Please check any that apply)
Housing Type
Right
now?
In the next
5 years?
In the next
10 years?
A single detached dwelling on a large parcel

A single detached dwelling in a pocket
neighborhood

An apartment

A townhouse/rowhouse

A modular home

A mobile home on property

A mobile home in a mobile home park

Other, please specify:



D14) In the future would you prefer to:
Rent your home Own your home (including mortgage) Either rent or own
D15) Is it important for you to live in pet-friendly housing (housing where pets are
permitted) in the future?
Not sure Yes No
D16) How do you expect your housing needs will change: (Check any that apply)
Changed need: In the next 5 yrs? In the next 10 yrs?
Require more space

Require less space

Will need a home requiring less maintenance

Will need a yard requiring less maintenance

Will require a home designed for mobility

Will be moving closer to services in Houston

Will be moving into a nearby larger centre

Will be unable to live alone due to age

Will have housing affordability issues

Other, please specify:



I do not expect my housing needs to change:

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Social Engagement, Recreation, Arts and Culture
The following questions tell us about the social, educational, recreational, arts and culture
opportunities available and needed for older adults in Houston.

E1) Are there a wide variety of social and cultural activities/events for older adults
to choose from in Houston? (Please check one)
Not sure Yes No
E2) What social and cultural activities/events are important for improving Houston
for older adults? (Check any that apply)
Live music nights/afternoons Jam sessions
Open mic nights/afternoons 65+ choir
Widow/widower support groups Games events
Coffee/Tea socials 65+ Luncheons
Art classes Music classes
Other, please specify: ______________________________________________
___________________________________________________________________
E3) Is there a diversity of sports and recreation for older adults to choose from?
Not sure Yes No
E4) What programs are needed to improve sports and recreation opportunities for
older adults in Houston? (Check any that apply)
65+ indoor walking program Pitch and putt program
65+ outdoor walking program Table Tennis
Gentle yoga Sit and Be Fit program
Chair yoga Carpet Bowling
Injury rehabilitation classes Tai Chi
Pickle Ball Badminton
65+ hiking club 65+ cycling club
65+ cross country ski program Floor curling
65+ Pilates and fitness classes Billiards programs
Drop in sports, please specify: _______________________________________
Other, please specify: ______________________________________________
__________________________________________________________________
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E5) Are there a diverse number of education programs for older adults in Houston?
Not sure Yes No
E6) What education programs are important for improving Houston for older
adults? (Check any that apply)
Older adults literacy programs Will creation workshops
Tax seminars Basic computer training
Internet use/searches courses Writing groups
Dementia care information Cooking classes
Healthy living seminars (e.g. on healthy food, etc.)
Other, please specify: ______________________________________________
________________________________________________________________
E7) Do you attend many programs, activities, or events in your community?
Yes or No
E7i) If you do NOT attend many programs, activities, or events in your
community, what are your reasons? (Check any that apply)
Nothing of interest Lack of transportation
Too much noise while out Mobility issues
Dislike being around a lot of people Cost
Scheduled at the wrong time Lack of information
Other, please specify: ____________________________________________
________________________________________________________________
E7ii) What would make you more inclined to participate in community
programs, activities, or events?
If they were offered for free If transportation was provided
If I received a personal invitation If I had someone to go with
If I learned something at the event If it was multi-cultural
If it was intergenerational Other, please specify:________
___________________________________________________________________
___________________________________________________________________


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E8) What is your preferred means of receiving communication about community
events, activities, or programs?
Email Friends or Family Newspaper
Flyers Posters Radio
Other, please specify: ____________________________________________
E9) At what location would you like to see programs for older adults delivered in the
future? (Check ONE).
Seniors centre Houston Leisure Centre Northwest Community College
Other, please specify:_______________________________________________
_______________________________________________________________________
E10) How much would you be willing to pay, per class, for recreation, sports, arts,
or culture programs in the future?
Under $5 $5 to $7 $7.01 to $10 $10.01 to $13 over $13
E11) Are you happy with currently available recreation, sports, arts, or culture
facilities for older adults in Houston?
Not sure Yes No
E11i) If NO, please explain why and/or what improvements are needed:______
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
E12) Are you happy with currently available parks and recreation areas for older
adults in Houston?
Not sure Yes No
E11i) If NO, please explain why and/or what improvements are needed:______
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
E13) Are there enough employment opportunities for older adults in Houston?
Not sure Yes No
E14) Are there enough volunteer opportunities for older adults in Houston?
Not sure Yes No
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E15) Are there enough opportunities for older adults to provide input on local
government matters?
Not sure Yes No
E16) Are older adults treated with respect in your community?
Not sure Yes No
E17) Do you feel that social exclusion is an issue for older adults in Houston?
Not sure Yes No
E18) What is the most important improvement needed to enhance community and
social engagement in Houston (e.g. a new program, more communication, a different
venue, a social issue to be addressed, etc.)?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

E19) Please check the 4 aspects of community engagement that are most important
to you (please check 4). Opportunities to:
Provide input on municipal decisions Take educational courses
Participate in local clubs/organizations Participate in outdoor recreation
Volunteer in the community Participate in indoor recreation
Engage with local youth Participate in social activities
Connect with different cultures Feel a sense of belonging
Other, please specify: __________________________________________
____________________________________________________________________
____________________________________________________________________
Community Health, Well-being, and Social Networks
In this section, we ask you about your health, and social networks. These questions create
a better understanding of your needs for support right now and in the future.

F1) In general, how is your physical health? (please check one)
Very Good Good Fair Poor Very Poor
F2) Do you have a medical condition that impacts your mobility?
Yes or No
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F3) Do you use an assistive devise?
Yes or No
F3i) If yes, please specify (check all that apply):
Manual wheelchair Walker Mobility scooter Crutches
Power wheelchair Cane Hearing aid White cane (for vision)
Other, please specify: ______________________________________________
F4) Do you have family in Houston?
Yes or No
F5) Do you have close friends in Houston?
Yes or No
F6) Do your family or friends make you want to stay in Houston?
Not sure Yes No
F7) Do you have family or friends in the area who could be thought of as a support
network (e.g. people you could turn to when help is needed)?
Not sure Yes No
F8) Are wait times to see physicians reasonable (under 7 days) in Houston?
Not sure Yes Usually Sometimes No
F9) Are primary health care services sufficient in Houston?
Not sure Yes No
F9i) If no, please explain why: _________________________________________
___________________________________________________________________
___________________________________________________________________
F10) What are the top 4 most important health services needed to improve care for
older adults in Houston? (check 4)
Nursing care Counselling services
Home care Optometrist services
Personal care Physiotherapy
Respite care Information about health services
Massage therapy Visiting service for isolated seniors
(continued on next page)

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Flu Shots Other, please specify:___________
________________________________________________________________
________________________________________________________________
F11) What are the top 4 most important community services needed in Houston?
(check 4)
House cleaning Summer yard work
Winter yard work (e.g. snow clearing) Home repair/maintenance
Help with shopping Delivery of goods/groceries
Meals-on-wheels Affordable healthy food-box
Seniors services directory Rubbish collection
Other, please specify: _____________________________________________
__________________________________________________________________
__________________________________________________________________
F12) What is the most important community or health service improvement needed
to enhance Houston for older adults?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

*Additional Information*
Is there anything you would like to add about how Houston is, or could be, meeting the
needs of older adults? (Feel free to use the back side of this page)___________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

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