MUNICIPALITY FRIEND OF SENIORS Survey In which municipality do you live? Question Title * 1. In which municipality do you live? Bedford Pike River Stanbridge East Canton de Bedford Saint-Armand Stanbridge Station Notre-Dame-de-Stanbridge Saint-Ignace-de-Stanbridge OK Gender Question Title * 2. Gender A man A woman I will not answer OK You live ... Question Title * 3. You live ... Alone With a spouse With a member of my family With a person that is not my spouse OK Your age group is : Question Title * 4. Your age group is : Less than 50 50-54 55-59 60-64 65-69 70-74 75-79 80 and over OK Do you feel Good at home ? Question Title * 5. Do you feel Good at home ? Not at all A little Enough Very good OK Name 3 measures that appear the most important to live a home as long as possible : Question Title * 6. Name 3 measures that appear the most important to live a home as long as possible : Have help to do housework Have help to do the shopping Have help to do the exterior maintenance Have access to health care in the vicinity Have access to transport for my appointements or activities Have support to care for my sick spouse Have frequent contact with people of all ages Have psychological help Other : OK If you or your spouse's health forced you to move, where would you hope to live? Question Title * 7. If you or your spouse's health forced you to move, where would you hope to live? Bigenerationnal house Retirement home with services Non-profit dwelling with services (ex. Villas des Rivières) Dwelling coop with services Condo Apartment near services With a member of my family The nearest possible to where I live now In a town, even if far from where I live now Other OK In your present home, do you feel safe facing the following dangers Question Title * 8. In your present home, do you feel safe facing the following dangers Not secure at all Little Secure enough Very secure fire fire Not secure at all fire Little fire Secure enough fire Very secure theft theft Not secure at all theft Little theft Secure enough theft Very secure vandalism vandalism Not secure at all vandalism Little vandalism Secure enough vandalism Very secure fraud fraud Not secure at all fraud Little fraud Secure enough fraud Very secure flooding flooding Not secure at all flooding Little flooding Secure enough flooding Very secure great heat great heat Not secure at all great heat Little great heat Secure enough great heat Very secure great cold great cold Not secure at all great cold Little great cold Secure enough great cold Very secure intimidation intimidation Not secure at all intimidation Little intimidation Secure enough intimidation Very secure Other OK MUTUAL AND INTERGENERATIONAL CONNECTIONSIn the last year have you used or participated at: Question Title * 9. MUTUAL AND INTERGENERATIONAL CONNECTIONSIn the last year have you used or participated at: Never 2-3 times/year Every month Every week Library Library Never Library 2-3 times/year Library Every month Library Every week Petanque game Petanque game Never Petanque game 2-3 times/year Petanque game Every month Petanque game Every week Shuffleboard Shuffleboard Never Shuffleboard 2-3 times/year Shuffleboard Every month Shuffleboard Every week Arena Arena Never Arena 2-3 times/year Arena Every month Arena Every week Community center Community center Never Community center 2-3 times/year Community center Every month Community center Every week Group outings outside of area Group outings outside of area Never Group outings outside of area 2-3 times/year Group outings outside of area Every month Group outings outside of area Every week Municipal festivities (Canada Day, Christmas, Festival, etc.) Municipal festivities (Canada Day, Christmas, Festival, etc.) Never Municipal festivities (Canada Day, Christmas, Festival, etc.) 2-3 times/year Municipal festivities (Canada Day, Christmas, Festival, etc.) Every month Municipal festivities (Canada Day, Christmas, Festival, etc.) Every week Internet access center Internet access center Never Internet access center 2-3 times/year Internet access center Every month Internet access center Every week Other OK In the last year, did you do any volunteering Question Title * 10. In the last year, did you do any volunteering Never 2-3 times/year Every month Every week For other seniors For other seniors Never For other seniors 2-3 times/year For other seniors Every month For other seniors Every week With young families With young families Never With young families 2-3 times/year With young families Every month With young families Every week With a local organization With a local organization Never With a local organization 2-3 times/year With a local organization Every month With a local organization Every week With a community organization (Popote, CABBE, etc.) With a community organization (Popote, CABBE, etc.) Never With a community organization (Popote, CABBE, etc.) 2-3 times/year With a community organization (Popote, CABBE, etc.) Every month With a community organization (Popote, CABBE, etc.) Every week With members of your family With members of your family Never With members of your family 2-3 times/year With members of your family Every month With members of your family Every week Other OK During the next year, would you like to volunteer Question Title * 11. During the next year, would you like to volunteer Never 2-3 times/year Every month Every week For other seniors For other seniors Never For other seniors 2-3 times/year For other seniors Every month For other seniors Every week With young families With young families Never With young families 2-3 times/year With young families Every month With young families Every week With a local organization With a local organization Never With a local organization 2-3 times/year With a local organization Every month With a local organization Every week With a community organization With a community organization Never With a community organization 2-3 times/year With a community organization Every month With a community organization Every week With members of your family With members of your family Never With members of your family 2-3 times/year With members of your family Every month With members of your family Every week Other OK WORK AND RETIREMENTIf you are retired...If you had the possibility to return to the work force, would you be interested in Question Title * 12. WORK AND RETIREMENTIf you are retired...If you had the possibility to return to the work force, would you be interested in Not at all Maybe A lot Part time job (less than 20hrs./week) Part time job (less than 20hrs./week) Not at all Part time job (less than 20hrs./week) Maybe Part time job (less than 20hrs./week) A lot Full time job Full time job Not at all Full time job Maybe Full time job A lot Occasional job (less than 6 months/year) Occasional job (less than 6 months/year) Not at all Occasional job (less than 6 months/year) Maybe Occasional job (less than 6 months/year) A lot Other OK If you are still working...If your job or your actual employer would allow, would you be interested in Question Title * 13. If you are still working...If your job or your actual employer would allow, would you be interested in Not at all Maybe A lot Part time job (less than 20 hrs/week) Part time job (less than 20 hrs/week) Not at all Part time job (less than 20 hrs/week) Maybe Part time job (less than 20 hrs/week) A lot Continue to work full time Continue to work full time Not at all Continue to work full time Maybe Continue to work full time A lot Occasional job (less than 6 months/year) Occasional job (less than 6 months/year) Not at all Occasional job (less than 6 months/year) Maybe Occasional job (less than 6 months/year) A lot Change jobs Change jobs Not at all Change jobs Maybe Change jobs A lot Other OK If you are a farmer or if you know some farmer...Which of the following statements corresponds the best to the current concerns of people in agriculture Question Title * 14. If you are a farmer or if you know some farmer...Which of the following statements corresponds the best to the current concerns of people in agriculture I am happy to be able to continue to work I would like to work less hours I am awaiting on the next generation of farmers in order to be able to stop working I would like to sell my farm and go live in the village/town I would like to be able to change my situation, but I cannot see a way out Other OK HEALTHI am well informed on the health care offered in Bedford Question Title * 15. HEALTHI am well informed on the health care offered in Bedford Not at all A little Well-passably Sufficiently Other OK I need to go out of Bedford, but in Brome-Missisquoi to get health care Question Title * 16. I need to go out of Bedford, but in Brome-Missisquoi to get health care Never Rarely Occasionaly Regularly Other OK I have problems with transport to receive health care Question Title * 17. I have problems with transport to receive health care Never Rarely Occasionaly Regularly OK I am satisfied with the health care offered in Bedford Question Title * 18. I am satisfied with the health care offered in Bedford Not at all A little Satisfactory Very satisfactory Other OK I am satisfied with the health care offered in the Brome-Missisquoi territory Question Title * 19. I am satisfied with the health care offered in the Brome-Missisquoi territory Not at all A little Satisfactory Very satisfactory Other OK I receive support to take care of a person of my entourage Question Title * 20. I receive support to take care of a person of my entourage Not at all Very little Satisfactory Does not apply OK If so, I receive this support from Question Title * 21. If so, I receive this support from Health services Community organization Family OK Suiv.