Ageism in Health Care 10 question survey

Survey responses are anonymous and secure. If you want to provide specific information in question 10, we will be able to use it in a general sense.


A red asterisk (*) indicates required questions.

  1. Gender*
    male
    female


  1. How old are you?*


  1. Have insurance companies or Medicare denied or delayed your health care?*
    No
    Yes
    More than once.


  1. Do you live in Western Colorado?*
    Yes
    No


  1. Increased pain and depression are inevitable for people over 55.
    strongly disagree
    disagree
    no opinion
    agree
    strongly agree


  1. Social isolation, decreased thinking ability, function, energy and enjoyment in life are inevitable for people over 55.
    strongly disagree
    disagree
    no opinion
    agree
    strongly agree


  1. Have you been talked down to or had a health care provider use "elderspeak” (speaking slowly, more loudly with repetition and a simpler vocabulary) structure. to by a health care provider? (doctor, nurse, pharmacist, office personnel?)
    Yes
    No


  1. I personally know of other adults 55 years of age or older who reported age discrimination in health care.
    No
    I know of 1 other adult
    I know of more than one other adult.


  1. I feel like health care providers listen to me and take the steps needed to get me the health care I need.
    strongly disagree
    disagree
    some do and some don't
    agree
    strongly agree
    no opinion


  1. What else would you like to share anonymously about age and health care?