senior well being

What is your age

60-65

66-70

71 and up

How often does family or friend visit you?

Weekly

Biweekly

Monthly

Never

Do you need assistance with food

Yes, need someone to cook

Yes, need someone to help feed me

No, can feed myself

Do you need assistance with getting from one place to the next.

Yes, need a walker

Yes, shortness of breath

Yes, due to pain

No, get around fine

Do you need help with keeping your home clean

Yes

No

What do you need to help you live more comfortable

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