Step 1 (of 13) 12My Health3My Home4My Transportation5My Finances6My Connections7My Safety8My Supports and Services9My Community10My Partner and I (if applicable)11My Reflection12My Action Plan13 The questions in this checklist were prepared with you in mind and aim to help you age in place. United Way and the Aga Khan Council for Canada will be able to view a copy of your summary/results, however, we do not collect any information that could identify you. If you wish to remain completely anonymous, please do not provide an email address on the last page (you may skip to the last page to print or download your summary/results). If you do provide an email address, United Way will be able to see it, however, they will not use or share it in any way. The demographic questions on this page are to assist with understanding what demographic groups are using the Toolkit.Are you completing this Toolkit for yourself or on behalf of someone else? Please selectFor MyselfOn behalf of a family memberOn behalf of someone I am a caregiver forOther (please comment):If "Other" selected: What is your age? Please select< 3031 to 4950 to 5960 to 6970 to 7475 to 7980 to 8485 to 8990 to 94>95What Province / Territory do you live in? Please selectI live outside outside of CanadaAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukonWhat is your current living situation? Please selectI live aloneI live with a spouseI live with a family memberI live with a caregiverI live in an assisted living facilityOther (please comment:)If "Other" selected: Health includes physical, emotional, cognitive, and mental well-being. Think about your state of health as it is now. What can you do now to help ensure a healthy future? Your health may change as you age, and it is important to prepare for support and services you may require in the future. Reflect on your values and wishes for your health, and discuss these with your loved ones and care providers.I can manage activities of daily living, such as cleaning my home, managing money and paying bills, shopping for groceries and planning and preparing my meals, and managing my medicines. Yes No View the following resources to learn more: Instrumental Activities of Daily Living Learn MoreI am physically active and do a variety of physical activities that I enjoy.The Canadian Physical Activity guidelines recommend 150 minutes of moderate to vigorous intensity aerobic activity per week. Yes No View the following resources to learn more: Physical Activity Guidelines for 65+ Learn More Canadian 24-Hour Movement Guidelines Learn MoreI eat a well-balanced diet including fruits, vegetables, whole grains, and protein-rich foods. Yes No View the following resources to learn more: Canada's Food Guide Learn More Dietitian of Canada: A Guide to Healthy Eating for Older Adults Learn MoreI schedule regular appointments for physical, vision, dental, and hearing check-ups. Yes No I know what screening tests, immunizations, and examinations are recommended for my age and discuss these with my health care.Some examples of screening tests to discuss with your health care provider includes those for : High blood pressure Cervical cancer Cholestoral Diabetes Breast cancer Colon cancer Osteoporosis Abdominal aortic aneurysm (enlarged blood vessel) Yes No View the following resources to learn more:Vaccination for Adults Learn More Health Check-Ups: When you need them and when you don't Learn MoreI do not smoke cigarettes. If do smoke, I have a plan to quit in the future. True False View the following resources to learn more: Quitting smoking: Provincial and territorial services Learn More 211 Learn MoreI do not consume alcohol, use illicit substances or recreational drugs. True False View the following resources to learn more: Quitting smoking: Provincial and territorial services Learn MoreIf I drink alcohol, I stay below the limits suggested for adults my age. True False Not Applicable View the following resources to learn more: Canada's Low-Risk Alcohol Drinking Guidelines Learn MoreI understand the reason I am taking medications and/or supplements and know how to take these safely.It can be helpful to keep a list of your medications including prescription, over-the-counter, and vitamins/supplements. Remember to return unused or expired medications to the pharmacy for disposal. Yes No View the following resources to learn more: Medication Use in Older Adults Learn MoreI am aware of electronic tools that will allow me to remain healthy, such as medication reminders.Ask your provider or pharmacist for electronic tools/apps that may be helpful for your specific health condition(s). Yes No I am aware of the signs and symptoms of mental health challenges and generally feel positive about my mental health. Yes No View the following resources to learn more: Here to Help BC Learn More Managing Emotions - Anxiety & Depression Learn MoreI will seek out support if I feel a worsening in my mental health. Yes No View the following resources to learn more: Canadian Mental Health Association Learn More Mental Health Support Lines for Seniors in Canada Learn MoreI keep my mind active through a variety of interests and hobbies, such as reading.Keeping our minds active reduces the risk of diseases, and promotes brain health. Consider physical activity, ongoing learning, social activities, nutritious diets, and managing stress. Yes No View the following resources to learn more: Brain-healthy Tips to Reduce your Risk of Dementia Learn More Mobility and Optimal Aging: E-Learning Learn More *Ontario Only: Senior Toronto – Lifelong Learning Learn MoreI have talked with my health care provider about my pre-existing medical condition and what services and supports I may need as I age. Yes No I am aware of my family's medical history and I have talked with my health care provider about what I can do now to maintain my health and how my care needs may change as I age. Yes No I have thought about my wishes for medical care in the event I am not able to provide consent and have communicated these wishes and my values in a legal manner, i.e. advanced directives and power of attorney.Advance Care Planning in Canada and Canadian Virtual Hospice provide resources and tools as you reflect on and speak with your loved ones and care providers about your values and wishes. You can select your province-specific resources to make your own plan. Refer to the financial section for more resources. Yes No View the following resources to learn more: Advance Care Planning in Canada Learn More Canadian Virtual Hospice Learn More The majority of older adults live in the community and want to age in place in their own home. Think about the home you live in now. Do you plan to live there when you are 70 or 80 years of age or older? Do you own or rent? If you rent, your ability to make changes to your home to support your needs may be limited. Consider what you can do to age in place as a renter or homeowner. My home is in a location where I will have access to services and amenities that are important to me, such as health care professionals, transit, family, and friends, and I will not feel isolated in my later years. Yes No View the following resources to learn more:Planning for aging in place Learn MoreI have thought about the current and future costs of staying in my home (e.g. mortgage or rent, condo fees, taxes, repairs, maintenance, insurance, etc.) and whether I can afford to live there as I age. Yes No View the following resources to learn more:Government of Canada: Budget Planner Learn MoreI can afford to pay for services (e.g. house cleaning, yard maintenance) to maintain my home if needed. Yes No View the following resources to learn more:Government of Canada: Budget Planner Learn MoreIf I find myself living alone in the future, I could manage it on my own.Consider situations such as living alone for the first time and doing tasks that someone else normally has (e.g. household tasks, financial tasks, etc.). Yes No I have spoken to my landlord or condo board to find out if changes can be made to my current home. Yes No The features in my home will adequately support my safety, mobility, and health needs over the next 15 to 20 years (e.g. entryways and doorways that can be accessed by a walker, bathroom walls that can support the installation of handrails, etc.). Yes No View the following resources to learn more:Government of Canada: Housing Options for Seniors Learn More Government of Canada: What Every Older Canadian should know about Planning for their Future Housing Needs Learn MoreIf my health changes and I require a wheelchair/mobility device, I can make necessary changes to my home (e.g. night lights, solid handrails, grab bars in the bathroom, widen doorways, ramps, walk-in tubs). Yes No View the following resources to learn more:Home Safety Tips for Seniors Learn MoreI am aware of other housing options in my community and have researched the cost and eligibility criteria if I am no longer able to remain in my current home. Yes No View the following resources to learn more:Government of Canada: Housing Options for Seniors Learn More Government of Canada: What Every Older Canadian should know about Planning for their Future Housing Needs Learn MoreI have thought about reducing my belongings and/or moving to a small home. Yes No View the following resources to learn more:Moving Seniors Safely Learn More Downsizing Your Home Learn More Parents finally downsizing? How to help with the big move — without the big costs Learn More Most older adults will live 7 to 10 years past their ability to drive safely. Think about the type(s) of transportation you use now. Do you plan to continue traveling in the same way when you are older? If I am able to continue driving, I plan to take a refresher course to maintain my skills and knowledge of the rules and regulations.In every province, you will receive a letter before your 75th and 80th birthdays that will tell you what the next steps will be. Please refer to your province’s Ministry of Transportation for the information needed to renew your licence and/or learn about educational sessions as an older adult. Yes No View the following resources to learn more: CAA: Senior Drivers Learn More Government of Canada: Driving in Canada Learn More CAA: Assess and Maintain Your Driving Skills Learn More CAA: Refresher Courses Learn More Canada Safety Council: 55 Alive Driver Refresher CourseLearn MoreI am aware of, and have access to, alternative means of transportation in the event that my health and/or vision declines, and I have to give up driving. Yes No View the following resources to learn more:CAA: Alternatives to Driving Learn More 211 Learn More I have thought about what it costs to run and maintain my own vehicle compared to the cost of other means of transportation. Yes No View the following resources to learn more:CAA: Driving Cost Calculator Learn More CAA: Driving Cost Calculator Learn More CAA: Canadians Unclear About the True Cost of Owning a Vehicle Learn More Government of Canada: Canadian Retirement Income Calculator Learn MoreI plan to take up or increase walking or cycling as a healthy and active form of transportation. Yes No View the following resources to learn more:Canadian 24-Hour Movement Guidelines for Adults ages 65 years and older Learn More Physical Activity Tips for Older Adults Learn More Safe Winter Walking Learn More Physical Activity Toolkit for Older Adults Learn MoreI am aware of delivery and/or online shopping services I can use if I am not able to travel.Check with your nearest grocery store if they offer delivery service and how to access these services. Yes No View the following resources to learn more: 211 Learn MoreI have thought about my future transportation needs and would be willing to relocate so I can continue to have access to the services I need. Yes No Financial planning leads to greater well-being regardless of household income. Think about the state of your finances and your source(s) of income now. What will they be like when you are 70 or 80 years of age or older? The need for help in making legal and financial decisions can arise at any time and for a wide range of reasons. If you get ill, have an accident or even if you are just away for a period of time, having someone you trust who is ready and able to help you can save time and trouble. Check with your provincial or territorial government, or speak to a lawyer to find out what laws are in place to allow someone else to have legal authority to manage your finances for you. I have researched the cost of my retirement based on the lifestyle I wish to maintain. Yes No View the following resources to learn more: Government of Canada: Retirement Planning Learn More Government of Canada: Budget Planner Learn More Government of Canada: Your Retirement Financial Checklist Learn More Government of Canada: What Every Older Canadian Should Know about Financial Planning Learn More I have researched the income sources such as benefits and supplements available to me at retirement. Yes No View the following resources to learn more: Government of Canada: Canadian Retirement Income Calculator Learn More Government of Canada: What Every Older Canadian should know about Income and Benefits from Government Programs Learn More I will be able to live comfortably within my retirement income.If your income is low and you are receiving the basic Old Age Security pension, you may also be eligible for the Guaranteed Income Supplement. Spouses and common-law partners of Old Age Security pensioners who are receiving the Guaranteed Income Supplement may receive the Allowance between the ages of 60 and 64. Similarly, widows and widowers in this age group who have low incomes may also receive the Allowance for survivors. You must apply for the Guaranteed Income Supplement or the Allowance. Yes No View the following resources to learn more: Government of Canada: Programs and Services for Seniors Learn More Government of Canada: Benefits Finder Learn MoreI have money set aside for unexpected expenses such as health-related supports and major home repairs. Yes No I have someone I trust that I can consult for financial advice when needed. Yes No I have thought about the kinds of supports and services I may need to purchase as I age (e.g. cleaning, shopping, yard maintenance, and personal care support). Yes No View the following resources to learn more:211 Learn MoreI know how much money is required to sustain the lifestyle I want in the future. Yes No View the following resources to learn more:Government of Canada: Budget Planner Learn More Government of Canada: Canadian Retirement Income Calculator Learn MoreI plan to retire debt-free (e.g. pay off mortgage and credit cards). Yes No I know of ways I could transition to retirement that can maintain or increase my income (e.g. work part-time, become a consultant, retire early and try a new career, or start a business on the side and keep it going post-retirement). Yes No View the following resources to learn more:How to Transition to Retirement Learn More Back to Business: 10 Ways to Supplement Your Income in RetirementLearn More I plan to have my retirement income based on more than one source (e.g. personal savings, Canada Pension Plan (CPP), Registered Retirement Savings Plan (RRSP), Old Age Security (OAS), other pensions, investments, and/or employment income). Yes No If my circumstances change, I could manage financially. Yes No View the following resources to learn more:Government of Canada: Canadian Retirement Income Calculator Learn More Government of Canada: Budget Planner Learn More I have a plan for who will be responsible for my financial affairs if I am not able to look after them myself (e.g. an enduring power of attorney) and have communicated my plan to those involved. Yes No View the following resources to learn more:Government of Canada: What Every Older Canadian Should Know About Power of Attorney (for Financial Matters and Property) and Joint Bank Accounts Learn More I have a will and my loved ones know where all my important documents and what my important passwords are (e.g. will and insurance). Yes No View the following resources to learn more: Wills and estates law in Canada: the basics Learn More Estate Planning in Canada: A Checklist Learn More How important are wills and estate planning for Canadians? Learn More Government of Canada: What Every Older Canadian Should Know About Having a Will and Making Funeral Plans Learn More Social networks of friends or family are known to make an important contribution to general well-being and quality of life. Volunteering helps to keep people connected with their community, is associated with longevity, and increases happiness and satisfaction in older age. Think about your social life as it is now. What will it look like when you are older? I maintain good relationships with my family members. Yes No I have friends/family I can rely on for support if needed. Yes No I have someone I can talk to when I need to do so. Yes No View the following resources to learn more:Mental Health Support Lines for Seniors in Canada Learn More Talk2NICE Learn More Suicide Crisis Help Line Learn MoreI have friends I enjoy spending time with, and I nurture the friendships I have. Yes No View the following resources to learn more:Friendships: Enrich Your Life and Improve Your Health Learn More I have friends of different ages, some of whom are younger than I am. Yes No I enjoy connecting with people through my work and plan to work full - or part-time for as long as I am able and I intend to stay connected with them after retirement. Yes No I have developed social networks outside of my work. Yes No I have considered how I would like to stay connected with my community.Examples of ways to stay connected with your community can include participating in programming at your local community centre or library, taking online courses, or participating in group recreational activities. Yes No View the following resources to learn more: Tackling a Silent Beast: Strategies for Reducing Loneliness and Social Isolation Learn More Cyber-Seniors Learn More Connected Canadians Learn More Men’s Sheds Canada Learn MoreI may explore volunteering as a way to contribute to my community and provide social connections. Yes No View the following resources to learn more:Volunteer Canada Learn More Government of Canada: Volunteer Learn More I have explored different ways of connecting with friends and family, such as Skype, FaceTime, or social media. Yes No View the following resources to learn more:Staying Connected While Practicing Social and Physical Distancing Learn More Cyber-Seniors Learn More Connected Canadians Learn More Think about some of the things you do now to protect yourself and reduce the potential for various types of injury, harm, or abuse. Will you have other safety concerns when you are older? What could you do to reduce the risk of these occurring?I feel safe in my home, neighbourhood, and community and know where to report concerns and how to make my community safer. Yes No View the following resources to learn more:Government of Canada: The Safe Living Guide - A Guide to Home Safety for Seniors Learn More I know how to protect myself from fraud, abuse, and neglect (including emotional, physical, digital, and financial abuse and neglect) and know where to go for support. Yes No View the following resources to learn more:Government of Canada: What Every Older Canadian Should Know About Fraud and Scams Learn MoreI understand the risk of falls as I age and know what to do to decrease this risk. Yes No View the following resources to learn more:Government of Canada: You CAN Prevent Falls Learn More Falls in Seniors Learn MoreI keep my home uncluttered by removing scatter rugs and other tripping hazards. Yes No View the following resources to learn more:Government of Canada: You CAN Prevent Falls Learn MoreI keep my walkways clear of snow and ice. Yes No I have considered using a home monitoring system, a personal emergency response system, or a fall detection system to help keep me safe at home. Yes No View the following resources to learn more:How to Choose a Medical Alert System Learn More I know some people in my neighbourhood whom I could call on in an emergency. Yes No I have plans and preparations in place in case of an emergency such as a power outage, extreme weather event, flood, fire, earthquake, or other natural or human-caused disasters. Yes No View the following resources to learn more:Government of Canada: Get Prepared – Your Emergency Preparedness Guide Learn More Reflect on the care you and your loved ones may need in the future. Consider what services are available through various avenues such as the government, family, friends, and within the community. I have researched the services and supports I may need to remain in my home in the future. Yes No View the following resources to learn more:211 Learn More Government of Canada: Videos – Planning for Aging in Place Learn MoreI know where to go to find information if I have questions about my care needs or community services, including faith-based community services. Yes No View the following resources to learn more:Government of Canada: Programs and Services for Seniors Learn More 211 Learn More Government of Canada: Federal/Provincial/Territorial Ministers Responsible for Seniors Forum (Resources for Seniors and Caregivers by Province) Learn More I have discussed with family and friends about the help I may need in the future, and we have agreed on a plan for the future. Yes No View the following resources to learn more:Instrumental Activities of Daily Living Learn MoreAs a caregiver, or if I become a caregiver in the future, I am aware of external resources to give me, as a caregiver, some relief (respite) from this role (e.g. adult day programs, overnight care, etc.) Yes No View the following resources to learn more:211 Learn More Canadian Red Cross: Adult Day Program Learn More Government of Canada: Federal/Provincial/Territorial Ministers Responsible for Seniors Forum (Resources for Seniors and Caregivers by Province) Learn More When Dementia is in the House: Advice for Parents Learn More McGill Dementia Education Guide Learn MoreIf I am a caregiver, I have a plan for self-care to help maintain my own health and well-being. Yes No View the following resources to learn more:Government of Canada: Balancing Work and Caregiving Responsibilities Learn More Caregiver Self-Care Learn More Dementia Education for Care Partners Learn MoreI have thought of using devices such as a video monitoring system, medication reminders, and personal response services to help take care of myself or a loved one at home. Yes No View the following resources to learn more:211 Learn More How to Choose a Medical Alert System Learn More Seniors Stay Home Longer in the US with Simple Fixes Learn More CBC: Use of Surveillance Tech to Monitor Seniors at Home on the Rise Learn More CBC: Technology that Helps Seniors Remain Independent Learn More In an age-friendly community, policies, services and structures related to the physical and social environment are designed to support and enable older people to "age actively" - that is, to live in security, enjoy good health and continue to participate fully in society. Think about the community you live in now. How close are you to a grocery store, a drugstore, a coffee shop, the library or a restaurant? How much farther do you travel to reach medical offices, a dentist or a hospital? And how far do you travel to visit family and friends? What features are important to have in your community when you are older, and will your current community meet your future needs?I am comfortable getting around in my community and will continue to be comfortable in the future. Yes No View the following resources to learn more:211 Learn More I know what programs and services (e.g. shopping, personal services, health and support services, and recreation programs) are available in my community. Yes No View the following resources to learn more: 211 Learn More Government of Canada: Federal/Provincial/Territorial Ministers Responsible for Seniors (Resources for Seniors and Caregivers by Province) Learn MoreThere are activities in my community that interest me, and I know how to find out more about them.Services include those that may be available in your community, grocery deliver, pharmacy delivery, library, community social services, or applications that deliver meals. Yes No View the following resources to learn more: 211 Learn More Government of Canada: Federal/Provincial/Territorial Ministers Responsible for Seniors (Resources for Seniors and Caregivers by Province) Learn MoreI have considered whether I need to move to another community that is better designed to help older adults to live safely, enjoy good health, and stay involved. Yes No View the following resources to learn more:Government of Canada: Age-Friendly Communities Learn MoreI am able to access my place of worship as frequently as I like to. Yes No I know my neighbours and feel welcome in my community. Yes No Your partner will play a critical role in your later years and will likely become a more central part of your life. Scroll down to move to the next section if this is not applicable. Think about your relationship with your partner as it is now. What changes might you anticipate as you age and your needs change? My partner and I have discussed our plans for old age and aging in place. Yes No My partner and I have shared our plans for what we want to be able to do financially. Yes No My partner and I have discussed when we plan to retire. Yes No My partner and I have shared our plans for what options we may explore to work part-time or in a new job. Yes No View the following resources to learn more:Canada Job Bank Learn More Canada Job Bank (filtered for Seniors) Learn MoreMy partner and I have shared our plans for what we will do with our time.Have you considered exploring hobbies, community centres, volunteering, libraries, etc? Yes No View the following resources to learn more:211 Learn More Volunteer Centre Directory Learn MoreMy partner and I have shared our plans for what activities we can do together and separately. Yes No View the following resources to learn more:Men’s Sheds Canada Learn MoreMy partner and I have shared our plans for how aging or changing needs could affect our relationship. Yes No My partner and I have shared our plans for where we want to live. Yes No My partner and I nurture our relationship, and if we face any challenges, we know how to access supports. Yes No View the following resources to learn more:211 Learn More What do you need to do to be better prepared to age in place? Use this section of the tool as a mini-planning guide to identify some things you can work on. You can review the resources suggested to help you decide the steps you can take now and later to help support your plans for aging in place, thus giving you more control over your future. My HealthAs you work through this section, reflect on your personal health goals and what changes you can make or actions you need to take to reach those goals. My HomeWhen completing this section, reflect on what you value in your home environment, and what kind of support you or your loved ones would benefit from in the long run. You may want to think about making changes to your home or consider having an alternative housing plan if that becomes necessary. My TransportationReflect on your current transportation needs and methods, while considering how this may change in the future and what services/options may be available to you. My FinancesAs you reflect, consider your current financial situation and how much you may need as you plan to age in place. Consider planning for anticipated and unanticipated expenses and seeking advice from a financial planner. You may also want to reflect on who would make decisions on your behalf in the event you are unable to make decisions for yourself. My ConnectionsReflect on what activities and relationships make you feel connected to your loved ones and your community. Think about ways you would like to remain connected as you age in place. My SafetyAs you reflect on how you feel in your home and social environment, you may want to consider how safely you are able to navigate in your home and in your neighbourhood. You may also consider having an emergency preparedness kit that is easily accessible and regularly maintained. My Supports and ServicesReflect on the care you and your loved ones may need in the future. Consider what services are available through various avenues such as the government, family, friends, and within the community. My CommunityReflect on how and what community means to you. What activities, individuals, and places bring you joy and contribute to your overall wellbeing? My Partner and I (if applicable)Reflect on your relationship with your partner, and what you value within this relationship. Consider how you can continue to build and strengthen this relationship as you age together. Use this section to create your personal plan of action. These are the things you can do now and in the future to be better prepared for your later years. Write down one action for each area that you could work on now, and another to work on later. As you plan, remember to incorporate the 9 key themes from the checklist: My Health My Home My Transportation My Finances My Connections My Safety My Supports and Services My Community My Partner and IActions I can take nowActions I will take in the futureFor example, within the next year Would you like to be emailed a copy of your checklist Summary? Note: This is not required. You can complete the checklist and download your Summary (responses and suggested resources) on the next page. If you do provide an email address, United Way will be able to see it, however, will not use or share it in any way. Yes, I want to be emailed. No, I will review/download on the next page. Email PhoneThis field is for validation purposes and should be left unchanged.
