Senior Living Questionnaire




This senior living questionnaire is to be used in conjunction with Independent Living Aids in giving assistance in visualizing how you want your life to be, and your decisions about your future in independent senior living.


My suggestion would be to read that page first, come here and answer the questions, then return to the former page to finish this segment.


Nothing is etched in stone here. There are no right or wrong answers, just a format to get you thinking about how you can make all things better for you. Use this Senior Living Questionnaire to assist you in your plans.


  1. If you could go back to a simpler, quieter, time in your life, where would you go? _____________________
  2. What will you do there? _______________________
  3. If you could do anything you wanted to do, it would be _________.
  4. If money were no object, you would ______________.
  5. If money were no object, you would live __________________.
  6. The thing you love to do best is _________________.
  7. The thing you dislike most about your life is_________________.
  8. Remember back when ______________ when you loved to ___________.
  9. Wouldn't it be wonderful if ____________________.
  10. Have you ever wished that _______________________?
  11. ____________________ is so much fun!
  12. Who can/can't you live with? ___________________
  13. Who can/can't you live without? _____________________
  14. If you could fly, what would you see first? _________________
  15. Would you have a dinner party for 50 people? ________________
  16. Who would be your guests? _____________________
  17. Who would be your guest of honor? __________________
  18. What can't you let go of that you can't change? ______________
  19. What can you change that you can't let go of? ________________
  20. What is the think you like best about other people? _____________
  21. What is the thing you dislike most in other people? _____________


On the following pages, we will walk you through a few exercises to assist you as senior retirement living aids. You can view each page of thought provoking ideas below:

Or Return To The Home PageSeniors Live it Up

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