GERON 302/PSYC 374 – PSYCHOLOGY OF AGING
SUCCESSFUL AGING INTERVIEW FORMAT
Subject of Interview:
Name : (first name only or pseudonym)
Age: Sex: Ethnicity:
A. Family
Married? How long?
Single?
Widowed? How long?
Divorced? How long?
Children? How many? All living?
Grandchildren? How many?
Great grandchildren? How many?
How many children and/or grandchildren live close enough to visit easily?
Sisters or brothers? How many living? How many can visit easily?
How many family members keep in close touch?
How frequently to you see your family?
Are you still consulted in family decisions?
How do you think having a close family and close friends affects having a long life?
B. Health
What medicine do you take every day? Prescription? Over-the-counter?
Do you take vitamins and/or other food supplements? Which ones?
How often do you see a doctor or other health practitioner? How long since your last complete physical?
When was last hospitalization? For what?
What chronic health problems do you have?
What adjustments have you had to make to cope with chronic problems?
Do you believe you can personally control your health to a large extent?
How?
How often do you get your heart beating hard by exercising, sports, dancing, or some kind of hard work?
How long have you been doing this activity?
Which of these foods are a daily part of your meals?
Vegetables Dairy foods
Fruits Fish
Grains Fowl
Red Meat “Fast” food
“Junk” food
What special dietary requirements or habits do you have?
Alcohol consumption? How often? What type?
Smoking? How often? How long?
Alternative healing methods used?
Relaxation Biofeedback
Massage Visualization
Acupuncture Acupressure
Are you able to perform daily physical tasks without strain or uncomfortableness? How do you cope?
At what age did your father die? Mother?
How would you rate your overall health?
Excellent Fair
Good Poor
Average
What advice would you give others on staying healthy in their later years?
C. Living Arrangements
How long have you lived in this area? Where else have you lived?
Own home or apartment?
Who shares this with you? What is their relationship to you?
Live in someone else’s home? Relationship to you?
How do you feel about your living arrangements?
D. Social Contacts
Do you enjoy being involved with people? Prefer to be alone?
Are you as socially active now as you were before you reached 70?
How has your social live changed in the past 10 years?
Do you see people weekly, other than those you live with?
Do you feel your life is important to other people?
What types of social activities do you participate in regularly?
Educational Mental
Physical Creative
Religious Other
E. Personal Beliefs
Attend church or other worship service? Pray?
Would you describe yourself as basically an optimist or pessimist?
Do you feel you have achieved your major goals or plans in life? What are these?
Are you still working on plans and goals?
Do you feel basically responsible for how your life has gone? If not, who was?
Have you had a “life well spent” without too many regrets?
Have you thought about death? Talked with your family about your death? If so, who? If not, why?
F. Personal
Do you care for a pet? What kind?
Do you tend a garden or plants?
Do you make your own decisions about your daily affairs? If not, who does?
Are you relatively secure financially?
Do you feel you live comfortably?
Do you have adequate transportation? What kind?
Do you worry about crime? What type of crime? How do you protect yourself?
Do you feel your life is still filled with interesting things?
Do you participate in activities just because you enjoy them? What type do you enjoy most?
Do you have at least one friend or family member to whom you feel very close? Do you see this person frequently?
Are you happy at this time of life?
Have you achieved most of what you really wanted in life?
Are you satisfied with your life so far?
If you could go back and change something in your life, what would it be?
Why?
Do you feel you are aging successfully?
What advice do you have for others so that they might age successfully?
What advice do you have for young people today?
Do you have any other comments or thoughts you would like to share?