Age:

Gender:

Education level:

Occupation:

Family income level:

Instructions: Please place answer the following questions about yourself by placing an X on the line above the choice that best
represents your experience.

On a typical day, how many individuals over the age of 65 do you communicate with?

____ ____ ____ ____ ____

0 1 2-3 4-7 8+

How much time did you spend communicating with individuals over the age of 65 when growing up (e.g. grandparents)?

How many individuals over the age of 65 have you provided regular assistance to help them with their daily activities?

________ ________ ________ ________ ________

None Very little Some Quite a bit A lot

AAS
-4 -3 -2 -1 0 1 2 3 4

Strongly Disagree Somewhat Disagree Neither Somewhat Agree Strongly Agree

I enjoy being around old people.

____ ____ ____ ____ ____ ____ ____ ____ ____

-4 -3 -2 -1 0 1 2 3 4

I like to go visit my older relatives.

____ ____ ____ ____ ____ ____ ____ ____ ____

-4 -3 -2 -1 0 1 2 3 4

1. I have never lied about my age in order to appear younger.

2. I fear it will be very hard for me to find contentment in old age.
3. The older I become, the more I worry about my health.
4. I will have plenty to occupy my time when I am old.
5. I get nervous when I think about someone else making decisions for me when I am old.
6. It doesn’t bother me at all to imagine myself as being old.
7. I enjoy talking with old people.
8. I expect to feel good about life when I am old.
9. I have never dreaded the day I would look in the mirror and see gray hairs.
10. I feel very comfortable when I am around an old person.
11. I worry that people will ignore me when I am old.
12. I have never dreaded looking old.
13. I believe that I will still be able to do most things for myself when I am old.
14. I am afraid that there will be no meaning in life when I am old.
15. I expect to feel good about myself when I am old.
16. I enjoy doing things for old people.
17. When I look in the mirror, it bothers me to see how my looks have changed with age.

FSA
1. Many old people are stingy and hoard their money and possessions.

____ ____ ____ ____ ____ ____ ____ ____ ____

-4 -3 -2 -1 0 1 2 3 4

2. Many old people are not interested in making new friends, preferring instead the circle of friends they have had for years.
3. Many old people just live in the past.
4. Most old people should not be trusted to take care of infants.
5. Many old people are happiest when they are with people their own age.
6. Most old people would be considered to have poor personal hygiene.
7. Most old people can be irritating because they tell the same stories over and over again.
8. Old people complain more than other people do.
9. I would prefer not to go to an open house at a senior’s club, if invited.
10. Teenage suicide is more tragic than suicide among the old.
11. I sometimes avoid eye contact with old people when I see them.
12. I don’t like it when old people try to make conversation with me.
13. Complex and interesting conversation cannot be expected from most old people.
14. Feeling depressed when around old people is probably a common feeling.
15. Old people should find friends their own age.
16. Old people should feel welcome at the social gatherings of young people.
17. Old people don’t really need to use our community sports facilities.
18. It is best that old people live where they don’t bother anyone.
19. The company of most old people is quite enjoyable.
20. It is sad to hear about the plight of the old in our society these days.
21. Old people should be encouraged to speak out politically.
22. Most old people are interesting, individualistic people.
23. I personally would not want to spend much time with an old person.

OP
1. It would probably be better if most old people lived in residential units with people of their own age.
____ ____ ____ ____ ____ ____ ____ ____ ____

-4 -3 -2 -1 0 1 2 3 4
2. There is something different about most old people; it’s hard to figure out what makes them tick.
3. Most old people get set in their ways and are unable to change.
4. Most old people would prefer to quit work as soon as pensions or their children can support them.
5. Most old people tend to let their homes become shabby and unattractive.
6. It is foolish to claim that wisdom comes with old age.
7. Old people have too much power in business and politics.
8. Most old people make one feel ill at ease.
9. Most old people bore others by their insistence on talking about the “good old days.”
10. Most old people spend too much time prying into the affairs of others and giving unsought advice.
11. If old people expect to be liked, their first step is to try to get rid of their irritating faults.
12. In order to maintain a nice residential neighborhood, it would be best if too many old people did not live in it.
13. There are a few exceptions, but in general most old people are pretty much alike.
14. Most old people should be more concerned with their personal appearance; they’re too untidy.
15. Most old people are irritable, grouchy, and unpleasant.
16. Most old people are constantly complaining about the behavior of the younger generation.
17. Most old people make excessive demands for love and reassurance.