Third Act Self Assessment -- Readiness for Healthy Mid-Adulthood

Third Act Self Assessment -- Readiness for Healthy Mid-Adulthood

Created by Alex Mackenzie, MFT
This is an assessment of your readiness for a healthy, successful Third Act. Your answers will provide you with feedback about areas of strength and opportunities for improvement.

We are not collecting your PHI as you take this examination, but you should be aware this site is not encrypted. Therefor your answers may be viewable as you are taking the assessment. Your specific results will only be viewable by you, however aggregate results will be sent to the owner of the site. By continuing to fill out this assessment you are consenting to this minimal risk.

The scale is 1-5 with 1 expressing strong disagreement and 5 expressing strong agreement

Please note, all the fields are required.
Physical Health

Taking care of our bodies is important both for longevity and quality of life.
1. I have a good relationship with my primary care physician and can talk with them about any concerns*

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5

1 is Disagree, 5 is Agree
2. I am confident that I can take steps necessary to positively impact my healt*

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1 is Disagree, 5 is Agree
3. I get regular physical exercise that builds my endurance, balance, strength, and flexibility*

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1 is Disagree, 5 is Agree
4. I know what my nutritional needs are, and have a plan to meet those*

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1 is Disagree, 5 is Agree
5. I have motivation to take care of my body*

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1 is Disagree, 5 is Agree
6. I sleep well and feel rested and refreshed*

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1 is Disagree, 5 is Agree
Section 1 Percentage
Core Relationships

Intimate connectedness is important for life satisfaction as well as thriving and longevity.
1. I have regular, frequent contact with the people I love*

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1 is Disagree, 5 is Agree
2. I am satisfied with the amount and kind of affection and/or sex I have*

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1 is Disagree, 5 is Agree
3. I have good, honest talks with people I am close to*

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1 is Disagree, 5 is Agree
4. I can accept people’s negative feelings or opinions about me without having to defend myself*

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1 is Disagree, 5 is Agree
5. I feel secure in the love and positive regard my loved ones have for me*

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1 is Disagree, 5 is Agree
6. I feel like I can be my real self when I am with my important people*

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1 is Disagree, 5 is Agree
7. I have nothing to hide when I’m with my important people*

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1 is Disagree, 5 is Agree
Section 2 Percentage
Financial/Social Determinants of Health

Taking care of our material needs and security is foundational for well-being and self-actualization, as well as longevity.
1. I know how much money is going out and coming in – I have a budget*

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1 is Disagree, 5 is Agree
2. I know how long my money has to last*

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1 is Disagree, 5 is Agree
3. I have a safe, clean, comfortable, pleasant place to live*

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1 is Disagree, 5 is Agree
4. I have access to transportation that I can rely on*

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1 is Disagree, 5 is Agree
5. I am monitoring my financial well-being in case I need to make changes*

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1 is Disagree, 5 is Agree
6. My “affairs” are in order*

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1 is Disagree, 5 is Agree
7. I think about money not just as a number, but in terms of the opportunities and what it can provide for me*

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1 is Disagree, 5 is Agree
8. I have self-efficacy about financial well-being – Confident that I am in charge of it*

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1 is Disagree, 5 is Agree
Section 3 Percentage
Satisfaction

This life stage is about evaluating yourself, your actions, the impacts you’ve had, and what you’ve accomplished.
1. I am satisfied with the person I am*

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1 is Disagree, 5 is Agree
2. I feel good about the way I have used my time and resources in life*

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1 is Disagree, 5 is Agree
3. I am proud of my accomplishments*

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1 is Disagree, 5 is Agree
4. I have been the kind of partner, parent, friend, student, worker, community member I wanted to be*

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1 is Disagree, 5 is Agree
5. I have done a lot of things on my bucket list*

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1 is Disagree, 5 is Agree
6. I have said the important things to the people in my life*

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1 is Disagree, 5 is Agree
7. I am proud of what my decisions and actions say about me*

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1 is Disagree, 5 is Agree
8. I can relax without being troubled with worries about what I should be doing*

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1 is Disagree, 5 is Agree
Section 4 Percentage
Intentionality

Optimally living this life stage means that you use your freedom to make thoughtful decisions about how to use your energy and resources to live the way you truly want. It means you are unafraid of acknowledging what you want and willing to act on our own behalf.
1. I place a high value on the time I have left and actively plan to make the most of it*

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5

1 is Disagree, 5 is Agree
2. I have places where I use the wisdom of my years of experience for good*

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1 is Disagree, 5 is Agree
3. I can succinctly say what my values are, and I am living and using my resources in ways that are congruent with those*

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1 is Disagree, 5 is Agree
4. My actions are based on what will be in my long term best interest, rather than on emotional impulses*

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1 is Disagree, 5 is Agree
5. I consider what I want to get out of the day and keep focused*

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1 is Disagree, 5 is Agree
6. I am already trying out some of the new activities and ways of being that I might be interested in during my third act.*

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1 is Disagree, 5 is Agree
Section 5 Percentage
Peace/Sprituality

This life stage presents an opportunity to find harmony with ourselves, our thoughts, and our sense of how we fit in the larger picture.
1. I don’t worry about much*

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1 is Disagree, 5 is Agree
2. I feel fine about taking it easy sometimes*

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1 is Disagree, 5 is Agree
3. I have ways of finding peace, whether through meditation, prayer, being in nature, or other methods; and I use them regularly*

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1 is Disagree, 5 is Agree
4. I’m not too tough on myself or others*

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1 is Disagree, 5 is Agree
5. I can accept my imperfections*

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1 is Disagree, 5 is Agree
6. My body no longer defines me. I experience something more profound and expansive about my “self”*

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1 is Disagree, 5 is Agree
7. I often feel joy from the beauty of life, relationships, experiences, nature, and my senses*

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1 is Disagree, 5 is Agree
8. My approach to life is loving and kind, and I notice that is what comes back to me*

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1 is Disagree, 5 is Agree
9. I am shifting from “what to do” to “how to be”*

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1 is Disagree, 5 is Agree
10. I notice and appreciate my wisdom and how it is becoming more fulfilling and important than performance*

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1 is Disagree, 5 is Agree
Section 6 Percentage
Legacy

Our satisfaction with how we are living life is tied to what we will be leaving behind.
1. Overall, I feel like I have contributed to the world being a better place*

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1 is Disagree, 5 is Agree
2.I have contributed to the continued wellbeing of my loved ones and/or community*

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1 is Disagree, 5 is Agree
3. The people in my life have benefitted from knowing me*

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1 is Disagree, 5 is Agree
4. I have made amends for hurt or harm I have caused, even if inadvertently*

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1 is Disagree, 5 is Agree
5. I imagine that people will talk well of me and remember me positively when I am gone*

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1 is Disagree, 5 is Agree
Section 7 Percentage
Social Connection

Humans have a deep evolutionary need to feel part of a tribe – to be recognized, to interact, to depend on one another, and feel like we matter to others and they matter to us.
1. I feel like I am part of a community*

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1 is Disagree, 5 is Agree
2. I have regular social contact*

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1 is Disagree, 5 is Agree
3. There are people I interact with in the community who greet me by name, and I do the same*

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1 is Disagree, 5 is Agree
4. If I needed help urgently, there are a few people I could call and they know they could call me.*

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1 is Disagree, 5 is Agree
5. People would notice if I went missing*

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1 is Disagree, 5 is Agree
6. I’m quick to notice when other people are happy, and when I do, it boosts my own happiness*

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1 is Disagree, 5 is Agree
7. I participate in activities that are available in my community*

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1 is Disagree, 5 is Agree
Section 8 Percentage
Active Mind

Like a muscle, your mind stays strong to the degree to which you exercise it.
1. I have activities that challenge me to think, grow, and learn*

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1 is Disagree, 5 is Agree
2. I know what’s going on in the world*

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1 is Disagree, 5 is Agree
3. I understanding that there are different kinds of intelligence, and appreciate my own type and style*

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1 is Disagree, 5 is Agree
4. I enjoy what my brain can do*

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1 is Disagree, 5 is Agree
5. I am open to “switching it up” – trying new things*

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1 is Disagree, 5 is Agree
6. I am curious about many different things*

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1 is Disagree, 5 is Agree
7. I get a kick out of challenging my own beliefs*

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1 is Disagree, 5 is Agree
8. I pursue the pleasure of learning for its own sake*

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1 is Disagree, 5 is Agree
9. I like to learn about points of view that are different from my own*

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1 is Disagree, 5 is Agree
Section 9 Percentage
Should be Empty:

Third Act Self Assessment -- Readiness for Healthy Mid-Adulthood

Physical Health

Core Relationships

Financial/Social Determinants of Health

Satisfaction

Intentionality

Peace/Sprituality

Legacy

Social Connection

Active Mind