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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
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I consent to the sharing of my consumer health data with qualified home care agencies.*
*If I am consenting on behalf of someone else, I have the proper authorization to do so. By clicking Get My Results, you agree to our Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our Terms of Use. for information about our privacy practices.
Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
My father lost an eye in childhood. The only activity he had trouble with is threading a needle. So don't have your guy take up needle work! Otherwise don't restrict his activities because of vision issues unless it is clear it causing a problem.
My husband had dementia and loved to read. He continued this activity throughout most of 10 years he had the disease. He liked watching tv, but complicated plots and commercial interruptions were frustrating. I got videos of some shows he used to watch. No commercials to interrupt the flow and even shows with somewhat complicated plots were familiar enough for him to follow. He also liked nature videos, especially of the national parks.
I have a big bag of private papers to shred now and that reminds me that both my mother (with dementia) and my husband loved this activity so much I often included junk mail to extend their time at it.
Both my mother and husband really liked folding washcloths -- lots of different colors and patterns and textures. I even brought a basket of them to the nursing home for Mom.
Sorting seems to be a pleasant activity for folks with dementia. My mom loved to match up socks. That wasn't as successful for my husband since his socks were mostly the same and he was colorblind.
It is always best if the activity seems meaningful. Mother sorted beads by color "for the craft ladies." Husband sorted stacks of magazines by date.
Many people in the nursing home liked doing jigsaw puzzles. Some colored. My mother could still pay cribbage to nearly the end, and keep that complicated score I never can master. We also played simple children's card games with her. I played a board game with my husband.
Carrying forward a former hobby or activity in a modified form often works. Gardeners may like tending plants on the windowsill. My husband golfed and we found a league run by a rehab center for people with handicaps. I've heard of other golfers being happy just to go to a putting green.
Mother continued to do crosswords (large print and easy) until her hands were too shaky. More than one person in her nursing home seemed absolutely addicted to word-find puzzles.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
My husband had dementia and loved to read. He continued this activity throughout most of 10 years he had the disease. He liked watching tv, but complicated plots and commercial interruptions were frustrating. I got videos of some shows he used to watch. No commercials to interrupt the flow and even shows with somewhat complicated plots were familiar enough for him to follow. He also liked nature videos, especially of the national parks.
I have a big bag of private papers to shred now and that reminds me that both my mother (with dementia) and my husband loved this activity so much I often included junk mail to extend their time at it.
Both my mother and husband really liked folding washcloths -- lots of different colors and patterns and textures. I even brought a basket of them to the nursing home for Mom.
Sorting seems to be a pleasant activity for folks with dementia. My mom loved to match up socks. That wasn't as successful for my husband since his socks were mostly the same and he was colorblind.
It is always best if the activity seems meaningful. Mother sorted beads by color "for the craft ladies." Husband sorted stacks of magazines by date.
Many people in the nursing home liked doing jigsaw puzzles. Some colored. My mother could still pay cribbage to nearly the end, and keep that complicated score I never can master. We also played simple children's card games with her. I played a board game with my husband.
Carrying forward a former hobby or activity in a modified form often works. Gardeners may like tending plants on the windowsill. My husband golfed and we found a league run by a rehab center for people with handicaps. I've heard of other golfers being happy just to go to a putting green.
Mother continued to do crosswords (large print and easy) until her hands were too shaky. More than one person in her nursing home seemed absolutely addicted to word-find puzzles.