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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.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
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:
The general rule is how they handle their activities of daily living such as dressing, eating and general self care. You may want to hire an agency to evaluate the person if you are not sure yourself. However, with the aid of a personal alarm system so that he or she can summon help if there is an emergency, plus someone to check daily and assist when necessary, many people can live independently for a long time. If this person needs help dressing, walking, cooking and remembering medicines, you may want to consider limited in-home health care through an agency for just the hours needed. The Alzheimer's Association can give you a good idea of where to draw the line, if there are cognitive issues involved. Independence is really a very personal matter, and much depends on the home where the person lives (can they get to the bathroom without going up or down stairs?). Is the bedroom on the same floor. Can they do at least limited cooking? Talk with the person, observe his or her comfort level with being alone, and do consider a personal alarm system. There are many on the market. You can get recommendations for your area by checking with a local in-home care agency or hospital. Take care, Carol
The book "Stop Alzheimer's Now," by Bruce Fife, includes appendixes with Mental Status Tests, and Parkinson's Disease Rating Scale. Not only that, the book has a tremendous amount of helpful medical information. I have no financial interest in this book, but I bought one copy for myself, then three more for friends.
My father is 94 and lives on his own. We have arranged private carers to go twice a day so they can cook his meals and see if he is alright. He has a personal alarm for about 10 years and now wears his pendant alarm around his neck all the time. He has macular degeneration and his eyesight has got worse. He has arthritis in his knees, pains in his back and shoulder. He has earing aids and doesnt wear them when he answers the phone because he can hear better without them. I am going to sort another gardener through Age Concern. My father told me he doesnt want to live with me, my sister or go into a Nursing Home. He does have difficulty dressing and cooking his meals. He is very independent man and likes to cook his own meals but occasionally he lets the carer cook his meals. He will not have meals on wheels but I am trying to persuade him to have them again. He has had numerous falls thats why he now wears his pendant alarm. I visit my father once a week and my sister visits once a week. He is a stubborn man. I mowed his lawn last week and he told me women shouldnt do that sort of thing. I just take every day as it comes. I am 62 and have nursed my 68 husband after his major operation removing a benign tumour from his pancrea (two years ago) he could have died if it had been left. I feel fortunate my husband is still with me. It is a struggle but other people are worse off. Keep thinking positive and things always work out in the end.
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.
If this person needs help dressing, walking, cooking and remembering medicines, you may want to consider limited in-home health care through an agency for just the hours needed. The Alzheimer's Association can give you a good idea of where to draw the line, if there are cognitive issues involved. Independence is really a very personal matter, and much depends on the home where the person lives (can they get to the bathroom without going up or down stairs?). Is the bedroom on the same floor. Can they do at least limited cooking? Talk with the person, observe his or her comfort level with being alone, and do consider a personal alarm system. There are many on the market. You can get recommendations for your area by checking with a local in-home care agency or hospital. Take care,
Carol