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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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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.
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I usually just get a small calendar in the dollar bin at Target. Around year's end they have a lot, both pocket-size and large enough to hang on the wall. It works with my mom, sort of, but when we have asked her to write down what she needs, she often forgets.
A note pad with wide-ruled lines may help. Pens should have a fat look to them, because gripping the skinny ones becomes difficult. Bright colors on the pen body makes them easier for her to find them.
When it became obvious that my mom was struggling and failing to remember things, dates, etc, (play bridge tomorrow didn't mean anything anymore because: is it tomorrow?), I came up with a brilliant idea: a huge desk calendar with those big spaces. Off I drove, high on missionary zeal, and bought the calendar. I presented it, beaming, to my mom, and placed it on the dining room table right where she walks past dozens of times a day. Also several pens. Here, I proclaimed, is where you can write everything down and always know what day it is and what is happening.
When I returned the next day, there was no calendar. Where is the calendar? Ah, it is stuffed into the little space between the desk and the wall--hidden away where no one can see it. So, I take the calendar--still a good idea, right--out of the space and put it on the dining room table. Go back to beginning of paragraph and repeat, oh, about two dozen times. Finally, I gave up.
I subsequently learned from neighbors that my mother had told them how insulting it was that I had brought the calendar. She was furious--never said that to me, of course. Just the neighbors. Sigh...
In spite of this, I continue to think the calendar was a great invention and recommend them to anyone who will listen.
I agree entirely its a great idea. I bought a slightly different type. You know the type of pads that are used in the office that have a calendar along the bottom? well the printers often given them away at the end of the year when the calendar bit is no use any more. tehy even cut the calendar bit off for me free of charge. Every day I write TODAY IS ....and whatever day it is, then I write the date and then I write down everything she has planned for the day. You could always do it yourself on the computer though although I imagine the Printing might be expensive. Mum doesnt write it down I do it with her but I tell HER it is because I forget what she has planned and she tells everyone that she HAS to write it down because her daughter forgets....whatever works!
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.
It works with my mom, sort of, but when we have asked her to write down what she needs, she often forgets.
When it became obvious that my mom was struggling and failing to remember things, dates, etc, (play bridge tomorrow didn't mean anything anymore because: is it tomorrow?), I came up with a brilliant idea: a huge desk calendar with those big spaces. Off I drove, high on missionary zeal, and bought the calendar. I presented it, beaming, to my mom, and placed it on the dining room table right where she walks past dozens of times a day. Also several pens. Here, I proclaimed, is where you can write everything down and always know what day it is and what is happening.
When I returned the next day, there was no calendar. Where is the calendar? Ah, it is stuffed into the little space between the desk and the wall--hidden away where no one can see it. So, I take the calendar--still a good idea, right--out of the space and put it on the dining room table. Go back to beginning of paragraph and repeat, oh, about two dozen times. Finally, I gave up.
I subsequently learned from neighbors that my mother had told them how insulting it was that I had brought the calendar. She was furious--never said that to me, of course. Just the neighbors. Sigh...
In spite of this, I continue to think the calendar was a great invention and recommend them to anyone who will listen.
You could always do it yourself on the computer though although I imagine the Printing might be expensive. Mum doesnt write it down I do it with her but I tell HER it is because I forget what she has planned and she tells everyone that she HAS to write it down because her daughter forgets....whatever works!