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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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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.
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I recently read an amazing book call Being Mortal by Atul Gawande, in which he discusses the inevitability of death and the struggle to find the balance between continuing the fight for life and letting go. Some treatments may be palliative, meaning that they can relieve symptoms and improve her quality of life. Others are a misguided attempt to avoid the inevitable and can cause her last months to be h3ll on earth. Often the difference in life expectancy between those who fight and those who surrender gracefully is only weeks or months. I hope you can find someone who can sit down to rationally go over her treatment plan point by point, weighing the pros, cons and importantly, the outcomes of each choice.
I am so sorry that you and your mother are facing this diagnosis. Hugs to you both.
Mother does not want surgery. Does she want any kind of treatment? What is her attitude toward this diagnosis? I think that is the single most important consideration. As cwillie suggests, having her options explained is a good and necessary first step. And then the options can be compared to her goals for herself.
Several years ago I was in the geriatrician's office with my mother. The doctor brought up a spot that had been found in her pelvic area during routine imaging for other reasons. She offered to arrange for further testing. This was their conversation:
Ma: No, I don't want further tests. Whatever it is I don't need to know about it. Dr: I respect your decision. As your doctor I need to tell you that if it is cancer it could be treated. Cancer treatments have improved greatly over the last few years. Ma: I would not go through the treatments. So there is no point in the tests. I have lived a good long life. I'm going to die of something. If this is it, then that is the way it is. Dr: Many of my patients feel that way. I will not try to talk you out of that decision, but I will tell you that if you change your mind I'll be happy to arrange further testing.
Well it was evidently not cancer because mother is still with us, in a nursing home with dementia and mobility problems. I was glad to be present during the conversation with the doctor, and I shared it with my sisters. I don't know if my mother made the "right" decision but it was certainly her decision to make.
My father, at 85, decided not to treat his colon cancer. He would have needed treatment for a potential aortic aneurysm before surgery. Either operation could have killed him. He lived 8 more months, and did not suffer horribly.
Honestly, 20 years later, I still second guess his decision from time to time. Maybe we should have poured the antidepressants down his throat and pushed him to get the surgery. He second guessed himself, but I think he had had enough of life. Maybe it would have been less painful for him to die during surgery than to linger.
I hardly even believe in any god, but in this sort of matter, I am driven to say that the outcome was God's will. It wasn't under MY control!
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.
Mother does not want surgery. Does she want any kind of treatment? What is her attitude toward this diagnosis? I think that is the single most important consideration. As cwillie suggests, having her options explained is a good and necessary first step. And then the options can be compared to her goals for herself.
Several years ago I was in the geriatrician's office with my mother. The doctor brought up a spot that had been found in her pelvic area during routine imaging for other reasons. She offered to arrange for further testing. This was their conversation:
Ma: No, I don't want further tests. Whatever it is I don't need to know about it.
Dr: I respect your decision. As your doctor I need to tell you that if it is cancer it could be treated. Cancer treatments have improved greatly over the last few years.
Ma: I would not go through the treatments. So there is no point in the tests. I have lived a good long life. I'm going to die of something. If this is it, then that is the way it is.
Dr: Many of my patients feel that way. I will not try to talk you out of that decision, but I will tell you that if you change your mind I'll be happy to arrange further testing.
Well it was evidently not cancer because mother is still with us, in a nursing home with dementia and mobility problems. I was glad to be present during the conversation with the doctor, and I shared it with my sisters. I don't know if my mother made the "right" decision but it was certainly her decision to make.
Some unanswered questions you might ask her doctor could be:
1. What's the prognosis if she were to go through surgery? What specific surgery would it be, and how normal a life could she live thereafter?
2. What's the prognosis if she declines surgery?
Honestly, 20 years later, I still second guess his decision from time to time. Maybe we should have poured the antidepressants down his throat and pushed him to get the surgery. He second guessed himself, but I think he had had enough of life. Maybe it would have been less painful for him to die during surgery than to linger.
I hardly even believe in any god, but in this sort of matter, I am driven to say that the outcome was God's will. It wasn't under MY control!