Are you sure you want to exit? Your progress will be lost.
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:
Durable Power of Attorney- DPOA. A stronger, longer lasting - usually - form of regular Power of Attorney is given to an individual by another individual or "principal".
First the principal must be mentally competent to assign/give DPOA to another person. This person can be anyone of age and mentally competent that the principal chooses. It need not be a family member and in fact there are professional DPOAs that can be hired for this responsibility.
From there DPOA can vary from state to state. Some require an attorney to draw up the document others states allow do-it-yourself versions that can use more generic forms that can be had on line or even made available through various senior services. Some states require a notary to witness and record the document- others do not.
If it is financially feasible it is best to have the DPOA document/agreement drawn up by an attorney and for it to be made as detailed and specific as possible - allowing a broad generalization of power is never a good idea as it opens the door for abuse. Also it is a good idea to name one person DPOA and to name a successor should the first person become unwilling or unable to continue with the responsibility. Some people name two separate people DPOA - one for financial and one for health care. Personally, I think it's best to have the same individual responsible for both as often finances and health care are tightly intertwined or some situations can be a bit grey as to which category of responsibility a decision lay - for instance an in-home personal caregiver for safety but non-medical care. If there are two separate people named it is crucial that they are able to get along and work together for the benefit of the principal.
A few things to keep in mind: POA and DPOA does not give power "over" the principal. I see that wording a lot here and find it disturbing. DPOA does not give the power to force someone to live as the DPOA would like or to take control of the persons money/assets. Not if the person is still legally competent. It allows the DPOA to make decisions in addition to the principal or in the place of the principal but not INSTEAD of the principal- if that makes sense.
I mentioned the word "agreement" earlier in referring to the DPOA document. The DPOA is agreeing to act and make decisions as if the principal is making the chooses - what the principal would prefer.
Also, if there are siblings and/or other family involved in the principals life, I would encourage the principal to allow the sharing of information among other family members. It need not be detailed - but preventing the DPOA from being able to share at least some information can easily put them in an adversarial role with family - which causes a lot of needless hassle and heartache for everyone involved. Also, it can lead to a DPOA becoming a bit power hungry, with a sense of omnipotence - flaunting their perceived total control over the principal and their assets to others involved in the principals care/life. Never a good thing.
Lastly - be very, very cautious about allowing the DPOA the power to give gifts or to pay themselves. I'm not saying not to allow this - just be very careful, very specific and very conservative. For many, having someone else's financial resources at their fingertips with no one else to answer to or monitor the accounting - well, it becomes too much of a temptation.
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.
First the principal must be mentally competent to assign/give DPOA to another person. This person can be anyone of age and mentally competent that the principal chooses. It need not be a family member and in fact there are professional DPOAs that can be hired for this responsibility.
From there DPOA can vary from state to state. Some require an attorney to draw up the document others states allow do-it-yourself versions that can use more generic forms that can be had on line or even made available through various senior services. Some states require a notary to witness and record the document- others do not.
If it is financially feasible it is best to have the DPOA document/agreement drawn up by an attorney and for it to be made as detailed and specific as possible - allowing a broad generalization of power is never a good idea as it opens the door for abuse. Also it is a good idea to name one person DPOA and to name a successor should the first person become unwilling or unable to continue with the responsibility. Some people name two separate people DPOA - one for financial and one for health care. Personally, I think it's best to have the same individual responsible for both as often finances and health care are tightly intertwined or some situations can be a bit grey as to which category of responsibility a decision lay - for instance an in-home personal caregiver for safety but non-medical care. If there are two separate people named it is crucial that they are able to get along and work together for the benefit of the principal.
A few things to keep in mind: POA and DPOA does not give power "over" the principal. I see that wording a lot here and find it disturbing. DPOA does not give the power to force someone to live as the DPOA would like or to take control of the persons money/assets. Not if the person is still legally competent. It allows the DPOA to make decisions in addition to the principal or in the place of the principal but not INSTEAD of the principal- if that makes sense.
I mentioned the word "agreement" earlier in referring to the DPOA document. The DPOA is agreeing to act and make decisions as if the principal is making the chooses - what the principal would prefer.
Also, if there are siblings and/or other family involved in the principals life, I would encourage the principal to allow the sharing of information among other family members. It need not be detailed - but preventing the DPOA from being able to share at least some information can easily put them in an adversarial role with family - which causes a lot of needless hassle and heartache for everyone involved. Also, it can lead to a DPOA becoming a bit power hungry, with a sense of omnipotence - flaunting their perceived total control over the principal and their assets to others involved in the principals care/life. Never a good thing.
Lastly - be very, very cautious about allowing the DPOA the power to give gifts or to pay themselves. I'm not saying not to allow this - just be very careful, very specific and very conservative. For many, having someone else's financial resources at their fingertips with no one else to answer to or monitor the accounting - well, it becomes too much of a temptation.
Hope this has helped.