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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:
If you are concerned that your older family member’s driving is dangerous, watch for the following telltale signs that signal a decline in their driving abilities.
Do they have difficulty in turning their head, neck, or body while driving or parking? Do not have enough strength to turn the wheel quickly in case of an emergency? Become angry and frustrated easily while driving?
syreeta2 This is a danger for some elders, not to mention the other drivers on the road. Try talking to him about this he may be scared himself but he doesn't want to say it to you. Offer another means of transportation. If asking him doesn't work. You can switch keys, give him fakes... on his familiar key ring, you can disconnect the battery, something to that affect to keep him off the road. Don't feel guilty if your doing what's best for him. You would really feel guilt if you found out someone or he was hurt and you did nothing!!!
Mom's driving wasn't too bad or at least she had no accidents,and she didn't have Alz but she wasn't paying attention and left her purse too many times at various places. That meant she was driving without her proper ID and leaving herself vulnerable to credit card fraud. After the 5th time of my kids and me spending hours on the phone cancelling said credit cards, we sat her down and suggested she give up driving. We were thrilled she agreed to it so quickly and calmly. If she hadn't been so cooperative, we would've been forced to do it. It was time to hang up the car keys and she knew it. She sold her car with nary a tear. If a parent is dangerous on the road then they have to be forced to give up driving whether they like it or not. They're just as bad as drunk drivers, neither needs to be endangering others.
My mother had five wrecks in three months, all were her fault. She even pulled up to a Jerry's Rest., ran six feet over the sidewalk into their shrubs and knocked out a six foot glass window. The table moved and three people had to be taken to the hospital, one having a heart attack. She and her friend then went in to have breakfast. The manager informed her that they had to close and she kept arguing that she couldn't believe they were closing the restaurant for the day, as she and her friend really wanted to have breakfast.
She had Alzheimer's dementia. We tried for nine months to get her to surrender her license and have the State cancel. Neither happened and then the above happened. The last thing we did was take her to have a driver's test and she failed everything. My brother then asked to borrow the car to get to his work, as his car needed repair. She agreed, and he never took the car back. He told her that the engine had blown up.
Make sure to inspect your parent's car frequently for dents or pain of another color. Also, check with some of her/his friends who your parent drives around. In my mother's case, two of her friends informed me that their children told them they could not ride with my mother anymore. Call these people to see why. My mother was turning down busy intersections the wrong way and parking sideways.
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.
Do they have difficulty in turning their head, neck, or body while driving or parking?
Do not have enough strength to turn the wheel quickly in case of an emergency?
Become angry and frustrated easily while driving?
She had Alzheimer's dementia. We tried for nine months to get her to surrender her license and have the State cancel. Neither happened and then the above happened. The last thing we did was take her to have a driver's test and she failed everything. My brother then asked to borrow the car to get to his work, as his car needed repair. She agreed, and he never took the car back. He told her that the engine had blown up.
Make sure to inspect your parent's car frequently for dents or pain of another color. Also, check with some of her/his friends who your parent drives around. In my mother's case, two of her friends informed me that their children told them they could not ride with my mother anymore. Call these people to see why. My mother was turning down busy intersections the wrong way and parking sideways.