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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.
Remember, this assessment is not a substitute for professional advice.
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Excellent point Barb, a POA or HIPPA release must be in place or no information will be released. They should have HIPPIA release at doctor office, mine even has a Durable POA online available to complete.
Barb is right. She should see her regular doctor. This doctor will get her to the correct neuro exam; that is the way to move to a diagnosis. The thing is that it is important now to have a POA for health care so that information can be shared with one chosen person. If your Mom suffers from short term memory currently, a lawyer would examine her without you in the room to be sure she understands POA, and you could get DPOA for financial (when needed) and POA for Health care documents. Do this before you see the MD because dependent on his wording, afterward it may be claimed she was too demented to do this document. When this is done, take her to her own doctor and start there. You will be able to help her function, and function for her when she cannot. If someone is taking advantage it is important to consider if this is a family member. If so you may wish to file for guardianship, as this person may file as well once he or she gets wind of the money train slowing, and any danger of it disappearing. If guardianship becomes a fight in court it is a real mess and can be upwards of 10,000 to clear it up, with occ. the judge deciding that NO ONE in a bickering family have guardianship, but that it be conferred upon the State to act in Mom's best interest. So first things first. Time to ascertain if your Mother wishes you to act in her behalf should she be unable to for any reason. Then off to Elder Law Attorney to get the papers drawn up. Then to the doctor which will give you an idea IF there is dementia starting, what kind it is, and a sort of a guidemap to probable prognosis and time frames.
Thank you so much. I called her doctor today and the office said she had an appt today. I told the office what had happened and that note was delivered to the doctor before she saw her. I am certain her doctor recommended a neuro for her to see, but I will have to call the doctors office because my Mom will remember nothing about the appt. Thanks again so much!!
Welcone, Jwmayer. Has your mother been diagnosed with dementia or some sort of cognitive decline? Does she have a doctor that she sees regularly and have you or she discussed this issue with them?
A neurologist is probably the sort of doctor mom needs to see, but a good check up first with her PCP would be a good place to start.
Who is taking advantage of your mother financially? Have you reported this to the police?
Yes, she has a pcp that diagnosed her with dementia about a year and a half ago. She does see her regularly. Unknown to me, I called her doctors office today and she had an appt today. I told the office person who answered my call the details and she forwarded it to the doctor before her appt. I’m sure her doctor recommended the next course of action but there is no way my Mom would remember ANYTHING! So I’ll have to call the doctors office again.
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 think going forward it's important for you to have this.
Your mom must have a system for keeping track of appointments, since despite her poor memory, she got to this one!
When this is done, take her to her own doctor and start there. You will be able to help her function, and function for her when she cannot.
If someone is taking advantage it is important to consider if this is a family member. If so you may wish to file for guardianship, as this person may file as well once he or she gets wind of the money train slowing, and any danger of it disappearing. If guardianship becomes a fight in court it is a real mess and can be upwards of 10,000 to clear it up, with occ. the judge deciding that NO ONE in a bickering family have guardianship, but that it be conferred upon the State to act in Mom's best interest.
So first things first. Time to ascertain if your Mother wishes you to act in her behalf should she be unable to for any reason. Then off to Elder Law Attorney to get the papers drawn up. Then to the doctor which will give you an idea IF there is dementia starting, what kind it is, and a sort of a guidemap to probable prognosis and time frames.
Jim
A neurologist is probably the sort of doctor mom needs to see, but a good check up first with her PCP would be a good place to start.
Who is taking advantage of your mother financially? Have you reported this to the police?
Yes, she has a pcp that diagnosed her with dementia about a year and a half ago. She does see her regularly.
Unknown to me, I called her doctors office today and she had an appt today. I told the office person who answered my call the details and she forwarded it to the doctor before her appt. I’m sure her doctor recommended the next course of action but there is no way my Mom would remember ANYTHING! So I’ll have to call the doctors office again.
Thanks so much! Jwmayer