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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:
I have been caring for my mother out of state goiing on our 11th year. Don't know what answer you are looking for but to be honest it has not been easy but her other kids live in the same state she does and I did not want to move her over here to where I live. Siblings do not help so everything has been up to me. She gets good care in assisted living eventhough she fought it tooth and nail as she does on everything. When she was living in her house before assisted living was pure hell. I call her every three days and if something happens the facility will call you. We do have a really good friend that helps me with momma over there. Couldn't do it all from out of state without her. Hubby and I try to go see her once a month. The covid restricted us but we can see her now. Good luck and take care.
thank goodness for Amazon… costco now has instacart… my mom buys her depends , TP , poise pads with her costco credit card. I buy everything else on Amazon. Put everything on autopay, newspaper etc… that way you only have to pay the CC and make sure enough money in checking to autopay that as well. The AL needs to have a dr or NP coming in. Hair salon as well. Plus transportation to other appointments. I do it all alone . My mom refused to move here when I had an apartment set up for low income seniors. When she finally said she would move to AL , I jumped on it .. in Arizona. I’m in the Midwest. She will be 90 in October. It’s been difficult yes… but it can be done. My mom now wants to move here, but her health conditions frightens me to move her .
take copies of all credit cards front and back, Drivers license, Medicare card, social security card. Set up accounts with your email address , cell phone number. I’ve had to get into, life insurance , dmv, Medicare , dr portals, life insurance etc…anything that your mom has, make sure you have access .. my mom can’t hear , it does no good for my mom to try to straighten anything out…
keep receipts of anything you take payment for. As there is a 5 year look back for Medicaid. everything you do keep in mind the Medicaid Rules in case your mom would ever need to use it.
make sure DNR is in place. check for durable financial POA and mPOA. keep original will and poa stuff with you.
I keep a small notebook with all passwords , log in information /copies of CC etc along with doctors and clinics
get a name of a good in home care company you can call if your mom needs to go to a specialist. AL should have a number as well. My mom has to have an endoscopy done in a week and a half. Prior care company will take her, stay with her and return her to AL .
i also have needed my grandparents maiden names for things .
just be thorough, it can be done. Amazon has been a life saver…
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.
take copies of all credit cards front and back, Drivers license, Medicare card, social security card. Set up accounts with your email address , cell phone number. I’ve had to get into, life insurance , dmv, Medicare , dr portals, life insurance etc…anything that your mom has, make sure you have access .. my mom can’t hear , it does no good for my mom to try to straighten anything out…
keep receipts of anything you take payment for. As there is a 5 year look back for Medicaid.
everything you do keep in mind the Medicaid Rules in case your mom would ever need to use it.
make sure DNR is in place.
check for durable financial POA and mPOA.
keep original will and poa stuff with you.
I keep a small notebook with all passwords , log in information /copies of CC etc
along with doctors and clinics
get a name of a good in home care company you can call if your mom needs to go to a specialist. AL should have a number as well. My mom has to have an endoscopy done in a week and a half. Prior care company will take her, stay with her and return her to AL .
i also have needed my grandparents maiden names for things .
just be thorough, it can be done. Amazon has been a life saver…