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:
This is a forum for caregivers. Aging Care does not provide workers. Contact your Area Agency on Aging by phone. They can tell you how to get this assistance in your area.
If you're not familiar with locating local resources, here are some suggestions.
1. Post in your profile your general area, city and state, or just your state if you're concerned about revealing too much personal information. Someone may live in your area or state and know of specific sources in addition to the AAA which might provide help.
2. Check with your local Senior Center. One in our area leases 2 small buses for various needs: medical, shopping, etc. They can best tell you what might be available in your area. Or they may be able to include you in the shopping trip circuit with other people unable to do their own shopping.
3. If groceries are your prime or only concern while you're apparently recovering, you might want to contact local stores and find out what their delivery arrangements are. ShipT shoppers are in one of the big grocery stores everytime I go, SmartPhone in hand, and conferring with someone who asked them to shop for him/her.
You could probably make other arrangements besides SmartPhoning, such as e-mailing your shopping list and being available by phone if the person has questions (which some of them do, as I've seen folks making selections of products about which they've asked other shoppers - no problem in that though.)
4. My local county has a very good list of sources of help for seniors. So, check your county, either online or by phone to see if they can help.
I had major foot surgery 4 months ago. 2 months spent in bed or on the couch--totally non-weight bearing. I could slowly do a few things, but rolling around a grocery store? Nope. Sending DH to the store meant at least 2 hours of him trolling the aisles and calling me 10 times with ??. Then he'd forget half the stuff anyway.
My girls 'gifted me' one grocery delivery and I was in heaven! Yes, there is a fee to shop, and I tip well, but still, I am spending far less than I did when I randomly shopped. AND they delivered AND a couple times they came in and unpacked it all for me (tho they are not supposed to do that).
I have only been in a grocery store twice in four months and although I am basically completely healed---I probably will never go back to doing my own shopping. esp as snow and ice are heading our way.
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.
1. Post in your profile your general area, city and state, or just your state if you're concerned about revealing too much personal information. Someone may live in your area or state and know of specific sources in addition to the AAA which might provide help.
2. Check with your local Senior Center. One in our area leases 2 small buses for various needs: medical, shopping, etc. They can best tell you what might be available in your area. Or they may be able to include you in the shopping trip circuit with other people unable to do their own shopping.
3. If groceries are your prime or only concern while you're apparently recovering, you might want to contact local stores and find out what their delivery arrangements are. ShipT shoppers are in one of the big grocery stores everytime I go, SmartPhone in hand, and conferring with someone who asked them to shop for him/her.
You could probably make other arrangements besides SmartPhoning, such as e-mailing your shopping list and being available by phone if the person has questions (which some of them do, as I've seen folks making selections of products about which they've asked other shoppers - no problem in that though.)
4. My local county has a very good list of sources of help for seniors. So, check your county, either online or by phone to see if they can help.
My girls 'gifted me' one grocery delivery and I was in heaven! Yes, there is a fee to shop, and I tip well, but still, I am spending far less than I did when I randomly shopped. AND they delivered AND a couple times they came in and unpacked it all for me (tho they are not supposed to do that).
I have only been in a grocery store twice in four months and although I am basically completely healed---I probably will never go back to doing my own shopping. esp as snow and ice are heading our way.