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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
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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:
Medical power of attorney empowers that person to interact with the health care profession -- doctors, hospitals, pharmacies -- on medical matters. You'd have to take the position that the visit is harmful to the senior's health. If the senior is in a setting not his/her home you'd have to get their help enforcing it, and make that case to them. Of course, they don't want trouble. And most seniors badly need as many visits as they can get, so why are you wanting to throw your weight around in this way?
Alwayslearning I have an adult sibling who is my judge, etc. She limits visits,and phone calls. For Christmas only her family visited with my Mom. I am taking her to court.
And to those of you with an evil sibling who is keeping you away from an elderly parent for no reason (other than to continue the sibling abuse visited upon you as a child) do not be afraid to take them on in a court of law. If you have no money for a lawyer, look for free or some type of legal aid group to help you. Do not let them use an elderly parent as a pawn to hurt you!
Yes my mother needed help, but there was no way so called family members never came to see my mother for five month's in a psych ward, in sc. I felt something was wrong I came down to sc. From philly to see my mother. I beleave my sister needs to be in jail for her selfish ways.
Make your own decisions and leave other people to make theirs. Siblings have different experiences of the same parents, and for some it is the right decision, or the best decision they are capable of making, to stay away. Evil? Jail? If we seriously think we have the right to be our siblings' judge, jury, and executioner then we are huge contributors to whatever problems our family as a whole might have.
Well gee, alwayslearning, sounds like YOU are judge and jury. For those of us who have been violated by evil siblings, we know how harmful they are to our health. Imagine it happening to older people who no longer have good health. As for my mom, if someone comes along and is detrimental to her health, I don't care if that person is the archangel Gabriel, he ain't gettin in.
alabamaspitfire, my younger sibling has refused any private visits with me and my mother (a widow) since my father died. i have a legal case and am considering filing an action pro-se (without legal counsel). what did the judge order to protect your aging parent's wellbeing? my mother has not seen any of her grandchildren in more than 4 years (grandson and five grand-daughters).
alabamaspitfire, i love my mother! younger sib is a brother who is unmarried and has not worked any wage paying job for more than twelve years.
my mom is not getting proper medical care - she went off her meds, and has been alienated from me, from my youngest sibling and grandchildren. all the money from the sale of my parents home is gone (spent these last seven years). mom's rent is beyond her means. it's a nightmare.
where i live? i will have to file in probate court to get temp conservatorship.
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.
my mom is not getting proper medical care - she went off her meds, and has been alienated from me, from my youngest sibling and grandchildren. all the money from the sale of my parents home is gone (spent these last seven years). mom's rent is beyond her means. it's a nightmare.
where i live? i will have to file in probate court to get temp conservatorship.
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