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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 take care of my MIL full time. I am youngish, 48 and I still have a teenager at home and a mother of 5 and a grandmother of 6. I was also a special needs teacher before I quit my job to stay home and take care of her 4 months ago. My kids and sisters and other family members always tease that I'm an air head, but since I started staying home with my MIL my memory has got worse. I have to use sticky notes for things in the house or set an alarm for her meds [that I use to remember when to give her] and I have to keep notes for every thing I do. I asked my doctor [we have the same doctor] he said mine is due to stress and that I need a break to regroup with my brain. So I know that some people think they get it from a parent and maybe they do but stress can bring it on. No one in my very large family has ever had it so my doctor ruled that out. Don't give up!
I have wondered if I have dementia too, but my husband says I really don't have it. My mother says things to like you don't remember right and is really aggressive about it. I also think the stress of taking care of a parent with dementia makes us forget things we wouldn't normally forget. At least I am hoping I am right and not going to end up like mom.
I've noticed my own decline in memory. It's especially alarming in light of Mom's diagnosis of dementia. I've also noticed it in my husband, who's nearly 75. We forget where we put stuff a lot but usually find it. He forgets things I said. I forget things he said. If I don't make a list prior to shopping, I come home without stuff I need. This is mostly short-term memory. Not long ago I got a 23 and Me genetic and medical DNA analysis. I do not have the APOE gene linked to early-onset Alzheimer's, which doesn't particularly reassure me, given we know the presence or absence of the gene doesn't guarantee anything.
Very sobering. I talked to my primary doctor. I told her about my astronomical stress over the past few months (death of father, care of mother with dementia). She said she saw no reason at this point to test me. She recommended making sure my vitamin D and B12 levels are adequate (they are), keeping my cholesterol levels in a healthy range (I do, without statins), and keeping my sodium levels down (they are borderline high). She recommended keeping my brain engaged with new challenges and maintaining social contacts. I want to learn how to play an instrument to create new neural pathways and looking for a good beginner's dulcimer. Watched my cousin play and was intrigued!!!
I sure feel your anxiety. For now, I suppose, we pray for medical breakthroughs and live the healthiest lives we can.
Stress does a lot to the body. When I had Mom living here my husband was always telling me he worried about me. I would say Like I don't have enough going on. I had her 24/7 only getting out for errands when he was home. Besides Mom I had her house up keep and a disabled nephew living there that needed to be taken grocery shopping and taken to doctor visits. Our brains can only do so much. So it's not Dementia just too much responsibility.
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.
Very sobering. I talked to my primary doctor. I told her about my astronomical stress over the past few months (death of father, care of mother with dementia). She said she saw no reason at this point to test me. She recommended making sure my vitamin D and B12 levels are adequate (they are), keeping my cholesterol levels in a healthy range (I do, without statins), and keeping my sodium levels down (they are borderline high). She recommended keeping my brain engaged with new challenges and maintaining social contacts. I want to learn how to play an instrument to create new neural pathways and looking for a good beginner's dulcimer. Watched my cousin play and was intrigued!!!
I sure feel your anxiety. For now, I suppose, we pray for medical breakthroughs and live the healthiest lives we can.