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.
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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:
Oh my so sorry for your long haul taking care of your son. Poor guy. Good for you for getting yourself that long overdue vacation! Sweet!
Does he live by himself? Does anyone care for him besides you? If you provide needed care on a daily basis, I would put him in respite care while you're gone. Someone to do meds, care for him and feed him while you're gone.
I would check this with a lawyer. My daughter was 12 went she went to England with my mother. I was able to have paperwork made up giving my Mom the right to make decisions for my daughter if something happened.
A few questions... 1. Is he going to stay in your home while you are gone? A) If so will someone be there with him to help him? a. If the person that is going to stay with him is a family member you can fill out a form giving them temporary ability to act for you. (Forms like this are common if a parent leaves for a vacation and leaves a minor child with a relative, friend, nanny...) 2. If he is not staying in your home and you are placing him in Respite care then you can instruct the facility to act on your behalf. Again you would probably have to fill out that same form.
When I placed my Husband in Respite I gave the facility my sisters name and information stating that if there were an emergency that she would be the one they should call. There was 1 "emergency" call. Nothing was really wrong but the situation was taken care of easily. (when I got home and actually found out what the "emergency" was I was livid! I was out of the country...telephone calls back and forth, emails back and forth....When I got home and read the full bill..the "emergency" was ATHLETES FOOT! )
Bill paying can wait for 9 days unless you take your computer. I used to do a notarized paper stating that my cousin could make medical decisions when I travelled.
Here are other options since I have cruised more than 30 times. Purchase internet and instruct to contact you through hangouts or Facebook messanger You can check with your cell service to see how much more international service would cost when you are off the ship
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.
Does he live by himself? Does anyone care for him besides you? If you provide needed care on a daily basis, I would put him in respite care while you're gone. Someone to do meds, care for him and feed him while you're gone.
Have a WONDERFUL time!
1. Is he going to stay in your home while you are gone?
A) If so will someone be there with him to help him?
a. If the person that is going to stay with him is a family member you can fill out a form giving them temporary ability to act for you. (Forms like this are common if a parent leaves for a vacation and leaves a minor child with a relative, friend, nanny...)
2. If he is not staying in your home and you are placing him in Respite care then you can instruct the facility to act on your behalf. Again you would probably have to fill out that same form.
When I placed my Husband in Respite I gave the facility my sisters name and information stating that if there were an emergency that she would be the one they should call. There was 1 "emergency" call. Nothing was really wrong but the situation was taken care of easily.
(when I got home and actually found out what the "emergency" was I was livid! I was out of the country...telephone calls back and forth, emails back and forth....When I got home and read the full bill..the "emergency" was ATHLETES FOOT! )
Here are other options since I have cruised more than 30 times.
Purchase internet and instruct to contact you through hangouts or Facebook messanger
You can check with your cell service to see how much more international service would cost when you are off the ship