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:
I have high anxiety, panic attacks. My stress gets so high sometimes that I get physically sick! I worked in gastroenterology for 11 years and there are A LOT of nerves in your small intestines. That's why alot of ppl have IBS(irritable bowel syndrome). I started reading audiobooks bc it tends to relax me more than reading a book, every night I lay down and plug in my ear phones:)
I think she meant angular cheilitis...which is inflammation and/or cracks in the corner/s of the mouth. My mom and i both get this when in times of great stress....happened a lot to my mom before my dad died waiting for a heart transplant and to me while caring for my husband who was dying from pancreatic cancer...the first 2 months of 1997 were horrible, lost my grandmother, dad and husband in 2 months.....and yes i had a lot of gastro issues, bleeding ulcers etc....
I developed a mystery rash. It was down both sides of my torso and on my wrists. Didn’t itch or hurt but it sure wasn’t pretty.
For six months I saw doctors and dermatologist - being sent from one to another as no one could figure it out. Finally, one came up with “Adult On-Set Eczema”. He said it was kind of unusual as I had never had any sort of eczema in all my previous 50 years. Which pretty much told me - that was probably not what the rash really was.
The rash showed up during my fathers last month - hospice was involved, daddy wasn’t doing well and my mother was making matters worse with each passing day.
After my dad passed my hair started to fall out. Yeah - throw in the chronic insomnia and I was a complete mess. Literally and figuratively.
Oh thank you so much so that I am not weirdo. The thing THAT works on angular chelation chelitis is zinc oxide. You look like the the joker, but works. You have in mouth? Orange Listerine. Lemme tell you. You internalize, takes toll.
There is no study ever done that will convince me that stress does not cause cancer. I have seen it too many times with women looking after spouse skin breakouts are common. I get total body aches and pains. That’s when I know it’s time to go to my GP and get anxiety medication
My friend ended up in hospital when her dad was dying. For a good couple of days, some kind of E-coli. However you spell it. Hospital staff was asking her what she ate, where she ate, etc. She was always running around, and her body and mind just got over exhausted and couldn't fight off any infection very well. Put her in the hospital.
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.
For six months I saw doctors and dermatologist - being sent from one to another as no one could figure it out. Finally, one came up with “Adult On-Set Eczema”. He said it was kind of unusual as I had never had any sort of eczema in all my previous 50 years. Which pretty much told me - that was probably not what the rash really was.
The rash showed up during my fathers last month - hospice was involved, daddy wasn’t doing well and my mother was making matters worse with each passing day.
After my dad passed my hair started to fall out. Yeah - throw in the chronic insomnia and I was a complete mess. Literally and figuratively.
Thanjs you guys. More than you know.
The stress is unbelievable.
skin breakouts are common. I get total body aches and pains. That’s when I know it’s time to go to my GP and get anxiety medication
Stress... isn't it fun?
I found wine.