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:
Are clothes changed daily? Is the person clean and neat? Is there a noticeable odor? Is hair clean and brushed, combed? A person does not have to take a bath daily. (as a matter of fact I was surprised to learn when my Husband was in rehab that the requirement in the State of Illinois is 2 times a week) If this is a person that is living alone and you visit often check the bathroom, are there wet or damp towels? If this person is living with you monitoring can be done easily. (in most cases) If they seem to need help, help them. Don't "offer" to help as most offers will be rejected. Showers can be a scary place. Noisy, slippery and for someone with dementia there is a lot to remember when bathing/showering. I also suggest removing sliding doors to showers and replace with a shower curtain. (doors can be stored and replaced later) Often the door can become a hazard. Falling into the door can break the door. Grabbing the towel bar on the door is not a safe thing if it is being used as a Grab Bar to steady yourself. In addition with the door removed and a shower curtain in place it makes it easier to help.
We were advised to remove the shower doors because if someone falls especially in a tub, it can be very difficult for EMS to get them up and out of the tub. When we swapped for the shower curtain, we were advised to have permanent rods installed with screws so if someone fell and grabbed on the shower curtain it would not come tumbling on top of them. It may tear off the hooks, but it would be a slower process and hopefully prevent a serious injury.
The clothes are unchanged or the outfits do not match. Strong body odor indicates no bathing, showering or use of other cleansing methods, such as lotions or creams for long periods, maybe for a week or longer. Time for assistance.
Be sure to have a shower chair and floor mats that are non skid. My mother and aunt hated to shower due to getting so cold. We would warm several towels in the dryer prior to the shower ending. Then wrap around as much of their body as you can while drying them off. If they live in their own home you could get a small heater or a towel warmer for the bathroom. Heaters are not permitted on a senior campus.
One thing for me was I noticed my Mr. took extremely quick showers. They had a sit down tub so it wasn’t like I was looking at him in all his glory per se. but one day I I checked in on him and I saw that he was basically getting his face, head and shoulders wet with the spray and he was done. Also and this is really gross I’m sorry, but there was poop on his hands from not wiping himself properly. That was it for me.
and a little dark humor, I had to make sure there was no toilet paper or facial tissue or anything within arms reach of him being on the commode or I’d have that mess again.
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.
Clothes may be soiled.
Laundry basket is always empty.
Loved one says that they have showered, but you know they haven’t.
Loved one may have body odor, when they didn’t, previously.
Loved one may refuse to shower, or take a bath.
Shower/bath is unused, or dusty.
Is the person clean and neat?
Is there a noticeable odor?
Is hair clean and brushed, combed?
A person does not have to take a bath daily. (as a matter of fact I was surprised to learn when my Husband was in rehab that the requirement in the State of Illinois is 2 times a week)
If this is a person that is living alone and you visit often check the bathroom, are there wet or damp towels?
If this person is living with you monitoring can be done easily. (in most cases)
If they seem to need help, help them. Don't "offer" to help as most offers will be rejected.
Showers can be a scary place. Noisy, slippery and for someone with dementia there is a lot to remember when bathing/showering.
I also suggest removing sliding doors to showers and replace with a shower curtain. (doors can be stored and replaced later) Often the door can become a hazard. Falling into the door can break the door. Grabbing the towel bar on the door is not a safe thing if it is being used as a Grab Bar to steady yourself.
In addition with the door removed and a shower curtain in place it makes it easier to help.
Heaters are not permitted on a senior campus.
and a little dark humor, I had to make sure there was no toilet paper or facial tissue or anything within arms reach of him being on the commode or I’d have that mess again.