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
✔
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:
Thankyou everyone, it's very helpful to hear from people that have experienced, similar conditions, I am really trying and have been trying but all the process to get help takes so long, I just need a couple weeks away with, no worries and hearing my name called every 10 minutes, I hope i can find someone to step in for abit, but family and friends is not an option with the carw they need, so I have to rely on government services, I thank you all so much, and I will try take it 1 day at a time, but if I start to feel way to overwhelmed, I will definitely take your advice and call 000 to get an ambulance and be admitted for some help, with everything, to all who replied you are a God send and I can't thankyou all enough, it's good to know people truly care, even for someone they don't even know, it really does give me hope for a brighter future.
Heppner, thanks for coming back please do take care of yourself.
If I may suggest some little steps you can take. When you are able to get out , don't let yourself think about , your loved one. And every time you do tell yourself, a big fat NO! This is about me, and only me.
Practice mindfulness, put yourself in the moment, not in your problems. Practice, rule of 3, 3 deep breaths, find 3 pretty things, close your eyes and hear 3 things.
If you are feeling guilty! DON'T, you didn't cause this you have nothing to feel guilty about!
And most importantly please don't hesitate to call , emergency numbers for the country you live in!!!! And be sure to get yourself some counseling
Also, you have to accept the fact that for some things you have no control. So say to yourself as much as you can , " let go let God" or " Let the marbles fall where they may" what ever works for you.
Religion or not , read the serenity prayer. Change the things that you can, accept the things that you can not.
Exactly. I think that for believers the let go and let god can be so good in so many circumstances. And I couldn't agree MORE with the serenity prayer. Whether you are of faith or not, whether you are in AA or not the serenity pray is the best thing we can repeat to ourselves ever. The shortest and most to the point. The very best thing we can rely upon.
I feel so much better hearing your message to us now, and I just want to assure you that there is no shame whatsoever in getting help for yourself when you are feeling overwhelmed. The truth is that our despair and helplessness can hit us SUDDENLY and if our impulse control is down for the count we can get ourselves in serious trouble. Please reach out for help when you need it.
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.
If I may suggest some little steps you can take. When you are able to get out , don't let yourself think about , your loved one. And every time you do tell yourself, a big fat NO! This is about me, and only me.
Practice mindfulness, put yourself in the moment, not in your problems. Practice, rule of 3, 3 deep breaths, find 3 pretty things, close your eyes and hear 3 things.
If you are feeling guilty! DON'T, you didn't cause this you have nothing to feel guilty about!
And most importantly please don't hesitate to call , emergency numbers for the country you live in!!!! And be sure to get yourself some counseling
" Let the marbles fall where they may" what ever works for you.
Religion or not , read the serenity prayer. Change the things that you can, accept the things that you can not.