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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
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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:
I had a elder law attorney setup a Caregiver Agreement to deal with this issue. The agreement spells out exactly what care is to be provided & the amount paid for that care. You should keep very detailed records as to when, what, etc. care is being provided & the amount paid.
If the amount paid to the caregiver totals over $600 per year, you will need to provide a 1099 form to the caregiver & he/she will need to report it as income on their 1040 form.
I am a 64 year old woman who lives on a SS income of $945 a month. My 43 year old daughter had major brain surgery on 7/18/12 in Reno, NV. She has no insurance and does not qualifie FL medicaid, only if and when she is approved for SSI. I am her sole provider and caregiver. She needs medication around the clock, payment for prescription medication, transportation to and from doctor's offices and hospitals. There doesn't appear that she will recover for a very long time; based on her nuerosurgeon's report. He removed a very large tumor (size of a lemon) from her brain on 7/18/2012. However, there is still a mass (tumor) that is wrapped arround her brain stem. To operate could be a life threatening, if not a total disabilitating issue. They want to treat it with radiation, but there's no insurance. I am left to support her entirely financially, medical needs, around the clock care. Am I eligible for any caregiver financial assistance? Please advise, and thank you
terri33467: Can your daughter not get SDI....Disability? If you have filed paperwork for SSI, and they have not handled your case you need to find a Disability Attorney, they only received pay once they get your case settled. I filed for SDI and was turned down twice, and it took 2 years! I finally went to a Disability Attorney who filed the paperwork for me and we went before a judge and it was granted after almost 3 years. Do not mess around and wait all this time you need help right away. Attorneys who do this for a living know how to jump through all the "hoops" they place before you. They are doing this on purpose knowing that a lot of people will give up.
I care my husband, he had colon cancer, diabetes, arthritis left knee, cellulitis, amputee right leg above knee, heart failure, high blood pressure etc, I help him take bath, , clean up after puppy, groceries, drive him to doctor etc. We try need help to DAD Program in texas but they told me not qualify for pay family take care him I real up sad because I need something for my self too, I want go work but I can not leave him because sometime his puppy more than one time and make messy.because he had colon cancer stage 3, I Real need help for programs who can pay me because I care him
I was told by our Elder Law Attorney not to do that. He came up with better suggestions. You need to go see one and find out what you will need to do to put your Mom on Medicaid when the time comes. Do it fast.
I care for my elderly father w/MS. We've been through the private caregiver saga, the costs and I've had to end up doing most of the care b/c they turned out to be unreliable and I lost my job as a result I havent had much work, since , or been able to work as the main caregiver for my Dad and my own health issues. I dont know what will happen when I cant help him at all as he is very heavy and I have difficulty dressing him and cant pick him up when he falls . I work part-time for very little money, right now which actually has me out of the house for most of the day as it is a driving job and his financial situation has quite deteriorated since I've had to financially depend on him which Im ashamed to say and hes also assisted my sister who's on disability but cant afford cost-of-living. I've looked into many programs int the past re gettign more financial assistance but hes not eligible b/c of his pension, not eligible for Medicaid, I havent been able to get cash assistance for myself b/c I live with him and he owns the house. He has way too much financial responsibility, pays all the home-involved billsand as a result his saving has quite waned. We're really stuck, here and not sure where to turn next. He told me this morning he doesnt know how he'll get through the month.
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 the amount paid to the caregiver totals over $600 per year, you will need to provide a 1099 form to the caregiver & he/she will need to report it as income on their 1040 form.
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