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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:
Are you seeing symptoms in yourself? Or someone else?
If yourself, the best thing to do is make sure all your legal ducks are in a row (assigned PoA, Advance Healthcare Directive, POLST, Pre-need Guardianship, Last Will) and then make your free Medicare wellness annual exam where they will ask if you want a cognitive/memory test. There you can discuss your worrisome symptoms with your doctor.
If it's for a spouse, get them in for that appointment after helping them get their legal ducks in a row. It is very import to have your legal protections and plans in place first.
What are the early signs of dementia? If you notice that you or a loved one is experiencing any of the following symptoms of dementia, check in with your doctor to ensure a proper diagnosis:
Forgetting things you just learned We all forget a random bit of trivia now and then, but with dementia, you have trouble retaining new information to a point where it impacts your life, says Caccappolo. Many friends and relatives notice this when a loved one starts to ask the same question over and over in the same conversation, or they are unable to remember the details of a TV show they just watched. It also becomes increasingly more difficult to learn new tasks, such as using a cell phone or a new computer program, even if the steps are clearly written down for them.
Problems managing money One of the first line of questions Caccappolo asks her patients is, “Are you still managing the household finances? Are you paying your bills on time? Have you paid any bills twice? Are you making errors when you’re balancing your checkbook?” People with dementia often have trouble with abstract thinking, like math, and are unable to follow the steps to do a task like paying a bill. They may also make poor judgments about spending money or even giving it away.
Getting lost in familiar places Memory loss and visual and spatial difficulties can lead to disorientation, causing people with dementia to get lost easily, even when walking or driving to places they have been to hundreds of times.
Confusion about time and day When you eat breakfast, but then realize it’s dinner time, or you can’t remember the day of the week without looking at a calendar, that can be a sign of cognitive impairment. Caccappolo says patients who have more advanced dementia may get up in the middle of the night and get dressed. It may also become increasingly difficult to know what season or even what year it is.
Visuospatial issues Atrophy in the part of the brain that processes visual information can lead to difficulties with visual perception, causing falls, difficulty driving safely, and problems judging distances and colors. This is different from visual problems due to changes in the health of the eyes, so always be sure to check in with your ophthalmologist as well.
Forgetting common words In addition to forgetting names and being unable to retain new information, people with dementia may find themselves unable to come up with the word for a familiar object, like a watch or refrigerator; they also may stop in the middle of a sentence or not be able to carry on a conversation.
Constantly losing things When a person without dementia misplaces their keys or the remote control, they can typically retrace their steps or think of all the logical places the object might be. But for a person with dementia, it can be difficult to take those deductive steps, leading to frustration, and frequently suspicion that the items were “stolen.”
A lack of interest in reading “In cognitive evaluations, I always ask, ‘Are you reading as much as you always did?’” says Caccappolo. She points out that people who used to love reading books find they can’t follow the story or remember what came in the previous pages. “A lot of people will say they can only read short articles now—it’s especially noticeable with people who were really avid readers,” she says.
Skipping social gatherings When it becomes difficult to follow a conversation or remember the names of people you don’t see every day, a person with dementia may start to withdraw from friends, and avoid parties or other events involving large groups of people.
Changes in personality People with dementia may find themselves getting more irritable, having a lower tolerance for frustration, and crying more—“even men who never cried before in their life will cry,” says Caccappolo. And sometimes it goes in the opposite direction.
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 yourself, the best thing to do is make sure all your legal ducks are in a row (assigned PoA, Advance Healthcare Directive, POLST, Pre-need Guardianship, Last Will) and then make your free Medicare wellness annual exam where they will ask if you want a cognitive/memory test. There you can discuss your worrisome symptoms with your doctor.
If it's for a spouse, get them in for that appointment after helping them get their legal ducks in a row. It is very import to have your legal protections and plans in place first.
If you notice that you or a loved one is experiencing any of the following symptoms of dementia, check in with your doctor to ensure a proper diagnosis:
Forgetting things you just learned
We all forget a random bit of trivia now and then, but with dementia, you have trouble retaining new information to a point where it impacts your life, says Caccappolo. Many friends and relatives notice this when a loved one starts to ask the same question over and over in the same conversation, or they are unable to remember the details of a TV show they just watched. It also becomes increasingly more difficult to learn new tasks, such as using a cell phone or a new computer program, even if the steps are clearly written down for them.
Problems managing money
One of the first line of questions Caccappolo asks her patients is, “Are you still managing the household finances? Are you paying your bills on time? Have you paid any bills twice? Are you making errors when you’re balancing your checkbook?” People with dementia often have trouble with abstract thinking, like math, and are unable to follow the steps to do a task like paying a bill. They may also make poor judgments about spending money or even giving it away.
Getting lost in familiar places
Memory loss and visual and spatial difficulties can lead to disorientation, causing people with dementia to get lost easily, even when walking or driving to places they have been to hundreds of times.
Confusion about time and day
When you eat breakfast, but then realize it’s dinner time, or you can’t remember the day of the week without looking at a calendar, that can be a sign of cognitive impairment. Caccappolo says patients who have more advanced dementia may get up in the middle of the night and get dressed. It may also become increasingly difficult to know what season or even what year it is.
Visuospatial issues
Atrophy in the part of the brain that processes visual information can lead to difficulties with visual perception, causing falls, difficulty driving safely, and problems judging distances and colors. This is different from visual problems due to changes in the health of the eyes, so always be sure to check in with your ophthalmologist as well.
Forgetting common words
In addition to forgetting names and being unable to retain new information, people with dementia may find themselves unable to come up with the word for a familiar object, like a watch or refrigerator; they also may stop in the middle of a sentence or not be able to carry on a conversation.
Constantly losing things
When a person without dementia misplaces their keys or the remote control, they can typically retrace their steps or think of all the logical places the object might be. But for a person with dementia, it can be difficult to take those deductive steps, leading to frustration, and frequently suspicion that the items were “stolen.”
A lack of interest in reading
“In cognitive evaluations, I always ask, ‘Are you reading as much as you always did?’” says Caccappolo. She points out that people who used to love reading books find they can’t follow the story or remember what came in the previous pages. “A lot of people will say they can only read short articles now—it’s especially noticeable with people who were really avid readers,” she says.
Skipping social gatherings
When it becomes difficult to follow a conversation or remember the names of people you don’t see every day, a person with dementia may start to withdraw from friends, and avoid parties or other events involving large groups of people.
Changes in personality
People with dementia may find themselves getting more irritable, having a lower tolerance for frustration, and crying more—“even men who never cried before in their life will cry,” says Caccappolo. And sometimes it goes in the opposite direction.
Or let us know the symptoms you are seeing we can tell you if there symptoms.