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:
Yes, I'm on disability and have had my mom almost 1 year. She needs help brushing teeth, showering, dressing etc. We have had to add locks to the inside of our doors so she doesn't wander. She's up and down all night. Very hard on me.
Yes, I'm caring for my Mom & it's challenging, to say the least. For me, the loneliness of this is the worst. Sometimes, I go days on end without an intelligent adult conversation.
Yes, I am on disability and had been caring for my mom until last month. She fell several times, was not able to get herself back up, I could not lift her or help her back up because of my own disability, so she landed in the nursing home. I had a lot of problems caring for mom because of the physical problems that I had, I was concerned about me landing in the hospital with my back and neck problems. I have a lot of other health problems and I never felt that I could really take care of myself and get over illnesses because I would be up caring for me all the time. Right now I am going through a lot of sadness and separation anxiety not being there taking care of her all the time, adn have a deep sense of loss, and trying to adjust to living with my sister. Mom is resisting staying in the nursing home and sueing both me and my sister for having her in the nursing home and we have to go to court next month. I am at the point of a nervous breakdown now, making my anxiety disorder worse.
Yes, I did feel lonely caring for mom, I had to be there with her all the time and I did not have much social life. Now I am getting out to do things, but I am tied up at the nursing home trying to get mom adjusted to it and try to encourage her to want to stay and try to get our family problems resolved. I did not realize what chaos this was going to cause.
I feel your sense of loss and glad you have a sibling that you can live with. You did not mention either Durable or Medical POA. Do you have them? It sounds like you and your sister need an atty to file for guardianship for the protection and care of your mom who evidently needs to be in a nursing home but cannot or refuses to see that.
I understand that you must have had to move quickly to get your mom in a nursing home given your disabling health problems.
I'm on disability myself with bipolar two and the stress of all this sometimes triggers some strong mood swings.
I pray that all of this will work out and that you do not have a nervous breakdown.
Have you talked with the nursing home people about what you can do or not do to help your mom adjust? If not, I think that I've read some articles on line about this. Also, who checked her in the nursing home? If you did this with medical POA or with a doctor's orders then she has no ground upon which to sue you.
Also, has a doctor evaluated her for being competent to manage her own affairs.
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.
Right now I am going through a lot of sadness and separation anxiety not being there taking care of her all the time, adn have a deep sense of loss, and trying to adjust to living with my sister. Mom is resisting staying in the nursing home and sueing both me and my sister for having her in the nursing home and we have to go to court next month. I am at the point of a nervous breakdown now, making my anxiety disorder worse.
Yes, I did feel lonely caring for mom, I had to be there with her all the time and I did not have much social life. Now I am getting out to do things, but I am tied up at the nursing home trying to get mom adjusted to it and try to encourage her to want to stay and try to get our family problems resolved. I did not realize what chaos this was going to cause.
I understand that you must have had to move quickly to get your mom in a nursing home given your disabling health problems.
I'm on disability myself with bipolar two and the stress of all this sometimes triggers some strong mood swings.
I pray that all of this will work out and that you do not have a nervous breakdown.
Have you talked with the nursing home people about what you can do or not do to help your mom adjust? If not, I think that I've read some articles on line about this. Also, who checked her in the nursing home? If you did this with medical POA or with a doctor's orders then she has no ground upon which to sue you.
Also, has a doctor evaluated her for being competent to manage her own affairs.