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:
I opened a checking account with my LO and the two of us who are POAs.
As soon as our POA took effect, I began paying each bill, one at a time, with one of those checks.
If the bill asked for a “new address” I filled that out using MY address. If not, I put her last name/my last name and my address as the return address on the envelope.
All went very simply except the phone bill REFUNDS, which were a nuisance but just because it took a few phone calls.
My LO NEVER SIGNED ANYTHING, because the POA was already in effect.
I became LO’s “designated payee” for LO’s Social Security using a note written by the psychiatrist who had tested and diagnosed her as having dementia, and being in need of help and supervision, and IMMEDIATELY had her SS payment direct deposited to our (hers and the 2 POA’s) checking account.
EVERY bill that is incurred by LO is paid through that checking account, making record keeping, especially income tax and reporting as designated POA, relatively easy and straightforward.
I’ve used this “system” successfully twice. Hope it works as well for you!
You can also consider a change of address form from post office. I did this with my POA. You can then hand deliver to your Mom the mail that is personal and hers.
I had zero problem with switching all my Dad's mail over to my house. I brought home a change of address card, filled it out, Dad signed it. Also, did the same for his Post Office Box.
You do this one entity at a time, and they ALL want your paperwork, so get the copy machine going now. You call each entity as well. Your Mom will have to sign for a lot of it. For instance, for my brother we had forms to fill out for almost EVERYONE including medicare (sent copies to me) his supplemental insurance, his phone (Spectrum was an ongoing nightmare requiring hours and hours of mess ups and calls), just every single thing from home insurance, and et al. It took about a good year to get it all in place. Once done it was done for the most part. But I had to contact and arrange with everyone. Luckily we could do a lot of it together. Went to all the banks, and etc. For IRS and for the Social Security you cannot use POA and have whole other process and papers if you need to do them. It's tough. I know! And that was in a small estate well organized.
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.
As soon as our POA took effect, I began paying each bill, one at a time, with one of those checks.
If the bill asked for a “new address” I filled that out using MY address. If not, I put her last name/my last name and my address as the return address on the envelope.
All went very simply except the phone bill REFUNDS, which were a nuisance but just because it took a few phone calls.
My LO NEVER SIGNED ANYTHING, because the POA was already in effect.
I became LO’s “designated payee” for LO’s Social Security using a note written by the psychiatrist who had tested and diagnosed her as having dementia, and being in need of help and supervision, and IMMEDIATELY had her SS payment direct deposited to our (hers and the 2 POA’s) checking account.
EVERY bill that is incurred by LO is paid through that checking account, making record keeping, especially income tax and reporting as designated POA, relatively easy and straightforward.
I’ve used this “system” successfully twice. Hope it works as well for you!
Easy peasy.