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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.*
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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 was on all Moms utilities and other bills as the person to contact if payments weren't made.
My Mom asked me to pay her bills. It started out that we did it together. I wrote them, she signed them. Eventually, I did it all and signed with POA behind my name. I also was on her account.
I live in Texas and found that I was only asked for a POA by the credit card company when I wanted to cancel the card after my Mother died. Before that I simply called the utilities and explained the situation telling them I was trying to make sure Mom's bill got paid. EVERY one of them willingly changed the mailing address to mine. I was a signer on her checking account and paid them by check. Pretty much, all they were concerned with was someone paying the bill.
Agree, set up automatic bill paying. I remember when my BIL had both his mother and his aunt, different residences, both with early dementia. And working and supporting his own family. He set their bills up on autopay, and slightly overpaid the utility bills that fluctuate. When he visited, he reviewed the utility bills and adjusted those payments. That way he handled their bills approximately quarterly, only utility bill adjustments. They both eventually needed AL, and finally NH. In my opion he was a saint.
Agree with auto pay. Explain in detail why it's a great idea. Mother stopped paying her bills about ten years ago. She wasn't even opening her mail. I set up all her utilities and insurances on draft. Of course her first reaction was, "Oh, no no no." So, I explained to her how it would work and how it could be a matter of emergency if her phone was disconnected and she couldn't call out, how she could still get a paper bill showing what was drafted, etc. Then she was in agreement and we went to the utilities and arranged it. At that time she was just beginning to show signs of dementia .
Ive had auto pay for my insurance and long term bills for years and am beginning to consider for my phone too tho i just like having the ability to see the charges for it.
By having auto pay i know if i get sick i dont miss a bill and lose coverage.
Auto pay . Also, our utilities have a third party notification where a bill can be sent to a designated person in addition to the account holder to be sure it gets paid -or hasn't been lost in the mail, etc. You could put her checking account "on-line" and set up bill pay - most bills come about the same time each month - go online to them get amount and pay from her account. (That way you'll know if she has already paid bill.)
Unfortunately, when we tried to help my mother who was diagnosed with Alzheimer’s when she started not paying her bills, she was terribly resistant, even stopped speaking to my brothers and I, and threatened to sue us. We had to enlist an attorney and, go to court and do a “benevolent take over” of all her affairs. We did have to present medical proof of her dementia to the courts, As her daughter, I became court appointment guardian, POA and trustee. With the court documents it was easy to change her accounts, take control of all her assets, even medical decisions. Taking things to court is costly and time consuming. But, full proof and necessary if the person is deteriorating and resistant.
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.
My Mom asked me to pay her bills. It started out that we did it together. I wrote them, she signed them. Eventually, I did it all and signed with POA behind my name. I also was on her account.
Of course her first reaction was, "Oh, no no no." So, I explained to her how it would work and how it could be a matter of emergency if her phone was disconnected and she couldn't call out, how she could still get a paper bill showing what was drafted, etc. Then she was in agreement and we went to the utilities and arranged it. At that time she was just beginning to show signs of dementia .
By having auto pay i know if i get sick i dont miss a bill and lose coverage.
As her daughter, I became court appointment guardian, POA and trustee. With the court documents it was easy to change her accounts, take control of all her assets, even medical decisions. Taking things to court is costly and time consuming. But, full proof and necessary if the person is deteriorating and resistant.
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