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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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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.
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Change can be scary when you get to be 75 or 80, but it can be even scarier when you are in your 90's or developing dementia. Encourage your elders to make the changes now that can help them to avoid the sudden changes that may be the result of a crisis.... living in an accessible, senior friendly home - finding alternatives to driving - accepting outside help - using assistive devices like canes, walkers and hearing aids.
#43... learn to say "NO" or "I cannot possibly do that".
Oh how I wished I would have learned that years ago. It becomes more difficult as the years roll on. Let your elder know you are not able to leap tall buildings in a single bound, that you aren't faster than a speeding locomotive, and you can't bend steel with your bare hands.
#42 UTI in elderly have different symptoms, are life threatening. Learn the symptoms online. Get changes in behavior diagnosed. PUSH for a diagnosis, often missed using a dip-stick urinalysis. NEVER skip a dose of antibiotics, use the entire bottle, or the bladder infection won't clear. Then you will be writing us to ask why your loved one's behaviors are so weird, again.
Do not promise an elder you will never put them into a nursing home.
Usually we make that promise when the elder is still active, still driving, still living at home, meeting friends for lunch, still mowing the lawn and shoveling snow. We cannot picture them being elderly, unable to do for themselves. Oh dear, now what do we do?
It's either bringing in caregivers to help out if you find that caregiving seven days a week for 15 to 20 hours each day is too much to handle... but so many times the elder will slam the door saying no strangers in the house. Or moving to Assisted Living and the elder blocking the way of the moving van demanding to stay in the house because you promised. You feel the guilt.
Have the conversation with the elder while they are able to comprehend the situation. I made it known to my own parents that in their best interest that they should have caregivers. My Dad was all for it, but NOT Mom. Oh dear, we have a problem in the room. I was a senior myself with my own age decline, like who would pick ME up if I fell? So start this conversation early.
Do not quit a job, leave your home or make large financial decisions without a clear understanding of the consequences. Despite what ANYONE ELSE tells you, Medicare does not pay family members as in-home caregivers. Medicaid does not pay full time hours in most situations and does not pay health care premiums for caregivers. You will need to have a real understanding of your caregivee's finances and do your best to come to a fair arrangement to all parties involved. If a parent insists that you must care for them in their home without financial support, look to their own behaviors as caregivers. Don't be trapped by Fear obligation and guilt into taking on more than you are capable of doing without devastating consequences to yourself.
#40 Keeping with Stacey's above comment. Learn to delegate. Don't ask siblings for help, tell them I need you to do this. Say it with authority. If they start making excuses, say this is your job now, If you can't do it find someone who can and then walk away.
#39 If you are Caring for someone 24/7, Find and set up Respite Care, as Soon you will be finding yourself So Burnt out, and in need of a a break, a Long One! Do this several times a yearfor a week or more, and better yet, monthly if possible, for a couple of days!
If you want to start World War III, taking away one's car keys. It's not easy. But remember when you take away something from an elder you need to give a replacement. Meaning setting up a list of people who can drive the elder. Or a set up with a local taxi company.
36. An elder with dementia often benefits from an evaluation of their mental health by a geriatric psychiatrist. I wish I'd now about this earlier. Depression and anxiety often accompany dementia and are treatable.
35: Prepare an emergency folder to accompany you to the elder's doctor's visits and trips to the emergency room! Copies of medical insurance and health care proxy are important to have with you. AND make sure the HIPPA form is signed by your elder at the first visit to allow you to discuss the health issues with the provider. Ditto for health insurance carriers permission forms
#33 Feeling a bit punchy here, but this lesson is: nothing you ever are left to choose for them on your own will EVER be right. Chocolates? These are too sticky. Toothbrush? This isn't the same color as the last one. Lotion? This one doesn't smell right.
#33.Also, ask your doctor to give you extra specimen containers and requisition slips for urine samples. That way, if you suspect your parent has a urinary tract infection you can obtain sample without the hassle of transporting them to the clinic etc.
My Mom had chronic bladder infections so this saved time.
Your elder had been going to the same doctor for decades, yet as soon as you sign in, the gal behind the window hands you a clip board to fill out an application type paperwork, 4 or 5 pages worth.
Good grief. Both my parents had eye issues thus they would need a really big magnifying glass to read anything. My Mom was hard of hearing so I had shout the questions to her, some questions were embarrassing for a waiting room to hear. When I got most of her paperwork done, the nurse would call in my parents to go to the exam room before I even started on my Dad's paperwork. That was sooooo stressful, those gosh darn papers.
So what I decided to do the next time was just write across the page in big lettering "SAME AS BEFORE", had my parents sign it and handed it back to the gal behind the glass window.
Oh and make sure your Elder has his/her Medicare card, secondary insurance card, and photo ID. Make sure it is easy to obtain, not back home in the top desk drawer. Seems like every time we walk into a doctor's office the Staff needed that. Like who is going to pretend to be someone else going to a urologist?
Keep a list of all your loved one's medicines with you all the time so if a paramedic, doctor, nurse etc. needs to know what medicines they are on you don't have to go scrambling around for them.
Also, be in the moment with them. Try to adjust to their world because they have lost the ability to adjust to yours. It may seem unfair to you but it's their new reality so to be supportive, make it yours.
My Dad had a favorite winter jacket, but it was a tug-of-war trying to get him into that jacket. I found if I bought him clothes one size larger it was a tad bit easier.
And for socks, don't get the ones with tight elastic around the top. My Dad wore his socks to bed, and in the morning his knee was quite swollen. It was the tightness of the socks. The swelling can also be above the elastic line.
#27 Get a whiteboard and dry erase markers. Attach one (only one) marker by string to the whiteboard. Store the others out of reach. Write reminders and notes and appointments on whiteboard, and also on calendar next to whiteboard - 2 reminders. Get a digital clock with the date, day of the week and year on it so they can match clock date to calendar & appointment. (for parents who are in early dementia) Tape notes to the bathroom door as needed. When I made a date for her, Mom would say "I'll remember" (but she wouldn't) so I always said "write it on the whiteboard and calendar, I'll wait while you do it"
The elder needs supplies and groceires. If they are mobile and helpful have them come along with you. If not, you do the shopping on your own. Otherwise when you are in Aisle 26 of the grocery store, the elder is still in Aisle 5. And afterwards wants a tour of a half dozen stores since you are driving.
Set boundaries on other things. Don't sit in doctor's waiting rooms 3 times a week. If the elder is seeing a dozen specialists [which they do], that's a lot of waiting rooms especially when the doctor says come back in 2 or 3 months... stretch it out to 5 or 6 months if it isn't anything urgent.
Don't trust the doctor or the facility social worker or your neighbour or great auntie mary to tell you what you need to know, go to the library, read online, read through this site and educate yourself.
Totally release yourself from the idea that you have to please your parents. It's a habit we formed as a very young age...the cheers you got from the time took your first steps to the time you got your first A on a math test to the time you started your first job to the time you had your first child.... you've been programmed to please them, to make them smile, to make them proud of you. It's ingrained and unless you let it go now, you're going to have many tearful nights.
There comes a point that you'll have to make hard decisions and simply will not be able to get their approval, often quite the opposite. There will be times when nothing will please them, nothing will make them happy, and they will look for someone to lash out against. This will often be those who are closest to them, those such as yourself, who love them and are trying to do they best they can.
The sooner you realizing that that you do NOT have to please them to do the right thing the better off you both will be. As caregiver, it's only your job get them the help they need, to do your best to keep them fed, clean, safe and as comfortable as possible. Realize this and you will empower yourself to do what much be done to achieve these goals, regardless no matter how they act toward you. If you get them, that's great, but don't expect pleases and thank you's. Expect resistance, and, sometimes downright uglyness. It's the nature of the beast...
#22. Yield extravagantly to the family member who is the leader. Wait for that person to learn, don't fight them. Even if they are not exactly right, get behind them, allow days to go by until they get it, support them. Try. Avoid a family fight-no one is the enemy-even if they are idiots. Be a peacemaker. Try not to get in the middle though, you will be condemned in a dysfunctional family wherein no good deed goes unpunished. Expect this to happen, back off slightly-this is not the time to fight or correct someone. Apologize often-even if it is for nothing!
#21. Try not to make the mistake of doing everything for them because it is convenient or expedient for you. Conversely, don't fool yourself and automatically assume they can get their own meals. Spend time with them. No one can do all this perfectly, but you will learn, get better at it. Just when you do, they will change it up on you-it will be you surprised.!!
My parents Wills were older than dirt, and almost all the names on the Will the people had passed and thus money would go to heirs. Ok, immediate heirs, or a huge redwood family tree of heirs? Many of which my parents never met. Parents were glad to update their Will with the help of an Elder Law attorney.
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.
Oh how I wished I would have learned that years ago. It becomes more difficult as the years roll on. Let your elder know you are not able to leap tall buildings in a single bound, that you aren't faster than a speeding locomotive, and you can't bend steel with your bare hands.
UTI in elderly have different symptoms, are life threatening.
Learn the symptoms online.
Get changes in behavior diagnosed.
PUSH for a diagnosis, often missed using a dip-stick urinalysis.
NEVER skip a dose of antibiotics, use the entire bottle, or the bladder infection won't clear. Then you will be writing us to ask why your loved one's behaviors are so weird, again.
Usually we make that promise when the elder is still active, still driving, still living at home, meeting friends for lunch, still mowing the lawn and shoveling snow. We cannot picture them being elderly, unable to do for themselves. Oh dear, now what do we do?
It's either bringing in caregivers to help out if you find that caregiving seven days a week for 15 to 20 hours each day is too much to handle... but so many times the elder will slam the door saying no strangers in the house. Or moving to Assisted Living and the elder blocking the way of the moving van demanding to stay in the house because you promised. You feel the guilt.
Have the conversation with the elder while they are able to comprehend the situation. I made it known to my own parents that in their best interest that they should have caregivers. My Dad was all for it, but NOT Mom. Oh dear, we have a problem in the room. I was a senior myself with my own age decline, like who would pick ME up if I fell? So start this conversation early.
If you are Caring for someone 24/7, Find and set up Respite Care, as Soon you will be finding yourself So Burnt out, and in need of a a break, a Long One! Do this several times a yearfor a week or more, and better yet, monthly if possible, for a couple of days!
If you want to start World War III, taking away one's car keys. It's not easy. But remember when you take away something from an elder you need to give a replacement. Meaning setting up a list of people who can drive the elder. Or a set up with a local taxi company.
Refer back to rule #32.
My Mom had chronic bladder infections so this saved time.
Your elder had been going to the same doctor for decades, yet as soon as you sign in, the gal behind the window hands you a clip board to fill out an application type paperwork, 4 or 5 pages worth.
Good grief. Both my parents had eye issues thus they would need a really big magnifying glass to read anything. My Mom was hard of hearing so I had shout the questions to her, some questions were embarrassing for a waiting room to hear. When I got most of her paperwork done, the nurse would call in my parents to go to the exam room before I even started on my Dad's paperwork. That was sooooo stressful, those gosh darn papers.
So what I decided to do the next time was just write across the page in big lettering "SAME AS BEFORE", had my parents sign it and handed it back to the gal behind the glass window.
Oh and make sure your Elder has his/her Medicare card, secondary insurance card, and photo ID. Make sure it is easy to obtain, not back home in the top desk drawer. Seems like every time we walk into a doctor's office the Staff needed that. Like who is going to pretend to be someone else going to a urologist?
Also, be in the moment with them. Try to adjust to their world because they have lost the ability to adjust to yours. It may seem unfair to you but it's their new reality so to be supportive, make it yours.
My Dad had a favorite winter jacket, but it was a tug-of-war trying to get him into that jacket. I found if I bought him clothes one size larger it was a tad bit easier.
And for socks, don't get the ones with tight elastic around the top. My Dad wore his socks to bed, and in the morning his knee was quite swollen. It was the tightness of the socks. The swelling can also be above the elastic line.
When I made a date for her, Mom would say "I'll remember" (but she wouldn't) so I always said "write it on the whiteboard and calendar, I'll wait while you do it"
The elder needs supplies and groceires. If they are mobile and helpful have them come along with you. If not, you do the shopping on your own. Otherwise when you are in Aisle 26 of the grocery store, the elder is still in Aisle 5. And afterwards wants a tour of a half dozen stores since you are driving.
Set boundaries on other things. Don't sit in doctor's waiting rooms 3 times a week. If the elder is seeing a dozen specialists [which they do], that's a lot of waiting rooms especially when the doctor says come back in 2 or 3 months... stretch it out to 5 or 6 months if it isn't anything urgent.
There comes a point that you'll have to make hard decisions and simply will not be able to get their approval, often quite the opposite. There will be times when nothing will please them, nothing will make them happy, and they will look for someone to lash out against. This will often be those who are closest to them, those such as yourself, who love them and are trying to do they best they can.
The sooner you realizing that that you do NOT have to please them to do the right thing the better off you both will be. As caregiver, it's only your job get them the help they need, to do your best to keep them fed, clean, safe and as comfortable as possible. Realize this and you will empower yourself to do what much be done to achieve these goals, regardless no matter how they act toward you. If you get them, that's great, but don't expect pleases and thank you's. Expect resistance, and, sometimes downright uglyness. It's the nature of the beast...
Avoid a family fight-no one is the enemy-even if they are idiots. Be a peacemaker.
Try not to get in the middle though, you will be condemned in a dysfunctional family wherein no good deed goes unpunished. Expect this to happen, back off slightly-this is not the time to fight or correct someone. Apologize often-even if it is for nothing!
Conversely, don't fool yourself and automatically assume they can get their own meals.
Spend time with them. No one can do all this perfectly, but you will learn, get better at it.
Just when you do, they will change it up on you-it will be you surprised.!!
My parents Wills were older than dirt, and almost all the names on the Will the people had passed and thus money would go to heirs. Ok, immediate heirs, or a huge redwood family tree of heirs? Many of which my parents never met. Parents were glad to update their Will with the help of an Elder Law attorney.