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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:
Can a neurologists pa or rn give me the docs I need to activate health POA for my mom? They're giving me an emergency appointment today but I dread taking my pia mom if they won't give me docs?
Call ahead, find out how they handle this. Find out if there's a form for you, the family member, to fill out ahead of time. See if there's anything you need to bring with you.
For example in my mom's case she has Kaiser. There was a long form for me to fill out before hand. Once she saw the neuro and got diagnosed with Alzheimer's I had to submit a form through Kaiser's medical records request portal. Her doctor signed the form without seeing my mom based on the diagnosis.
Yes. The neurologist could possibly give you a letter saying your mom has a medical diagnosis of incompetence but not before testing, observing, etc that she is indeed incompetent. You might not leave with the results or it might be given to you at the end of the appointment. We can’t know the operations of your chosen doctors office.
In my experience, different I’m sure from others, the neurologist would always provide a report describing the complete summary of the appointment complete with diagnosis. I could get that if I waited or go back and pick up. The dr did not ask me if I had PO (I did and it was already in effect on date of signing) He simply reported his findings of how she presented etc. I just filed those reports along with my POA documents in case anyone ever asked. No one did. But, my name was already on all her financial and medical forms for several years before we visited the neurologist.
I have read on this site that if your mom presents well (aunt did) then best to take them on appointments at a time when their issues were either at their best (example: signing documents, going to social security office, going to the bank etc) or worse, going for medical help if possible. However well aunt presented, the test quickly confirmed her problems. If your mom has never been to a neurologist before or had cognitive testing, be aware that it can be a shock to her when she realizes she can’t recall the answers etc that are a part of the test. These tests are fairly standard and can be found online.
It greatly saddened aunt and made her realize that she did indeed have a need for assistance. in her day to day life she had become an observer and not a doer and much had slipped away that she didn’t realize was simply gone. I’m sure this depends on which areas have been most affected by the disease.
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.
For example in my mom's case she has Kaiser. There was a long form for me to fill out before hand. Once she saw the neuro and got diagnosed with Alzheimer's I had to submit a form through Kaiser's medical records request portal. Her doctor signed the form without seeing my mom based on the diagnosis.
Yes. The neurologist could possibly give you a letter saying your mom has a medical diagnosis of incompetence but not before testing, observing, etc that she is indeed incompetent. You might not leave with the results or it might be given to you at the end of the appointment. We can’t know the operations of your chosen doctors office.
In my experience, different I’m sure from others, the neurologist would always provide a report describing the complete summary of the appointment complete with diagnosis. I could get that if I waited or go back and pick up. The dr did not ask me if I had PO (I did and it was already in effect on date of signing) He simply reported his findings of how she presented etc. I just filed those reports along with my POA documents in case anyone ever asked. No one did. But, my name was already on all her financial and medical forms for several years before we visited the neurologist.
I have read on this site that if your mom presents well (aunt did) then best to take them on appointments at a time when their issues were either at their best (example: signing documents, going to social security office, going to the bank etc) or worse, going for medical help if possible. However well aunt presented, the test quickly confirmed her problems. If your mom has never been to a neurologist before or had cognitive testing, be aware that it can be a shock to her when she realizes she can’t recall the answers etc that are a part of the test. These tests are fairly standard and can be found online.
It greatly saddened aunt and made her realize that she did indeed have a need for assistance. in her day to day life she had become an observer and not a doer and much had slipped away that she didn’t realize was simply gone. I’m sure this depends on which areas have been most affected by the disease.
Good luck and let us know how it goes.