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.
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I acknowledge and authorize
✔
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:
We don't talk much any more, I miss his hugs. We've always been very close. I know he needs things and won't tell me what. He feels he needs to try and do things for himself, but then I worry about him falling or hurting himself
I’m so sorry that your husband is struggling to manage. Of course, you are concerned about him.
Do you feel like he is safe at home? Are you concerned about being able to continue to care for him?
I understand that you miss the person that he once was. It’s very hard to see our spouses suffering. He may not want to be a burden on you, so therefore he won’t ask for help.
Do you have any outside help? Would he be more comfortable asking them for help? Do you think he may be approaching the point of needing to be placed in a facility? What health concerns does he have?
Wishing you peace as you continue on in your caregiving journey.
He’s not wrong for wanting to do things for himself as we should all value and want to hang on to our independence. The falls will happen no matter what you do, and worrying won’t change a thing. Don’t mean that to sound harsh, I just had to learn myself that falls are the bane of the elderly and will happen even when they are right beside you. Make your home as fall “friendly” as possible by removing tripping hazards and living on one floor, getting ramps installed if needed in place of steps outside. Never attempt to pick him up when the falls happen as this can injure you both. Call for help and let first responders safely lift him and assess for injury. Try to engage in conversation often, and seek outside time with friends for yourself. Your husband is feeling his independence slipping away and it’s normal for him to feel sad and withdraw over it. Consider talking with his doctor about a medication to help. I wish you both peace
Can you tell us about your husband's assessments and diagnosis by his MD? Has he had PT? Is balance his issue, or weakness, or something other? Is there a diagnosis of dementia or depression? Eventually, for us all, it becomes companionship in the waiting room as we address current issues. What are your issues, and your husband's?
You may just be undergoing the changes that come with aging, the process. I am 81, my partner is 83, and, as we continue to age, I know we often look at one another and wonder: Where is that vital woman laughing in pictures in Paris, cuddling dogs on the stone steps in Italy, weed whipping an acre in the country--WHERE DID SHE GO? That vital man, sailing in races on the Bay, laughing with friends at dinners out, racing the dogs down the sands to the beach, raising his grandbabies up to the ceiling? Where did he go? Now it sometimes comes down to it's Tuesday and garbage-can night. Which of us has a back strong enough to do it, or is it a two person slog? It can become tiring and too scary to remember the good times. But it's important to. And to remember there's something to be said for enjoying together a good documentary on Netflix, a sit down in the sun on the back deck by the apple tree.
Trust me that I feel you. I hope you will tell us more about what you're facing.
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.
Do you feel like he is safe at home? Are you concerned about being able to continue to care for him?
I understand that you miss the person that he once was. It’s very hard to see our spouses suffering. He may not want to be a burden on you, so therefore he won’t ask for help.
Do you have any outside help? Would he be more comfortable asking them for help? Do you think he may be approaching the point of needing to be placed in a facility? What health concerns does he have?
Wishing you peace as you continue on in your caregiving journey.
Has he had PT?
Is balance his issue, or weakness, or something other?
Is there a diagnosis of dementia or depression?
Eventually, for us all, it becomes companionship in the waiting room as we address current issues.
What are your issues, and your husband's?
You may just be undergoing the changes that come with aging, the process. I am 81, my partner is 83, and, as we continue to age, I know we often look at one another and wonder: Where is that vital woman laughing in pictures in Paris, cuddling dogs on the stone steps in Italy, weed whipping an acre in the country--WHERE DID SHE GO?
That vital man, sailing in races on the Bay, laughing with friends at dinners out, racing the dogs down the sands to the beach, raising his grandbabies up to the ceiling? Where did he go? Now it sometimes comes down to it's Tuesday and garbage-can night. Which of us has a back strong enough to do it, or is it a two person slog?
It can become tiring and too scary to remember the good times. But it's important to. And to remember there's something to be said for enjoying together a good documentary on Netflix, a sit down in the sun on the back deck by the apple tree.
Trust me that I feel you. I hope you will tell us more about what you're facing.