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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.
✔
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:
1. There are two types of VA benefits available for non-career military; compensation and pension. Compensation is what most are familiar with...a veteran is injured or disabled as a result of service and they receive a "rating" and a compensation check every month. Pension is a non-service connected benefit in that the veteran's disability does not have to be service related. A veteran cannot receive compensation and pension at the same time.
2. There are three levels to VA pension benefits - basic, homebound, aid and attendance. All are needs based. Basic pension can be received without medical evidence. Homebound and Aid and Attendance do. 3. The pension (monthly maximum for vet = $1,650, for couple = $1,950, for surviving spouse = $1,056) is paid directly to the veteran. Claim can be made for virtually any service including care provided by a relative except a spouse), home health aids, geriatric care management, assisted living facilities or nursing homes.
4. To qualify the vet must have served at least 90 continuous days one day of which must have been during a TIME of combat (the vet does not have to have served IN combat). The vet must have received at least a general discharge. To be eligible for the survivor benefit, the spouse must have been married to the vet at the time of the vet's demise (no divorce).
5. You will need help to successfully apply for the benefit. You can try a local Veteran Service Office (search for National Association of Veteran Service Officers to find same near you). Keep in mind that Service Officers will not make recommendations with respect to financial planning if the claimant is "over-resourced". Also keep in mind that if the application is not done properly the first time it may take up to 9-12 months to receive an award. Although you can apply on-line for veteran benefits, you cannot do so for survivor benefits.
6. Benefits will be retroactive to the month AFTER application.
7. If you use a private consultant pay a fee. Do not use one of the profilgate "we help vets for free" firms that are actually financial service firms, typically insurance brokers, looking to sell high commission annuities. My experience has been that most of these firms are woefully inexperienced in coordinating VA benefits with other public benefit programs and as a result future access to Medicaid may be seriously compromised.
By the way...qualifying for Medicaid now, if the financial situation warrants it, may free up cash for other purposes. Call your local Area Agency on Aging for additional resources.
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.
1. There are two types of VA benefits available for non-career military; compensation and pension. Compensation is what most are familiar with...a veteran is injured or disabled as a result of service and they receive a "rating" and a compensation check every month. Pension is a non-service connected benefit in that the veteran's disability does not have to be service related. A veteran cannot receive compensation and pension at the same time.
2. There are three levels to VA pension benefits - basic, homebound, aid and attendance. All are needs based. Basic pension can be received without medical evidence. Homebound and Aid and Attendance do.
3. The pension (monthly maximum for vet = $1,650, for couple = $1,950, for surviving spouse = $1,056) is paid directly to the veteran. Claim can be made for virtually any service including care provided by a relative except a spouse), home health aids, geriatric care management, assisted living facilities or nursing homes.
4. To qualify the vet must have served at least 90 continuous days one day of which must have been during a TIME of combat (the vet does not have to have served IN combat). The vet must have received at least a general discharge. To be eligible for the survivor benefit, the spouse must have been married to the vet at the time of the vet's demise (no divorce).
5. You will need help to successfully apply for the benefit. You can try a local Veteran Service Office (search for National Association of Veteran Service Officers to find same near you). Keep in mind that Service Officers will not make recommendations with respect to financial planning if the claimant is "over-resourced". Also keep in mind that if the application is not done properly the first time it may take up to 9-12 months to receive an award. Although you can apply on-line for veteran benefits, you cannot do so for survivor benefits.
6. Benefits will be retroactive to the month AFTER application.
7. If you use a private consultant pay a fee. Do not use one of the profilgate "we help vets for free" firms that are actually financial service firms, typically insurance brokers, looking to sell high commission annuities. My experience has been that most of these firms are woefully inexperienced in coordinating VA benefits with other public benefit programs and as a result future access to Medicaid may be seriously compromised.
To learn more about this benefit directly from the VA, visit here http://www.vba.va.gov/bln/21/pension/
By the way...qualifying for Medicaid now, if the financial situation warrants it, may free up cash for other purposes. Call your local Area Agency on Aging for additional resources.