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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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When my mom, with dementia, entered the nursing home, she insisted on having a phone as well. But, within a few months she became more confused, hallucinatory and delusional. She also could not differentiate day from night and would call me at 3AM. She was paranoid and was convinced a man from her old apartment was “stalkIng” her. When her phone would ring and there was no one there, she was convinced it was this man and became upset, I was forced to take her phone after that. I made quite certain she knew she could always call me from the nurse’s station and they would even dial the phone for her.
If Mom can still handle making phone calls, let her have the phone until she is no longer capable. One day, it just disappears and you explain to her it’s being fixed. Of course, it’s never fixed.
I would not give her one. She will be calling you all the time for things you have no control over or can't possibly do because its 3am. I gave Mom my old very simple cell phone. It turned on and off by the same button. It was like using her cordless. She never got the hang of it. One of the first things she couldn't do anymore was answer a phone or use the remote.
How to deal? How bad is her Dementia, might have to tell a little white lie. Tell her you are looking for the right one and haven't found it. It may get stolen.
If your Mom already has a phone (either a land line or a cell phone) in her room at the nursing home, please talk to the Nursing Coordinator and the Social Service Director for your Mom's Unit, prior to taking the phone away.
I got into REALLY BIG, BIG, trouble for taking Mom's cellphone home one night when she was extremely upset and having delusions that my brother and I had gambled away the farms and other delusions. She was calling her elderly friends in the town we used to live in at 8 PM that night. The next afternoon, the Social Service Assistant (SSA) called me and was extremely angry that I had taken Mom's phone away the previous night and she would not listen to my reasons for taking Mom's phone. The SSA demanded that I return Mom's cellphone immediately!! - which I did. (There is much more to this story, but I will not tell it here.)
If you have not given her a cellphone or landline phone, I support JoAnn and would not give your Mom a phone either and would also tell your Mom "white lies" as to why you have not bought a phone to her.
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.
If Mom can still handle making phone calls, let her have the phone until she is no longer capable. One day, it just disappears and you explain to her it’s being fixed. Of course, it’s never fixed.
How to deal? How bad is her Dementia, might have to tell a little white lie. Tell her you are looking for the right one and haven't found it. It may get stolen.
I got into REALLY BIG, BIG, trouble for taking Mom's cellphone home one night when she was extremely upset and having delusions that my brother and I had gambled away the farms and other delusions. She was calling her elderly friends in the town we used to live in at 8 PM that night. The next afternoon, the Social Service Assistant (SSA) called me and was extremely angry that I had taken Mom's phone away the previous night and she would not listen to my reasons for taking Mom's phone. The SSA demanded that I return Mom's cellphone immediately!! - which I did. (There is much more to this story, but I will not tell it here.)
If you have not given her a cellphone or landline phone, I support JoAnn and would not give your Mom a phone either and would also tell your Mom "white lies" as to why you have not bought a phone to her.