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.
✔
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:
There is always a lot of controversy when you ask if you need a lawyer. People will say that you can get forms on line, and you CAN, or in books and you CAN. And have them notarized and witnessed of whatever. So that much is true. My OWN advice therefore is just my OWN advice to be taken with a grain of salt. I had to do this for my brother and I needed to be made both POA and Trustee of his Trust. It was an amazingly thorough document drawn up by his Lawyer who visited with him to ascertain his mental status and ability to create it. I still remember him saying "Dee, this gives your sister the right to the gold in your teeth; are you aware of that". My bro had been diagnosed with probable early Lewy's Dementia. We were trying to make everything safe and we DID and I still remember the banks and how careful they were, how they told me I could do this or that dependent on the language in the document. Did I pay? Yes, I did. I was the one who paid, also, as he had had an accident (how the diagnosis was suggested as an incidental finding). The Lawyer had to do this with a Trust, so needed the document. And to do a POA. And to do two visits to my bro, one in hospital and one in rehab; interview me, him, and us together. It was about 4,000 in all. I think for a simple POA it would not cost half that but a call to Lawyers would answer that question. I was never so glad to have a solid document in my hands in all my life during the course of the next year in which I was a complete anxious learning curve. You will find that cost ranges vary enormously dependent on where you live. Wishing you good luck for certain. You will get widely varying answers on this one.
Your profile says brother has Dementia. This will cause a problem if its advanced. He has to understand what he is doing and how it will effect him. He has to be able to assign you and sign off on it. If he can't do this, then u file for guardianship which is expensive. With both you can use his money.
If you get a POA, like Alva said, get an attorney to draw it up.
NCken, I also agree, best to use an Attorney to draw up the Power of Attorney. I would recommend using an Elder Law Attorney. Elder Law Attorneys are more up-to-date with Federal and State laws regarding elder rights, etc.
Any legal paperwork is not a do-it-yourself project. All it takes is one missing word or a misspelled word to create a fire storm later down the road. Plus you would miss out on certain things that are needed in a Power of Attorney.... example, if your brother owns a house, the full address of said house needs to be placed in the Power of Attorney.
The Elder Law Attorney may recommend other legal documents, such as a Living Will or Medical Directive. I used an Elder Law Attorney, and I have a 3-ring binder filled with all sorts of forms given to me by the firm. Heavens, my POA is over 10 pages long.
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.
Did I pay? Yes, I did. I was the one who paid, also, as he had had an accident (how the diagnosis was suggested as an incidental finding). The Lawyer had to do this with a Trust, so needed the document. And to do a POA. And to do two visits to my bro, one in hospital and one in rehab; interview me, him, and us together. It was about 4,000 in all. I think for a simple POA it would not cost half that but a call to Lawyers would answer that question. I was never so glad to have a solid document in my hands in all my life during the course of the next year in which I was a complete anxious learning curve.
You will find that cost ranges vary enormously dependent on where you live.
Wishing you good luck for certain. You will get widely varying answers on this one.
If you get a POA, like Alva said, get an attorney to draw it up.
Any legal paperwork is not a do-it-yourself project. All it takes is one missing word or a misspelled word to create a fire storm later down the road. Plus you would miss out on certain things that are needed in a Power of Attorney.... example, if your brother owns a house, the full address of said house needs to be placed in the Power of Attorney.
The Elder Law Attorney may recommend other legal documents, such as a Living Will or Medical Directive. I used an Elder Law Attorney, and I have a 3-ring binder filled with all sorts of forms given to me by the firm. Heavens, my POA is over 10 pages long.