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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.
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Three elderly exhausted neighbors must withdraw their support. One handles her finances, dispenses meds, spends time & is primary HIPAA authorized. One does her grocery shopping and one drives her to her doctors with secondary HIPAA authorization.
Unfortunately, this is often one very difficult phase of the dementia journey. The dementia person goes through a period of making emotional and often unwise decisions base on what "I want" before the dementia yields them legally incompetent. As the elder law attorney advised me "... just making bad decisions doesn't make someone incompetent under the law." You cannot place them against their will as long as they are legally competent. It's very hard to watch and feel helpless.
I would suggest all three friends getting together with the neighbor for a good talk about reality. You might want to get some POA (durable and healthcare) papers prepared ahead of time naming the friend that handles finances as primary POA, with the other two as secondary POAs in case the primary cannot complete the duties. Focus the discussion on your concerns for your friend's continuing good care - and since you are all elderly too, you are afraid that one or more of you will have health problems that prevent you from helping as needed sometime in the future. Explain you would like to help him/her choose a care center while he/she is still able to be a bit picky; you will continue to visit or take to doctor as needed; and that the POAs are needed for when the dementia advances so you can continue to help out. Leave the POAs papers for him/her to think about and offer a ride to have them witnessed when he/she is ready to sign.
Please understand that not always being kind (particularly if this is a relatively new behavior) can be a symptom of the dementia and not just your friend being stubborn. Fear of losing control of your life can always make someone prickly and a bit unreasonable.
God Bless you and your friends for taking care of this neighbor to this point and continuing to care about his/her welfare.
Yes, if she has no family you need to call in whatever is your Office of Aging or Adult protective services. Just be honest and say you all can no longer do it. My husband and I helped a family a while back and we were in our early 60s and it really got to me. It got to be we were spending 2 or more days a week running some member of the family to doctor visits in the next state. I did set some boundries. So I sympathize. You have done enough, its time for someone else to step in.
JoAnn’s right. I would call APS as the area Agency on Aging can take a while to get information to you. APS is more immediate. If your neighbor has dementia, she will not be able to appoint anyone as POA since a person needs to be of sound mind to sign. She’s probably at the point where she will needa court appointed guardian. Be clear with APS that this is not a situation that can wait. Who authorized the HIPPA authorization ? Did she?
Bless you for being such good neighbors that you’ve done all this for her. People like you are few and far between.
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 would suggest all three friends getting together with the neighbor for a good talk about reality. You might want to get some POA (durable and healthcare) papers prepared ahead of time naming the friend that handles finances as primary POA, with the other two as secondary POAs in case the primary cannot complete the duties. Focus the discussion on your concerns for your friend's continuing good care - and since you are all elderly too, you are afraid that one or more of you will have health problems that prevent you from helping as needed sometime in the future. Explain you would like to help him/her choose a care center while he/she is still able to be a bit picky; you will continue to visit or take to doctor as needed; and that the POAs are needed for when the dementia advances so you can continue to help out. Leave the POAs papers for him/her to think about and offer a ride to have them witnessed when he/she is ready to sign.
Please understand that not always being kind (particularly if this is a relatively new behavior) can be a symptom of the dementia and not just your friend being stubborn. Fear of losing control of your life can always make someone prickly and a bit unreasonable.
God Bless you and your friends for taking care of this neighbor to this point and continuing to care about his/her welfare.
Bless you for being such good neighbors that you’ve done all this for her. People like you are few and far between.