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:
Yes PA does but you must qualify Go to the PA Caregiver and Support program site and apply to see if you qualify for the caregiver allowance. (see info below) Pennsylvania’s Family Caregiver Support Program... responding to the needs of family caregivers Caregivers are the focus When you’re not feeling well, home is where you want to be - no matter what your age. And when an older relative or friend is ill or frail, you want to keep them close; to take care of them at home. Pennsylvania’s Family Caregiver Support program makes that possible by assisting families caring for an older relative or friend at home. In some cases, the program can also support older caregivers of younger relatives. It’s purpose is to support - not replace - the care being provided to frail family members in their home. The Family Caregiver Support Program responds to the needs of caregivers, so that they can better care for their loved ones. How does the program work? Area Agencies on Aging assign staff professionals to help family caregivers assess their needs in taking care of older relatives who are sixty years of age or older or who are suffering from chronic dementia or Alzheimer’s Disease. This assistance is also available to older caregivers caring for qualifying younger relatives. Amounts are determined by actual expenses and family income. Established income guidelines are above poverty level to enable more middle income families to participate. Benefits and Services for Caregivers • Assessments of caregiver and older relative’s needs • Counseling in coping skills • Respite care • Training in caregiving skills • Home chore services • Financial assistance to purchase supplies or services • One-time grants for home adaptations • Benefits and counseling on services available through local, state and federal programs. • Referrals to family support or disease-specific organizations such as: Children of Aging Parents; Alzheimer’s Disease and Related Disorders Association. • Assistance in completing benefits and insurance forms Pennsylvania took a pioneering step when it enacted the Family Caregiver Support Act of 1990 The Family Caregiver Support Program is a cost effective program that enables nearly 8,000 families to receive some financial, emotional and physical relief. Services provided under the program may include care management, respite care, financial reimbursements for home modifications, and others. The program has not kept pace with the growing needs of elders and caregivers The Family Caregiver Support Program has not seen an increase in the monthly maximum allowance of $200/month or the lifetime home modification maximum allowance of $2,000 since the program’s inception. The Pennsylvania House of Representatives unanimously passed House Bill 1830 on October 23, 2007, increasing the monthly maximum amount to $500 for expenses and the lifetime home modification maximum allowance to $6,000. The legislation would expand the definition of a primary caregiver to include support to any informal caregiver who is not being paid to provide care to an older adult and who meets the program’s criteria. It also would help the Department of Aging to coordinate Pennsylvania’s program with the federal program and to utilize dollars left unspent due to more restrictive state rules. House Bill 1830 is currently in the Senate Appropriations Committee. The Pennsylvania Senate is encouraged to act on this bill, which would support the vital role caregivers provide. This information comes from carrie.org
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.
Go to the PA Caregiver and Support program site and apply to see if you qualify for the caregiver allowance. (see info below)
Pennsylvania’s
Family Caregiver
Support Program...
responding to the needs of
family caregivers
Caregivers are the focus
When you’re not feeling well, home is
where you want to be - no matter what your
age. And when an older relative or friend is
ill or frail, you want to keep them close; to
take care of them at home.
Pennsylvania’s Family Caregiver Support
program makes that possible by assisting
families caring for an older relative or
friend at home. In some cases, the program
can also support older caregivers of
younger relatives. It’s purpose is to support
- not replace - the care being provided
to frail family members in their home.
The Family Caregiver Support Program
responds to the needs of caregivers, so that
they can better care for their loved ones.
How does the program work?
Area Agencies on Aging assign staff
professionals to help family caregivers
assess their needs in taking care of older
relatives who are sixty years of age or older
or who are suffering from chronic dementia
or Alzheimer’s Disease. This assistance is
also available to older caregivers caring for
qualifying younger relatives.
Amounts are determined by actual expenses
and family income. Established income
guidelines are above poverty level to
enable more middle income families to
participate.
Benefits and Services for
Caregivers
• Assessments of caregiver and older
relative’s needs
• Counseling in coping skills
• Respite care
• Training in caregiving skills
• Home chore services
• Financial assistance to purchase
supplies or services
• One-time grants for home adaptations
• Benefits and counseling on services
available through local, state and
federal programs.
• Referrals to family support or
disease-specific organizations such
as: Children of Aging Parents;
Alzheimer’s Disease and Related
Disorders Association.
• Assistance in completing benefits
and insurance forms
Pennsylvania took a pioneering step when it enacted the Family Caregiver Support Act of 1990 The Family Caregiver Support Program is a cost effective program that enables nearly 8,000 families to receive some financial, emotional and physical relief. Services provided under the program may include care management, respite care, financial reimbursements for home modifications, and others. The program has not kept pace with the growing needs of elders and caregivers
The Family Caregiver Support Program has not seen an increase in the monthly maximum allowance of $200/month or the lifetime home modification maximum allowance of $2,000 since the program’s inception. The Pennsylvania House of Representatives unanimously passed House Bill 1830 on October 23, 2007, increasing the monthly maximum amount to $500 for expenses and the lifetime home modification maximum allowance to $6,000. The legislation would expand the definition of a primary caregiver to include support to any informal caregiver who is not being paid to provide care to an older adult and who meets the program’s criteria. It also would help the Department of Aging to coordinate Pennsylvania’s program with the federal program and to utilize dollars left unspent due to more restrictive state rules. House Bill 1830 is currently in the Senate Appropriations Committee. The Pennsylvania Senate is encouraged to act on this bill, which would support the vital role caregivers provide.
This information comes from carrie.org