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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.
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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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My Mom is 83 and has macular degeneration. She sees pretty well since she had cataract surgery. Don't want to chance her having another stroke, which can happen if she has the Lucentis injections
You are right to be concerned and you should talk it over with her doctor. The rate of stroke and heart attack with Lucentis is about the rate that would be expected for people in that age group. However, it IS higher in those who have had a previous stroke. It's a difficult decision, since Lucentis is very effective in slowing or halting the progression of age-related macular degeneration. I would absolutely opt for Lucentis injections if I had AMD. The alternative is a fast loss of central vision and legal blindness within 5 years or sooner.
Avastin has a similar safety profile, though it is being given "off-label".
The comments regarding profit are not based on fact. Retinal specialists charge for these drugs because they have to pay for them first! In fact, the reimbursement level for Lucentis has a lower profit margin for the doctor. Although the Avastin costs the doctor less, the mark-up is more. So the physician actually realizes more dollars per injection with Avastin. It's actually more complicated than that, but there is little incentive to prescribe Lucentis over Avastin.
At last week's Retina meeting, a survey of specialists showed that 59% of them use Avastin as the first choice of treatment.
I'd say go for it, sooner the better. My father also had "wet" macular degeneration, and a pacemaker, and stroke damage. Studies show Lucentis can sometimes be a miracle drug at slowing (not reversing) macular degeneration. (Unfortunately it had no impact in my father's case.) It didn't impact him negatively in terms of his pacemaker or prior stroke. It was just a waste of time and money, but his sight was quite far gone before they started. By the way, Genentech makes another drug (Avastin) that works just as well as Lucentis and is cheaper in terms of co-pays and costs to Medicare. The doctor must obtain it from a clean, reputable compounding pharmacy which splits it into small doses. (There was a rash of problems with infections some years ago, but that's not inherent to the drug, it was a problem with the compounding pharmacy. ) Unfortunately the doctor doesn't get paid as well when he uses Avastin (he gets paid a 4.3% markup on the price of any drug he administers. Lucentis costs $2,000 a dose, Avastin only about $50, so do the math.) One of the wierdnesses in Medicare reimbursement due to the powerful pharmaceutical lobby.
After reading the adverse events reports on Lucentis, I would not let anyone use this on me or anyone I cared about. Just remember there is a certain profit motivation on the MD's part.
From my search online it seems that blood clots and stroke are a rather rare and extreme side effect. I wish something like this would have been available 20 years ago when my mom discovered she had wet AMD. One day she had a bleed that destroyed the vision in one eye, and the gradual vision loss in her other eye robbed her of her independence. I'm sure that her impaired vision has contributed to her cognitive decline. I haven't kept up on the newer treatments available, if she doesn't have the shots what are her other options?
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.
Avastin has a similar safety profile, though it is being given "off-label".
The comments regarding profit are not based on fact. Retinal specialists charge for these drugs because they have to pay for them first! In fact, the reimbursement level for Lucentis has a lower profit margin for the doctor. Although the Avastin costs the doctor less, the mark-up is more. So the physician actually realizes more dollars per injection with Avastin. It's actually more complicated than that, but there is little incentive to prescribe Lucentis over Avastin.
At last week's Retina meeting, a survey of specialists showed that 59% of them use Avastin as the first choice of treatment.
Just remember there is a certain profit motivation on the MD's part.