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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.
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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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You go to the PCP first. Before a oncologist gets involved the PCP will give a referral to a gastroenterologist to do a colonoscopy to determine how far the cancer has spread. If your Aunt has already seen a gastroenterologist, then she needs referral from him to see an oncologist. If she refuses to see the oncologist, ask her if she is ready for hospice. I am not beyond putting a little scare in these stubborn ones. I would tell her if she plans on doing nothing, then maybe she should go into a NH. Because its not fair to expect your mother to care for someone who is too stubborn to do anything about something that is curable if caught early.
Usually, there is no consulting between a PCP and Specialists. Letters are written telling the PCP what the Specialist is doing concerning the patients care. Once a patient is in a Specialist hands, decisions are made between the patient and the Specialist. The patient can always consult with the PCP or get a second opinion.
With a DX of cancer, I'd see the oncologist for that and anything arising from it (i.e., metastasis), but you can take your mother to her primary or specialists for other conditions.
This is obviously my personal opinion; we went to specialists and found it much more expeditious and time saving than going through PCPs, some of whom eventually suggest specialists b/c the issues were beyond their scope of knowledge and practice.
With cancer of any kind, you don't need to waste time with someone who can't address that and the issues arising from it. And not to challenge JoAnn's advice, but my sister never had to go through PCPs to get to an oncologist, but that was likely b/c her medical insurance didn't require it.
And for you and the frustration, anxiety and concern that arise, try to locate a local Gilda's Club to meet and interact with other cancer patients as well as their families and caregivers.
In my experience with my dads wife once she had the cancer diagnosis her oncologist basically became her cancer primary so coordinated everything and all the cancer related doctors, tests, surgeon, radiation, rehab… Her primary continued to coordinate everything else and received notes from the oncologist regularly. They also communicated when they needed to, for instance when an issue crossed both domain’s but she tended to go to her primary for things first because she had a longer relationship with him and was more comfortable, he would just send her to the oncologist when that was warranted.
With straight Medicare I don't think you need a referral but with Medicare Advantages and some secondary insurances, they may require a referral. Without it, they may not pay. So its usually seeing your PCP first and he refers you to a specialists depending on what tests reveal. Some MAs are HMOs and they are notorious for referrals. So make sure if you need a referral by calling your insurance provider.
Choosing not to have active treatment for cancer is a reasonable choice, but it is not 'doing nothing.' Depending on her cancer and stage of disease, her PCP may be able to manager her care for a time. See if there is a palliative care team at the same hospital where the oncologist and PCP are affiliated. They are the experts on comfort care. Referral to hospice can come from PCP. Also, if you are not already her health care decision maker (health care proxy, Power of Attorney for health care, etc) please get this in place soon. Your aunt stays in charge until an MD involved in her care says that she cannot make her own decisions. Usually elders ask their POA to be part of medical appointments, to better understand what the situation is and what your aunt wants.
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.
Usually, there is no consulting between a PCP and Specialists. Letters are written telling the PCP what the Specialist is doing concerning the patients care. Once a patient is in a Specialist hands, decisions are made between the patient and the Specialist. The patient can always consult with the PCP or get a second opinion.
This is obviously my personal opinion; we went to specialists and found it much more expeditious and time saving than going through PCPs, some of whom eventually suggest specialists b/c the issues were beyond their scope of knowledge and practice.
With cancer of any kind, you don't need to waste time with someone who can't address that and the issues arising from it. And not to challenge JoAnn's advice, but my sister never had to go through PCPs to get to an oncologist, but that was likely b/c her medical insurance didn't require it.
And for you and the frustration, anxiety and concern that arise, try to locate a local Gilda's Club to meet and interact with other cancer patients as well as their families and caregivers.
Also, if you are not already her health care decision maker (health care proxy, Power of Attorney for health care, etc) please get this in place soon. Your aunt stays in charge until an MD involved in her care says that she cannot make her own decisions. Usually elders ask their POA to be part of medical appointments, to better understand what the situation is and what your aunt wants.