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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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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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My spouse has early to mid-stage Alzheimer's. He seems to be doing okay for now, but I'm concerned I could wait too long before hiring help. I don't want to insult him, but I also don't want to burn myself out or put him at risk.
I would start now, by hiring someone to come a few hours a day telling your husband that this person is now there to help you around the house while you're at work. That way he'll get used to having someone else around before he gets too far in his dementia and more difficult to deal with. And making this about you and not him will be a win win situation for all. Best wishes as you take this very difficult journey with your husband.
I totally agree with funkygrandma59. Think about what tasks you'd love to be done with and hire with that in mind. For me, it is cleaning the showers. I'd try to find a male companion aid for you husband if at all possible. You will also need to figure out if you will hire through an agency or privately pay someone. Each have benefits and downsides.
To elaborate on the mentioned "benefits and downsides" of using an agency or private pay: 1. TAXES - Read up on the related tax laws. I read that if you private pay a caregiver, you'll need to file/pay the associated taxes quarterly and stay on top of the social security and unemployment related taxes for your caregivers. And, its not just the ?7.5% or whatever like for an independent contractor under a form 1099. It is a felony to hire caregivers as 1099's! They are instead by law basically salaried, and you have to cover everything, accordingly. In fact, if you cash flow (under the table - illegal) or even 1099 contract a caregiver, if you've paid them over ?$2700 (currently) and let them go, if they then apply for unemployment--the unemployment office will see that you didn't do it correctly and report you (big trouble)! On the other hand, going through an agency typically transfers the tax responsibility to the agency. NOTE: Aging Care is *not an agency in this sense. AC connects you with agencies in your area (thank you). 2. Interviews & references & background checks & veteran services: These I-R-BC-V topics apply across all caregiver selections, whether private or via agency. These are vital, very important, heap-big considerations! You must consider: Personality, gender, pets, children, smoker, perfume wearer, their ability to navigate your steps or gravel or multilevel living spaces, thoughtfulness, dependability, transportation, safety consciousness, hours of availability, training/experience, references, connection to & certification for veteran services... The list goes on. AND, don't forget that you'll also need a substitute periodically! NOTE: An advantage to agencies is the consistent availability of caregivers 24/7 (multiple if needed), but a downside of agencies is that *they can opt to change who they send or simply terminate their contract with your fav. 3. SKILL/CERTS: Sadly, most caregivers via private search, online sites (e.g. Care.com), or agency are NON-medical. That means that the caregiver can say, "Take your meds now." But they can't distribute, administer, ... touch the meds at all. No, they cannot do finger pricks for blood sugar. No, they cannot insert a catheter. No, they cannot perform any significant wound care. A few agencies do hire or umbrella professionals with letters after their names, but -- you'll pay for them!! Which brings me to the last topic. 4. COST: In my area, I can private pay a random mom, high school student, or church member $10-$20/hour for a couple hours of babysitting-style caregiver here and there. Hiring through ads/sites, the vetted caregivers run $12-$40/hour and typically have both min/max and slot hour limits, e.g 3-6 hour shifts between 6am and 6pm (just don't forget about taxes for long-term agreements). Through an agency, the caregivers make comparable wages, BUT you typically pay the agency about twice their wage. You may also have overtime surcharges on crossing 40 hours of care per week (even if the hours were spread across multiple caregivers). Why so much? Well, remember those taxes and unemployment that the agency is handling for you? Also, remember your need for perhaps multiple caregivers to be retained as subs or split/long-shifts? Remember the reliability and punctuality promises the agency's reputation depends on? Remember the agency manager on the phone setting up all those interviews? And, the agency is typically not a non-profit! NOTE: A good agency even maintains a slush fund from which they Uber your caregiver that randomly had engine trouble so that they're still "on time".
In my experience caring for my post-stroke husband 2yrs now, using an agency has been my best option. I need the reliability so that I can work, and as caregivers move on, I've needed an endless supply of replacements (24/7). Plus, a vet-cert agency works with the VA, and the caregiver training & background checks are comforting. Plus, a good agency looks after YOU, too.
I think what you just said is the God's truth, and that's what I would tell him. I would tell him that you may jump the gun and get help earlier than needed but that help is for YOU and you WANT it and NEED it and INSIST on it. And tell him that without it he will be going into care.
Playing around the truth doesn't work, and it feeds paranoia and suspicion which is already somewhat the norm.
As to WHEN? You will know that much better than we do. You know your husband; you are there every day. You are aware of his doctor's thinking after assessment. And we know NONE of that. I trust you implicitly. That isn't to say you can't/won't make mistakes and the truth is that you must allow yourself that. There is NO perfection in end of life, dementia care. NONE. And it's predictable and can change on a dime. I wish you the very best of luck.
Let me put it like this. If you are asking this question...it may be time to start investigating possibilities before you get into the "what should I do now" mode.
This process is a journey and you are just starting out. Consider a "first step" in this process to be a medical alert device that he will wear while you are at work. It's way less expensive than a caregiver and can still give you and him some peace of mind while you are separated. For men who have no interest in wearing a pendant, there are now watch options. Here is a good review site. Or you can check Wirecutter. Hope this helps :) https://bestfalldetection.watch/
Is there is a chance that your husband can take off in a car or forget that he left the burner on the stove? What about leaving the door unlocked to your house. Dementia will take on different forms. Prepare for your husband's safety.
If you're asking this question, it almost certainly is time NOW.
Worry less about insulting him and more about getting your ducks in a row! You can work behind the scenes to hire help, and he doesn't have to know about it until shortly before the helper arrives or even as they're walking up your front steps. You're not in a situation where walking on eggshells is going to last long. Time to be brave, bold, and upfront if your H shows any interest in what you plan to do to help him. (Many don't. They've lost or never had the awareness to understand what you are or will be going through.)
Good luck. I'm glad you're getting a handle on this before your back's to the wall with the things that will inevitably happen next.
If you are beginning to worry of safety and you are looking for husband's cooperation, might I suggest an adult daycare. Drop him off and he might be interested in the program that they offer. Many include lunch and other services while he is there
Don't be left scrambling to get help when you are in crisis. It takes time to get good helpers in place. I think if you are asking this question, you already know what you need to do.
If you are asking, you are concerned. If you are concerned, then it is time to get a larger team of help so you both can thrive.
You need enough helpers to be able to do the caregiving tasks 24/7 - in case something happened to you. Ask family, friends, members of your faith community and hired help. Have enough people who will become familiar with your routines, medications and health issues - so they can step in whenever needed. You might start by asking for help for a couple hours for a couple (2-3) days per week. This gives your helpers time to know the routines, meds... and allow your spouse to be used to seeing them in your home.
The first thing to know is that your husband cannot be left unattended for one second. The time is now to get his doctor’s evaluation for either help in the home or memory care placement so you can work. If his funds will run out, contact an elder care attorney and Medicaid specialist.
Don't forget to obtain legal help to set up medical and financial POA for you and your alternates who can step in on his behalf when your husband cannot handle his affairs.
It sounds like you're in a tough spot, and it's completely understandable to feel conflicted. Wanting to support your spouse while also protecting his dignity shows how much you care. It's wise that you're thinking ahead — recognizing when to seek help can make a big difference for both of you. With Alzheimer's, the progression is unpredictable, and waiting until a crisis happens can be overwhelming. Many caregivers find that bringing in help earlier — even just a few hours a week — allows their loved one to get used to the idea gradually. It can also give you a chance to rest and recharge, which is crucial for providing the best care long-term. Here are a few things to consider:
Start Small: Introduce help in a non-threatening way, like having someone assist with household tasks or companionship rather than direct personal care. Frame It Positively: Instead of focusing on needing "help for him," frame it as extra support for both of you. For example, “I found someone who can help us around the house so we have more time to relax together.” Watch for Burnout Signs: Exhaustion, frustration, or feeling isolated are signs that it's time to bring in support. The earlier you act, the better you can avoid caregiver burnout. Safety First: If there are concerns about wandering, medication management, or falls, professional help could improve safety. At Anointed Senior Living & Memory Care in Austin, we understand how challenging this journey can be. Whether you need part-time support at home or full-time memory care services, we’re here to help you find a solution that fits your family’s needs. Early support can ensure your spouse receives compassionate care while you get the rest you need to stay strong. Feel free to reach out if you'd like to explore personalized care options. You don’t have to navigate this alone — we’re here to support both you and your loved one.
Your husband is never going to say that he can’t be left alone anymore, because people with dementia are unable to recognize their own limitations. No one can foresee every possible scenario that may arise. I was quite surprised at how early in my mom’s progression she stopped answering the question her neuro medical assistant asks at every visit. “ If something bad happened at home, who would you call or ask to help you.” The answer they are going for is 911 or to get me ( since I live with her ). Depending on where you live, there may be a dementia day program that he can go to. My mom started 2 days a week at one place. She didn’t like it, so we found another, and she goes 3 days a week. She absolutely loves it.
You should see if you have a memory cafe in your area. They typically meet once a month. There is usually an activity for the “VIPs” and then the caregivers break off. The one that I go to has 2 caregiver groups, one is more of a support group, and the other more of a nuts and bolts of dementia services in the area. Of course they kinda have a way of overlapping.
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.
And making this about you and not him will be a win win situation for all.
Best wishes as you take this very difficult journey with your husband.
1. TAXES - Read up on the related tax laws. I read that if you private pay a caregiver, you'll need to file/pay the associated taxes quarterly and stay on top of the social security and unemployment related taxes for your caregivers. And, its not just the ?7.5% or whatever like for an independent contractor under a form 1099. It is a felony to hire caregivers as 1099's! They are instead by law basically salaried, and you have to cover everything, accordingly. In fact, if you cash flow (under the table - illegal) or even 1099 contract a caregiver, if you've paid them over ?$2700 (currently) and let them go, if they then apply for unemployment--the unemployment office will see that you didn't do it correctly and report you (big trouble)! On the other hand, going through an agency typically transfers the tax responsibility to the agency. NOTE: Aging Care is *not an agency in this sense. AC connects you with agencies in your area (thank you).
2. Interviews & references & background checks & veteran services: These I-R-BC-V topics apply across all caregiver selections, whether private or via agency. These are vital, very important, heap-big considerations! You must consider: Personality, gender, pets, children, smoker, perfume wearer, their ability to navigate your steps or gravel or multilevel living spaces, thoughtfulness, dependability, transportation, safety consciousness, hours of availability, training/experience, references, connection to & certification for veteran services... The list goes on. AND, don't forget that you'll also need a substitute periodically! NOTE: An advantage to agencies is the consistent availability of caregivers 24/7 (multiple if needed), but a downside of agencies is that *they can opt to change who they send or simply terminate their contract with your fav.
3. SKILL/CERTS: Sadly, most caregivers via private search, online sites (e.g. Care.com), or agency are NON-medical. That means that the caregiver can say, "Take your meds now." But they can't distribute, administer, ... touch the meds at all. No, they cannot do finger pricks for blood sugar. No, they cannot insert a catheter. No, they cannot perform any significant wound care. A few agencies do hire or umbrella professionals with letters after their names, but -- you'll pay for them!! Which brings me to the last topic.
4. COST: In my area, I can private pay a random mom, high school student, or church member $10-$20/hour for a couple hours of babysitting-style caregiver here and there. Hiring through ads/sites, the vetted caregivers run $12-$40/hour and typically have both min/max and slot hour limits, e.g 3-6 hour shifts between 6am and 6pm (just don't forget about taxes for long-term agreements). Through an agency, the caregivers make comparable wages, BUT you typically pay the agency about twice their wage. You may also have overtime surcharges on crossing 40 hours of care per week (even if the hours were spread across multiple caregivers). Why so much? Well, remember those taxes and unemployment that the agency is handling for you? Also, remember your need for perhaps multiple caregivers to be retained as subs or split/long-shifts? Remember the reliability and punctuality promises the agency's reputation depends on? Remember the agency manager on the phone setting up all those interviews? And, the agency is typically not a non-profit! NOTE: A good agency even maintains a slush fund from which they Uber your caregiver that randomly had engine trouble so that they're still "on time".
In my experience caring for my post-stroke husband 2yrs now, using an agency has been my best option. I need the reliability so that I can work, and as caregivers move on, I've needed an endless supply of replacements (24/7). Plus, a vet-cert agency works with the VA, and the caregiver training & background checks are comforting. Plus, a good agency looks after YOU, too.
Playing around the truth doesn't work, and it feeds paranoia and suspicion which is already somewhat the norm.
As to WHEN? You will know that much better than we do. You know your husband; you are there every day. You are aware of his doctor's thinking after assessment. And we know NONE of that. I trust you implicitly. That isn't to say you can't/won't make mistakes and the truth is that you must allow yourself that. There is NO perfection in end of life, dementia care. NONE. And it's predictable and can change on a dime. I wish you the very best of luck.
https://bestfalldetection.watch/
Worry less about insulting him and more about getting your ducks in a row! You can work behind the scenes to hire help, and he doesn't have to know about it until shortly before the helper arrives or even as they're walking up your front steps. You're not in a situation where walking on eggshells is going to last long. Time to be brave, bold, and upfront if your H shows any interest in what you plan to do to help him. (Many don't. They've lost or never had the awareness to understand what you are or will be going through.)
Good luck. I'm glad you're getting a handle on this before your back's to the wall with the things that will inevitably happen next.
Best of luck in your journey.
You need enough helpers to be able to do the caregiving tasks 24/7 - in case something happened to you. Ask family, friends, members of your faith community and hired help. Have enough people who will become familiar with your routines, medications and health issues - so they can step in whenever needed. You might start by asking for help for a couple hours for a couple (2-3) days per week. This gives your helpers time to know the routines, meds... and allow your spouse to be used to seeing them in your home.
Don't forget to obtain legal help to set up medical and financial POA for you and your alternates who can step in on his behalf when your husband cannot handle his affairs.
With Alzheimer's, the progression is unpredictable, and waiting until a crisis happens can be overwhelming. Many caregivers find that bringing in help earlier — even just a few hours a week — allows their loved one to get used to the idea gradually. It can also give you a chance to rest and recharge, which is crucial for providing the best care long-term.
Here are a few things to consider:
Start Small: Introduce help in a non-threatening way, like having someone assist with household tasks or companionship rather than direct personal care.
Frame It Positively: Instead of focusing on needing "help for him," frame it as extra support for both of you. For example, “I found someone who can help us around the house so we have more time to relax together.”
Watch for Burnout Signs: Exhaustion, frustration, or feeling isolated are signs that it's time to bring in support. The earlier you act, the better you can avoid caregiver burnout.
Safety First: If there are concerns about wandering, medication management, or falls, professional help could improve safety.
At Anointed Senior Living & Memory Care in Austin, we understand how challenging this journey can be. Whether you need part-time support at home or full-time memory care services, we’re here to help you find a solution that fits your family’s needs. Early support can ensure your spouse receives compassionate care while you get the rest you need to stay strong.
Feel free to reach out if you'd like to explore personalized care options. You don’t have to navigate this alone — we’re here to support both you and your loved one.
No one can foresee every possible scenario that may arise. I was quite surprised at how early in my mom’s progression she stopped answering the question her neuro medical assistant asks at every visit. “ If something bad happened at home, who would you call or ask to help you.” The answer they are going for is 911 or to get me ( since I live with her ).
Depending on where you live, there may be a dementia day program that he can go to. My mom started 2 days a week at one place. She didn’t like it, so we found another, and she goes 3 days a week. She absolutely loves it.
You should see if you have a memory cafe in your area. They typically meet once a month. There is usually an activity for the “VIPs” and then the caregivers break off. The one that I go to has 2 caregiver groups, one is more
of a support group, and the other more of a nuts and bolts of dementia services in the area. Of
course they kinda have a way of
overlapping.