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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.
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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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I think the pros and cons of feeding tubes depend somewhat on the underlying condition that prevents the person from eating normally. I'd be much more likely to agree to a feeding tube for a family member if that person had a condition that was likely to be resolved or fixed so that the person could eventually eat normally. And I'd be much less likely to agree to a feeding tube if the person was likely to be in a vegetative state until death and thus would never be able to eat normally again.
I would decide based on the prognosis. Are you helping a body recover or are you keeping a body alive that should be allowed to die.
I personally have a medical directive that states specifically if I have no future beyond a bed then I refuse a feeding tube, however, if God forbid I am in an accident and it is required for my RECOVERY then by all means give me a fighting chance.
Prognosis based is the only way to make these decisions in my opinion.
I agree and we have similar requests on our directives. I however have refused all artificial nutrition. I am 77, and that as much as anything accounts for that choice. I am also quite a coward, and fear many things in life much more than death. I think that each case, every person, is such an individual case.
For us, it was a medical and quality of life issue. We allowed a gastrostomy tube for my husband after his stroke, hoping he would eventually be able to eat and have the tube removed. It was a life and death situation at the time. We wanted to give him a chance and hoped that, even if he continued needing the tube, he could be satisfied enough with his life. Because the feedings were keeping him alive artificially, we were assured by his doctor, the palliative care doctor, and the chaplain that my daughter and I could make the decision (ethically and legally) at any time in the future to have the tube removed if we felt that he no longer wanted to live in his condition. That was a year and a half ago. He still gets tube feedings four times a day, eats almost nothing by mouth. From time to time I have the conversation with him (he has aphasia so it's mostly just me talking), about the choice of keeping the tube, eating more, or starving. He indicates he doesn't want the tube and does want to eat. But then when given the opportunity and encouragement, he does not have the initiative or motivation to actually take in more than a spoonful or so of even his favorite foods. His life is boring, he sleeps a lot, often does not want to interact. But then there are the times when he lights up, is happy to see visitors, enjoys music, audiobooks, TV, or sitting outside, or attempts to talk. Those of us who know him well can see the same old expressions and know that he is not totally depressed and has some enjoyment in his life. He is medically stable (but does have a Do Not Resuscitate order), and he has 24-hour in-home care (partially paid for now by Medi-Cal IHSS). If his medical condition worsens or if he becomes more withdrawn (despite his anti-depressants), we will again have to make that tough decision about quality of life. For now, we just try to make each day as enjoyable as possible for him and remain grateful that we have glimpses of his former self. Hope this helps you in your process.
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.
https://www.choosingwisely.org/patient-resources/feeding-tubes-for-people-with-alzheimers/
https://www.agingcare.com/articles/the-risks-and-benefits-of-feeding-tubes-for-seniors-445699.htm
https://www.agingcare.com/articles/dysphagia-how-to-help-a-loved-one-eat-and-drink-safely-187010.htm
I personally have a medical directive that states specifically if I have no future beyond a bed then I refuse a feeding tube, however, if God forbid I am in an accident and it is required for my RECOVERY then by all means give me a fighting chance.
Prognosis based is the only way to make these decisions in my opinion.