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
[email protected] 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.
*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.
You don't need to explain it to him. He can get his own explanation when he calls.
Don't they have self test machines in the U.K?
If he wants to go out, he can go out via the surgery where the nice practice nurse will be happy to take blood for his warfarin tests.
However. Paul, why do you keep expecting your father, who is old and increasingly frail and fretful, to think and talk in a way that is rational and considerate of others?
Personally I wouldn't even bother. I would just use 101 variations on the theme of tut-tut, dearie me, and join in with his enjoyment of complaining. Or, tell him you can't get through. Or, tell him the surgery doesn't have phone lines, like it's not online and they don't have email. Blame the NHS, that's always good for a juicy five minute grumble at least. Whatever - just AGREE with him instead of trying to tell him he's wrong the whole time.
Consider what is valid about his complaints. Waiting for people and not knowing exactly when they will arrive is annoying, isn't it? Having to have your blood taken is not fun. Having to take Warfarin is not fun, and even less fun is the reason that he has to take Warfarin in the first place.
Your father is not an able bodied, independent person who is free to please himself and enjoy life to the full. He is an elderly man, living alone, with chronic heart disease. He feels like crap. Stop expecting him to be different from what he is actually like.
It sounds (and I'm basing this on your other posts) as though you are having tremendous struggle with accepting the fact that your dad, while annoying, is also getting older and more frail.
And yes, commiserate about how terrible it is!
Hes phoned me again today to ask me if I've "Told them what they need to do". I had to say no dad they refused. (I haven't phoned), so hes off ranting now. I feel sorry for the next one to visit him!
CM - yes if I said this to him he would say "yes why can't they come at 9am". He did it when he had carers. Wanted them there dead on 830am - to help him get dressed and get his breakfast. Of course, not everyone can have the ideal time - it was more like 945am. He gave this poor lady some stick, wanted me to put in an official complaint because she wasn't coming at 830am like he'd asked her.
Both her and I explained that she had a few people to see, she'd been told what times, and, of course, not everyone could have the time they wanted. In the end, he phoned up one day and cancelled it because he couldn't get his own way. I don't think the department providing the carers complained about that too much.
I know what you mean about him being old etc but honestly the more you do for him, the more help he needs if you know what I mean.
Like I said my wife is a DN. They see it all the time. She once visited a woman who was "housebound". Saw her drive up, carry bags of shopping up the stairs to her flat. Not only could she have driven, but she could walk fine.
The DNs "try" to say they don't have time for patients like this but half the time the patients or their families moan and management back down. Its the "I've paid tax all my life so the NHS can do something for me attitude I think".
I'm not sure the bulk of the NHS customer base realises that they still exist, and it's probably just as well or we'd all want one. With a proper hat, and a crossover cape, and a bicycle. And that little silver upside-down watch pinned to her apron. Ah happy days...
Paul. If you EVER find yourself explaining the same concept to your father more than five times at the absolute maximum, stop. Repeating the same action and expecting a different outcome is a working definition of madness; only in this case it's not your Dad who's nuts, it's you.
Forgive me, but I don't think you are clear enough on who is involved in doing what exactly across your father's weekly schedule. If he was assessed as needing carers, and he cancelled the service, and the district nurse has him on her list, then *somebody* is organising all this and you need to find out who and liaise with that person. They seem to restructure community services four times weekly so it might be tricky but persist - it's always the same people, only under different team headings. Stalk and capture the named lead individual and stick to her (probably) like glue. And for God's sake stop taking your father's word for anything you need to rely on.
You also need to turn your phone off more.
Because of the cost many insurance companies won’t approve a person to obtain a portable INR monitoring device unless it was well documented the person was homebound, that the INR was essential & needed to be done, etc.
Wondering, in the NHS, why they are using warfarin vs the newer Eliquis/Xarelto. My guess is the latter as too expensive for the NHS so warfarin is cheaper and prescribed more, which is actually less cost effective due to having a pro draw blood at a lab.
Is Eliquis & Xarelto widely prescribed in the UK?
As for the OP’s father, the father sounds as if he can get himself to a lab for a blood draw. The father is wasting someone’s very valuable time (the “District Nurse”) as he is NOT homebound.
Perhaps Paul's dad has an artificial valve. You can't use the newer blood thinners in conjunction with those.
Time was, not so many decades ago, they all had to troop in to outpatients to have their levels checked there. Those clinic mornings were horrendous. My ex won fame/notoriety for taking the patients' chair away so they didn't waste time sitting down.
My mother was on Clopidogrel but heaven knows that has its drawbacks too. At least Warfarin is comparatively easy to tinker with - to stop, in particular.
At 5.30 AM in the middle of the last NYC transit strike, our phone rang. It was our PCP. He'd just gotten notification from the lab that DH's INR was 15 ( it's supposed to be between 2.0 and 3.0). And that I should get him to an ER immediately. But, said Dr. W, it's probably an error because if it was 15, he'd be dead.
Cheerful news on a December morning. So we run to the ER in last night's clothes. Triage nurse measures DHs bp which is quite high. " You should really look into getting meds for that". He smiled.
INR was 1.5. Maybe that's why insurance company provided the home machine!
Also, not sure if related but he cant use the quick test machine.
CM - carers were organised by on call social people when he was last in hospital. Of course, when hes out and cancels them then they are out of the picture never to be seen again.
DN visit I understand are organised by staff at a GP surgery so my wife tells me. (DNs are allocated to a surgery). Winds the DNs up no end - do gooder at surgery allocates someone elses time (i.e. the DN) when patient doesn't really need it. Because they can.
Of course, people like my Dad think "ooh this is good I don't even have to leave my house now" and then the DN has a battle to get them off the list knowing full well they're NOT housebound.
But whichever way they sliced it it was still the same salami with the same ingredients/nurses. One of them turned up one day to give my neighbour (another neighbour, funny lot in that village) an injection for a tropical disease he'd picked up in the Far East and was so furious to find him out that she told me all about it before I could say 'confidentiality.'
Your father's what level is between 3 and 4 what units?
If you want to know what medications are available on the NHS you will find them in the British National Formulary. The fact that there are currently handbags at dawn over medicinal cannabis and childhood epilepsy does not imply that doctors are forced into the fray armed with nothing but aspirin and a trepanning chisel.