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Senior and ElderCare Glossary

  • Accelerated Death Benefit
    A life insurance policy benefit that lets the insured person use some of the policy's death benefit prior to death for purposes such as long-term care.
  • Activities of Daily Living (ADL)
    Activities usually performed in the course of a normal day. Examples of ADLs are:
    • Bathing
    • Dressing
    • Grooming
    • Eating
    • Bed mobility
    • Transferring
    • Toileting
    • Walking
    Many insurance policies use the inability to perform a certain number of ADLs (such as 3 of 8) to determine eligibility for benefits. See also Instrumental Activities of Daily Living (IADL).
  • Acute Care
    The care provided for a medical condition from which a patient is expected to recover and resume a "normal" lifestyle, even though it may not be the same as before onset of the condition. Acute care usually refers to physician and/or hospital services of less than three months' duration.
  • Administration on Aging (AOA)
    An agency of the US Department of Health and Human Services.
  • Adult Day Care
    Community-based care designed to meet the needs of functionally and/or cognitively impaired adults who, for their own safety and well-being, can no longer be left at home alone during the day.
    Adult day centers offer protected settings which are normally open five days a week during business hours and include a mixture of health, social an support services. Many programs provide meals and transportation services to and from a patients home, and specialized programs for individuals with Alzheimer's disease or related disorders. These programs often provide a respite, or break for family caregivers.
  • Adult Day Health Care
    A category of Adult Day Care which provides comprehensive, professional support in a protected environment, including on-site nurses, physical therapists, social workers, and other professionals.
  • Adult Guardian
    The person appointed by a court, usually a probate or surrogate court, to perform court-ordered tasks of caring for an incapacitated adult's financial affairs and personal needs.
  • Adult Protective Services
    State or county run program(s) designed to protect adults who may be physically, emotionally or financially abused and/or neglected.
  • Advance Directive for Health Care
    A written document that specifies how the signer wants medical decisions to be made. A health care advance directive may include a Living Will, a Durable Power of Attorney for Health Care or both.
  • Aids for Daily Living
    Simple and generally inexpensive items designed to help maintain independence and to make daily living easier.
  • Allied Health Professionals
    Persons with special training in fields related to medicine, such as medical social work and physical or occupational therapy. Allied health professionals work with physicians or other health professionals.
  • Alzheimer's Disease
    A progressive, neurodegenerative disease characterized by loss of function and death of nerve sells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer's disease is the most common cause of dementia.
  • Ambulatory Aids
    Ambulatory aids include a range of devices to help seniors move about safely and independently when additional support is needed. Types of ambulatory aids include: walkers, cruisers, forearm crutches, canes, wheelchairs, and motorized scooters. These aids are often paid for by Medicare/Medicaid or private insurance.
  • Ambulatory with Assistance
    Able to get about with the aid of a cane, crutch, brace, wheelchair or walker.
  • Ambulatory
    Able to walk about.
  • Analgesics
    A class of drugs used to reduce pain. Aspirin, Tylenol, Darvon, Codeine, Demerol and Dilaudid are analgesics.
  • Ancillary Services
    Those services needed by a nursing home resident, but not provided by a nursing home, such as podiatry, dentistry, etc., and which may not be included in the basic rate of the facility.
  • Annuitant
    The person entitled to receive an annuity.
  • Annuity
    A series of payments made periodically for a specific period of time. The payment amounts can be variable or fixed. Many insurance companies sell a wide variety of annuity contracts with payments that begin immediately upon purchase of the contract or are deferred until some time in the future. Some annuity contracts waive their surrender charges (early withdrawal penalties) in the event of a lengthy hospital stay, nursing home confinement, or terminal illness.
  • Aphasia
    A speech/language disorder that impairs a person's ability to communicate. It is most commonly the result of a stroke, but can occur from any severe head injury.
  • Area Agency on Aging (AAA)
    Local government agency that grants or contracts with public and private organizations to provide services for older persons, created by a provision of The Older Americans Act. Services include information and referral for in-home services, counseling, legal services, adult day care, skilled nursing care/therapy, transportation, personal care, respite care, nutrition and meals.
  • Assignment
    A method of billing Medicare for services. The provider agrees to bill Medicare directly for services and agrees to accept Medicare's allowed charge as payment in full. Medicare pays the provider directly. The provider can then bill the beneficiary for deductibles and coinsurance.
  • Assisted Living Facility
    A facility that provides care to residents who cannot live independently, but who do not require around-the-clock nursing care or extensive medical supervision. Congregate meals, laundry services, transportation to medical appointments and medication monitoring are some of the services offered. Some facilities offer a secure Alzheimer's/Dementia unit.
  • Assistive Equipment
    A range of products and technology designed to help elders or those with disabilities lead more independent lives. Examples include special telephones for people with hearing impairments, walking aids, elevated toilet seats, communication devices, etc.
  • Attorney-in-Fact
    In legal terms, the person who is granted power-of-attorney.
  • Authorized Representative or Representative Payee
    The person designated by a Social Security (SS) beneficiary or Supplemental Security Income (SSI) recipient to represent him/her before the Social Security Administration
  • Bed Hold
    Reservation of a nursing home bed when a nursing home resident is temporarily hospitalized or out of the facility on therapeutic leave. State Medicaid programs may pay for bed holds, but are not required to. Nursing facility residents on Medicaid have a right to return to the first available bed in the facility which they temporarily left, even if the state has not paid to hold their original bed.
  • Benefit Maximum
    The limit a health insurance policy will pay for a certain loss or covered service. The benefit can be expressed either as 1) a length of time (e.g., 60 days), or 2) a dollar amount (e.g., $350 for a specific illness or procedure), or 3) a percentage of the Medicare approved amount. The benefits may be paid to the policyholder or to a third party. This may refer to a specific illness, time frame or the life of the policy.
  • Benefit Period
    The number of years an insurance policy will provide benefits. Many long-term care insurance policies offer terms between three and five years. Some offer lifetime benefits.
  • Board and Care Home
    A small to medium-sized group residence that provides private or shared rooms, meals, and assistance with activities of daily living, but not skilled nursing.
  • Capitation
    A method of compensation for health care services under which doctors and other health care providers are paid a fixed monthly fee for each HMO member under their care, rather than for each service or treatment they perform.
  • Care Manager
    A health care professional, typically a nurse or social worker, who arranges, monitors or coordinates long-term care services. Also referred to as a care coordinator or case manager.
  • Care Plan
    The detailed formulation of a program of action that addresses consumer needs.
  • Categorically Needy Medicaid Program
    Pays for medical services under state Medical Assistance Programs (Medicaid) on the basis of financial need.
  • Certified
    A long-term care facility, home health agency, or hospice agency that meets the requirements imposed by Medicare and Medicaid is said to be certified. Being certified is not the same as being accredited. Medicare, Medicaid and some long-term care insurance policies only cover care in a certified facility or provided by a certified agency.
  • Certified Nursing Assistant (CNA)
    CNAs are trained and certified to help nurses by providing non-medical assistance to patients, such as help with eating, cleaning and dressing.
  • Chore/Housekeeping Services
    Services include yard and house maintenance, home and appliance repair, housekeeping or meal preparation, shopping and transportation. No personal care is provided. Not covered by Medicare.
  • Chronic Illness
    A physical or mental disability that continues or recurs frequently over a long period of time; often associated with disability.
  • Cognitive Impairment
    Deterioration of intellectual ability, such as disorientation as to people, places or time; impairment of short-term or long-term memory; and/or impairment of one's ability to reason; that has progressed to the extent that a person requires substantial supervision by another person. Cognitive impairment includes Alzheimer's disease and senile dementia. The existence of cognitive impairment is determined by clinical evidence and standardized tests that reliably measure the person's impairment. For more information, click on Senile Dementia symptoms.
  • Coinsurance
    The amount, usually 20% of Medicare allowed charges, not reimbursed by the Medicare program.
  • Community-Based Services
    Services designed to help older people live independently in their own homes, such as adult day care and senior centers.
  • Companion Services
    Volunteers, business and agencies that provide friendly assistance and companionship to elders. Can include conversation, light housekeeping and meal preparation, running errands and providing transportation.
  • Congregate Housing
    Apartment houses or group accommodations that provide health care and other support services to functionally impaired older persons who do not need routine nursing care.
  • Congregate Meals
    Meal that comply with the Dietary Guidelines for Americans. The meals are served in a group setting such as a senior center or elderly housing facility and are usually associated with activities to promote social interaction and reduce social isolation.
  • Conservator
    Person appointed by the court in a legal proceeding to act as the legal representative of a person who is mentally or physically incapable of managing his or her own affairs.
  • Continuing Care Facility, Multi-level Facility, Buy-In Facilities
    These facilities provide all levels of care, ranging from independent to skilled care. Usually the resident has to pay a monthly fee plus an entrance fee.
  • Continuing Care Retirement Community (CCRC)
    A retirement community that offers a broad range of services and levels of care based on what each resident needs over time. Sometimes called "life care," it can range from independent living in an apartment to assisted living to full-time care in a nursing home. Residents move from one setting to another based on their needs. Care in CCRCs can be expensive, with a large payment often required before moving in, and monthly fees thereafter.
  • Continuum of Care
    A comprehensive system of Long-Term Care services and support systems in the community, as well as in institutions. The continuum includes 1) community support services such as senior centers; 2) in-home care, such as home delivered meals, homemaker services, home health services, shopping assistance, personal care, chore services and friendly visiting; 3) community-based services such as adult day care; 4) non-institutional housing arrangements such as congregate housing, shared housing and Board and Care Homes; 5) nursing homes and sub-acute and acute facilities if necessary.
  • Coordination of Benefits
    A provision in a health insurance plan that specifies which health plan or insurance policy pays first if two health plans or insurance policies cover the same benefits. If one of the plans is Medicare, federal law may determine who pays first.
  • Co-payment
    This is the portion of a medical expense that is the member's financial responsibility. HMOs generally have fixed low co-payments, usually around $5-$10.
  • CPR
    Cardio-Pulmonary Resuscitation.
  • Cueing
    Directing or supervising the actions of someone with cognitive impairment (for example, showing them how to eat, reminding them which medications to take at the appropriate times, giving visual or verbal reminders for dressing or toileting, etc.).
  • Custodial Care
    Help and supervision with daily living activities - dressing, eating, personal hygiene, and similar functions.
  • Deductible
    A common cost-sharing arrangement of traditional indemnity insurers under which a policyholder must pay a set amount toward covered services before the insurer is required to pay claims. Typically, HMO members do not pay deductibles.
  • Dementia
    The loss of intellectual functions such as thinking, remembering and reasoning to the extent that a person's daily functioning is affected. It is not a disease in itself, but rather a group of symptoms which may accompany certain diseases or physical conditions. The cause and rate of progression of dementia vary. Some of the well-known diseases that produce it include
    • Alzheimer's Disease,
    • Multi-infarct Dementia,
    • Huntington's Disease,
    • Pick's Disease,
    • Creutzfeldt-Jakob Disease, and
    • Parkinson's Disease.
  • Dependent Care Tax Credit
    Federal income tax credits for certain home care services and adult daycare services. Consult the IRS or a tax advisor for details.
  • Depression
    An under-diagnosed condition among seniors. Symptoms include a persistent sad, anxious or "empty" mood, loss of interest or pleasure in activities once enjoyed, and difficulty sleeping. With proper medical care, depression is reversible.
  • Diastolic PressureBlood pressure reading when the heart is resting between beats; the second number in a blood pressure reading. See Systolic Pressure.
  • DieticianOne qualified by training and education in establishing dietary procedures and planning menus for regular and special diets.
  • Director of NursingA Registered Nurse (RN) who oversees the nursing department, including nursing supervisors, Licensed Practical Nurses, nurses aides and orderlies. A Director of Nursing typically writes job descriptions, hires and fires members of the nursing staff and writes and executes procedures and policies for nursing practice.
  • Discharge PlannerA social worker or other health care professional who assists hospital patients and their families in transitioning from the hospital to another level of care such as rehabilitation in a skilled nursing facility, home health care in the patient's home, or long-term care in a nursing home.
  • DiureticsA class of drugs given to help the body rid itself of excess fluid; often used on older persons with heart disease.
  • Do Not Resuscitate Order (DNR)A code or order indicating that in the event a patient's heart or breathing stops, there should be no intervention. This does not mean that the individual does not receive care. Continuing care is provided as it would to any individual (medications for pain, antibiotics, etc.) except as stated above.
  • Durable Medical Equipment
    Medical equipment that is ordered by a doctor for use in the home. These items, such as walkers, wheelchairs, and hospital beds, must be reusable. Durable medical equipment is paid for under Medicare, subject to a 20% coinsurance of the Medicare-approved amount.
  • Durable Medical Power of Attorney
    A legal document which names a person who will make health care decisions for the principal if that individual becomes incompetent or unable to express wishes for himself or herself.
  • Edema
    Collection of fluids in tissues that result in swelling.
  • Eldercare
    A wide range of services provided at home, in the community and in residential care facilities, including assisted living facilities and nursing homes. It includes health-related services such as rehabilitative therapies, skilled nursing, and palliative care, as well as supervision and a wide range of supportive personal care and social services.
  • Elder Care Placement Services
    Elder care placement services help families evaluate and assess a senior's daily living needs and attempt to place the senior in the most appropriate setting possible. Placement services have extensive knowledge and experience in the options available within a senior's community, including retirement communities, assisted living, skilled nursing facilities, and other elder care housing options.
  • Elder Law Attorney
    An attorney who specializes in the laws that deal with the rights and issues of the health, finances, and well-being of the elderly and the power of other individuals and the government to control them.
  • Elder Mediation
    Elder mediation, a sub-specialty of family mediation, is a relatively new field that brings together family members and professionals who can help them address and cope with major life changes related to aging. Potential areas of conflict or stress, such as housing options, daily caregiving needs, financial and legal decisions, end of life issues, etc. are discussed and explored with the guidance of an experienced mediator. The goal of elder mediation is to allow seniors to make informed decisions about their lives, while helping other family members adjust to their changing roles and responsibilities.
  • Elimination Period
    The length of time an insured person must pay for covered services before the insurance company will begin to pay benefits. Unless otherwise noted in the insurance policy, no benefits are payable for any days of an elimination period.
  • Emergency Monitoring System (Personal Emergency Response System)
    An electronic device, usually worn as a pendant or bracelet, which can be activated at the touch of a button in an emergency situation. When the alarm is activated, it sends a signal to a 24-hour emergency response center where an operator attempts to establish two-way contact with the client and dispatch appropriate assistance. Emergency monitoring services are usually private pay, and are rarely covered by Medicare/Medicaid.
  • Enrollment Area
    HMOs specify that an individual must reside in a particular geographic area in order to be eligible for plan coverage.
  • Estate Planning
    The process of planning for what will happen to a person's property after the person's death. Estate planning often requires the services of an attorney.
  • Estate Tax
    A tax that may be levied on a person's estate.
  • Exclusion
    A health condition, situation, item, service or expense that an insurance policy does not cover. Medicare excludes coverage for most prescription drugs, long-term care, and custodial care in a nursing or private home.
  • Executor
    The person or institution appointed in a will, or by a court, to settle the estate of a deceased person.
  • Federally Qualified HMO
    An HMO that has met certain standards established by the federal government pertaining to quality of care, financial soundness, member services, and similar criteria.
  • Fiduciary
    A person, such as a trustee or guardian, who holds the assets of another person, often with the legal authority and duty to make decisions regarding financial matters on behalf of the other party.
  • Free-Look Period
    The time period (usually 30 days) during which an insurance policy can be cancelled for any reason.
  • Gatekeeper
    A term sometimes used to refer to HMO primary care physicians or nurse practitioners because of their responsibility for referring members to specialists or other services.
  • Geriatric Care Manager
    One who develops and implements a plan for all aspects of long-term care to assist an elderly person and, indirectly, the person's family members.
    A geriatric care manager will usually hold a graduate degree, and may be certified or licensed by a professional organization or by state statute or regulations.
  • Geriatric Social Worker
    A licensed professional who assists the elderly and their families in understanding and coping with the social, emotional, and psychological aspects of aging.
  • Geriatrician
    A medical doctor with special education and training in the diagnosis, treatment, and prevention of disabilities in older people.
  • Geri-Chair
    A wheelchair that cannot be self-propelled and has a high back, a foot ledge and a removable dining tray.
  • Gerontologist
    A professional who specializes in the mental and behavioral characteristics of aging.
  • Grab Bar
    Bars or railings placed around tubs, showers and toilets to be used to steady oneself.
  • Group Practice HMO
    An HMO that contracts with medical groups to provide healthcare to HMO members.
  • Guaranteed Renewable
    Most Medicare Supplement and long-term care insurance policies are guaranteed renewable. That is, the policy cannot be cancelled by the insurance company unless (1) you committed fraud in your application for the policy, (2) you have not paid the required premium and the policy has lapsed, or (3) benefits have been exhausted. A guaranteed renewable policy cannot be cancelled because of a change in your health condition, or your marital or employment status. However, the insurance company may increase premiums, but only on an entire class of policies, not just on your policy, and never because of any claims paid to you.
  • Guardian
    An individual appointed by a court of law to manage a person's financial and/or personal affairs because the court has found that the person is not competent to manage his or her own affairs. A conservator is similarly appointed, but only for financial affairs.
  • Guardianship
    The process in which an individual is appointed by a court of law to manage a person's financial and/or personal affairs because the person is not able to or is not competent to manage his/her own affairs.
  • Health Care Financing Administration (HCFA)
    An executive department of the Department of Health and Human Services that has ultimate authority over Medicare and Medicaid.
  • Health Insurance Information Counseling Assistance Program (HIICAP)
    Program for Medicare beneficiaries where peer counselors respond to questions and requests for help in navigating the private and public insurance systems.
  • Home Care
    Services provided in the home to promote, maintain, and restore health or to minimize the effects of illness and disability. Home care can be for short-term purposes, such as rehabilitative care after a hospital discharge or care for the terminally ill.
  • Home Health Agency
    An organization that provides home care services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, and care by home health aides.
  • Home Health Aide
    A person who provides personal care including bathing, dressing and grooming, and some household services.
  • Home Healthcare
    Health services provided in the homes of the elderly, disabled, sick or convalescent. The types of services provided include nursing care, social services, home health aide and homemaking services, and various rehabilitation therapies (e.g., speech, physical and occupational therapy).
  • Homebound
    Unable to leave home or cannot leave home without considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for nonmedical reasons, such as a trip to the barber.
  • Hospice
    Medical and social programs for terminally ill patients and families either at home or in a facility. Hospice care emphasizes pain control, symptom management, and emotional support rather than life-sustaining equipment.
  • Incapacitated Adult
    A person impaired by sickness, accident, injury, mental illness, mental disability, chronic use of drugs, chronic intoxication or any other causes, to the extent that the person does not have sufficient understanding or ability to make or communicate responsible decisions concerning his/her day-to-day care.
  • Incompetence
    A legal determination that one is incapable of handling assets and exercising certain legal rights.
  • Independent Senior Housing
    Self-contained apartments designed to promote independence, and provide common space and activities; also called Independent Living Facilities.
  • Informed Consent
    A legal term that refers to a person's consent to a proposed medical intervention after receiving relevant information. The information that is legally required includes diagnosis, nature and purpose of the proposed intervention, risks and consequences of the proposed treatment, probability that the treatment will be successful, feasible treatment alternatives and prognosis if the treatment is not given.
  • Institutionalization
    Admission of an individual to an institution, such as a nursing home, where he or she will reside for an extended period of time or indefinitely.
  • Instrumental Activities of Daily Living (IADLs)
    Tasks that, in addition to activities of daily living, a person must be able to perform in order to live independently (without the assistance or substantial supervision of another person).
    Examples include grocery shopping, meal preparation, using the telephone, laundry, light housekeeping, bill paying, and managing medications. Most long-term care insurance policies will not pay benefits for the loss of ability to perform IADLs.
  • Intermediate Care Facility (ICF)
    A nursing facility that provides help with personal or social care and a minimum of medical supervision.; often a section of a nursing home or personal care home.
  • Intermittent Care
    Skilled nursing and home health aide services furnished up to 28 hours per week over any number of days per week so long as they are offered less than 8 hours per day.
  • Licensed Health Care Practitioner
    A physician (as defined by the Social Security Act) or a registered professional nurse, licensed social worker, or any other health care worker who meets the requirements of the U.S. Treasury Department.
  • Licensed Practical Nurse (LPN)
    One who has completed one or two years in a school of nursing or vocational training school. LPNs are in charge of nursing in the absence of a Registered Nurse (RN). LPNs often give medications and perform treatments. They are licensed by the state in which they work.
  • Life Care Arrangement or Life Care Contract
    Contract between a resident and a nursing home in which the resident assigns to the home all of his/her personal assets in return for a guaranteed lifetime of care.
  • Life Tenancy
    After the owner sells a home, he or she leases it back and receives a written guarantee (life tenancy) that he or she can continue to live in the home for the rest of his or her life. A life tenancy is often arranged with an annuity set up to pay the rent.
  • Lifetime Maximum
    The maximum amount of policy benefits available to an insured person during his or her lifetime.
  • Limited Payment Option
    Premiums are paid for only a set period of time. After the last premium payment, the policy becomes paid-up for the remaining duration of the policy. After it becomes paid-up, the insurance company cannot cancel the policy and they cannot ask for more premiums. The tradeoff? - while premiums are being paid, limited payment plans are more expensive than continuous payment policies.
  • Live-In Home Care
    Live-In Home Care is provided by a caregiver who lives on a round-the-clock basis with a senior in his or her own home. The caregiver may provide a wide range of medical or non-medical assistance, depending on the type of care required and the caregiver's level of experience. This type of intensive support allows seniors to remain in their homes rather than relocate to assisted care facilities or nursing homes.
  • Living Trust
    A trust created during the life of the grantor. An irrevocable living trust is often used in estate and tax planning. All assets become the property of the trust and, generally, the trust is liable for income tax payable on amounts earned by those assets, but may result in removing assets from the estate and, therefore, reducing possible estate tax liability. It should be noted, however, that the transfer of assets to the trust may result in gift tax liabilities.
  • Living Will
    A document that makes known a person's wishes regarding medical treatments in the event the person becomes incompetent or is unable to speak.
  • Long-Term Care
    A general term that describes a range of medical, nursing, custodial, social, and community services designed to help people with chronic health impairments or forms of dementia.
  • Long-Term Care Insurance
    This type of insurance policy is designed to cover long term care expenses in a facility or at home. Neither Medicare nor Medicare supplemental insurance (Medigap) will pay for these expenses.
  • Long-Term Care Facilities
    Institutions that provide nursing care to people who are unable to care for themselves and who may have health problems ranging from minimal to serious. These facilities are often used for short-term rehabilitation after hospitalization.
  • Long-Term Care Ombudsman Programs
    Independent, nationwide, federally-funded services that work to resolve problems between residents and assisted living facilities, nursing homes and other residential care facilities.
  • Long-Term Care
    The medical and social care given to individuals who have severe, chronic impairments. Long-Term Care can consist of care in the home by family members assisting through voluntary or employed help (e.g., as provided by established home health agencies) or care in institutions. Various types of Long-Term Care facilities exist throughout the country and they frequently differ in their available staff, reimbursements and services.
  • Managed Care
    Used as a description for an entire array of programs. Generally, managed care implies that there is some form of influence in the delivery of health care by persons other than the caregiver and patient. It includes several concepts as part of its program quality assurance, aggressive care management, peer review and data gathering and dissemination to providers. The gatekeeper - one person, usually a primary care physician - opens the door to the various disciplines and specialty providers, providing the necessary coordinated care. This type of care emphasizes that the use of services is controlled to manage costs.
  • Meal Preparation Services
    Assistance with meal preparation is especially useful for seniors who live in their own homes, but who can no longer safely prepare their own meals, or who need help ensuring proper nutrition. Meals may be supplied on a part-time or full-time basis through a homemaker service, home care provider, companion service, or by special senior meal programs, such as Meals on Wheels.
  • Medicaid
    Medicaid is a joint federal/state program which provides health care coverage for individuals and families with low incomes. Eligibility requirements vary from state-to-state as does the level and type of coverage. Medicaid is the primary payer of nursing home care. Some states also offer some home and community-based long-term care services for eligible individuals through their Medicaid programs. These additional services are at the option of the state and are not mandated by federal law.
  • Medical Directive
    See Living Will.
  • Medical Director
    A physician who formulates and directs policy for medical care in a nursing home.
  • Medical Social Services
    Help with social and emotional concerns one may have related to one's illness. This might include counseling or help in finding community resources.
  • Medicare
    Federal program providing health care coverage/insurance for people over 65 years of age, certain younger people with disabilities, and people with End-Stage Renal Disease (ERSD) (permanent kidney failure that must be treated with dialysis or a transplant). Part A covers inpatient care, skilled nursing facility, hospice and short-term health care. Part B covers doctors' services, outpatient hospital care, and durable medical equipment. It does not provide for long-term care of the elderly except under limited conditions.
  • Medicare Supplemental Insurance (Medigap)
    This is private insurance (often called Medigap) that pays Medicare's deductibles and co-insurances, and may cover services not covered by Medicare. Most Medigap plans will help pay for skilled nursing care, but only when that care is covered by Medicare.
  • Noncancellable Policies
    Insurance policies that cannot be cancelled by the insurance company, except for non-payment of the required insurance premiums; rates can never be changed by the insurance company.
  • Nursing Home
    A state-licensed residential facility that provides a room, meals, help with activities of daily living, recreation, and general nursing care to people who are chronically ill or unable to take care of their daily living needs. It may also be called a Long Term Care Facility. If it has been certified as such by Medicare, it is also referred to as a Skilled Nursing Facility.
  • Occupancy Agreement
    Generally, assisted living facilities have occupancy agreements that outline terms of residency. The terms should clearly define specific living arrangements for the community and for individuals.
  • Occupational Therapist
    A person trained to conduct therapy to maintain, restore or teach skills to improve manual dexterity and hand-eye coordination.
  • Older Americans Act
    Law enacted in 1965 (PL 89-73) that gives elderly citizens more opportunity to participate in and receive the benefits of modern society. For example, adequate housing, income, employment, nutrition and health care.
  • Ombudsman
    A "citizen's representative" in a nursing home who protects a person's rights through advocacy, providing information and encouraging institutions to respect citizens' rights.
  • Parkinson's Disease Parkinson's Disease ("PD") is a progressive disorder of the central nervous system which affects more than one million Americans. Individuals with PD lack a substance called dopamine, which is important in the central nervous system's control of muscle activity. PD is often characterized by
    • Tremors,
    • Stiffness in limbs and joints,
    • Speech impediments, and
    • Difficulty in initiating physical movement.
    Late in the course of the disease, some individuals develop dementia and eventually Alzheimer's disease. Medications such as levodopa, which prevents degeneration of dopamine, are used to improve diminished motor symptoms in PD patients but do not correct the mental changes that it causes.
  • Participating Provider
    An institution, facility, agency, health professional or other person certified or licensed by the appropriate agency of the state having jurisdiction, and holding a current signed participation agreement with the Medicaid agency.
  • Partnership Policy
    A type of long-term care insurance policy that allows you to protect (keep) some of your assets if you apply for Medicaid after using your policy's benefits. Only a few states have these policies.
  • Patient Bill of Rights
    A list of policies and procedures to be followed to ensure that patients receiving health care services will be treated with dignity and will participate fully in decisions relevant to their health care.
  • Patient Care Plan
    A plan formulated by a Registered Nurse in conjunction with a physician for the on-going care and rehabilitation for a nursing home resident to their optimum potential.
  • Patient Co-Payment
    The amount of allowed charges that is the responsibility of the Medicaid recipient to pay.
  • Personal Care
    see Custodial Care.
  • Personal Emergency Response System
    In case of a fall or other medical emergency, this electronic device enables the user to contact help 24-hours-a-day simply by pressing a button. A number of private companies offer these systems.
  • Physical Therapist
    A licensed professional who treats impaired motion or disease through exercise, massage, hydrotherapy, or mechanical devices to improve physical mobility.
  • Physician Assistant
    A person who performs a number of tasks that were traditionally performed by the physician (i.e., taking medical histories or making routine examinations). Training for Physician Assistants usually includes a specialized 2-year program. Physician Assistants always work under the supervision of a physician.
  • Plan of Care
    The written plan that describes the services and care you need for your health problem. Your plan of care must be prepared or approved by your doctor.
  • Point-of-Service Plan (POS)
    A type of managed care plan that combines aspects of health maintenance organizations and preferred provider organizations. POS offers the option of going to a network healthcare provider and paying a flat fee, or to an out-of-network provider and paying a deductible and/or a coinsurance charge. POS Plans are not currently available to Medicare beneficiaries.
  • Power of Attorney
    The simplest and least expensive legal device for authorizing a person to manage the affairs of another. In essence, it is a written agreement, usually with a close relative, an attorney, business associate or financial advisor, authorizing that person to sign documents and conduct transactions on the individual's behalf. The individual can delegate as much or as little power as desired and end the arrangement at any time.
  • Pre-existing Condition
    An illness or disability for which you were treated or advised within a certain time period (typically 6-12 months) before applying for an insurance policy. Any pre-existing condition would not be covered during a designated time period (again typically 6-12 months) after the effective date of the policy.
  • Primary Care Physician (PCP)
    The doctor who is consulted first when a health problem occurs and on whom the patient relies for advice, referrals, and ongoing care.
  • Primary Caregiver
    The person, usually the spouse or adult child, who takes on the primary day-to-day responsibility of caring for the physical, psychological and social needs of another person.
  • Private-Pay
    Many eldercare services are not covered by Medicare, Medicaid and/or insurance. These services are paid for directly by the individual. Examples of private-pay eldercare services include non-medical homecare, companion services, assisted living, adult daycare, and many home medical products etc.
  • PRN
    An abbreviation used to indicate that a medication is given or treatment performed only as the need arises.
  • Proprietary Facility
    A facility that is operated for the purpose of making a profit.
  • Provider
    A properly-licensed doctor, health care professional, hospital, or other health care facility, including a home health agency, that provides health care or related social services.
  • Psychotropic Medications
    Drugs used in the treatment and control of mental illness.
  • Recreational Activities Director or Recreational Therapist
    The person responsible in a nursing home for developing, scheduling and conducting a multifaceted program geared to meet the social and diversional needs of all residents.
  • Registered Nurse
    A graduate nurse who has completed a minimum of two years of education at an accredited school of nursing. RNs are licensed by the state in which they work.
  • Rehabilitation Hospitals
    Rehabilitation hospitals provide a multidisciplinary approach to goal setting, planning and delivery of patient care. The treatment team may include physicians, nurses, physical therapists, occupational therapists, speech therapists, respiratory therapists, social services, psychological services and orthotic/prosthetic services. Nursing care is available 24-hours-a-day. Therapies are provided throughout the day.
  • Rehabilitation Therapy
    Therapy aimed at restoring or maintaining the greatest possible function and independence. Rehabilitation therapy is especially useful to persons who have suffered from stroke, an injury or disease by helping them recover the maximum use of the affected area(s) of the body.
  • Representative Payee
    An individual who is chosen by the Social Security Administration (SSA) and who agrees to receive a Social Security or SSI recipient's check and to handle the funds in the best interest of the recipient. The process of selecting a Representative Payee was initiated by the SSA because not everybody who receives either a Social Security or an SSI check can handle his/her own funds. Also see Authorized Representative.
  • Residential Care Facility
    A generic term for a group home, specialized apartment complex or other institution that provides care services where individuals live. The term is used to refer to a range of residential care options including assisted living facilities, board and care homes and skilled nursing facilities.
  • Respiratory Therapy
    Exercises and/or treatments designed to help patients regain lung function.
  • Respite Carev
    Temporary caregiving services provided when the primary caretaker needs time away from caregiving. Respite care is provided in-home or an alternative location for a short stay.
  • Restraint
    A device used to prevent a person from falling out of a chair (e.g., a belt around the waist tied to a wheelchair or a jacket with straps tied to a wheelchair). A jacket restraint could be used to prevent a person from crawling over the side rails of a bed. Wrist restraints are used under unusual circumstances. Restraints should be used as protection for the resident only when other means are not reasonable.
  • Retirement Communities
    This is a housing option for those who want to be in an environment that offers social activities and meals but who want to maintain their independence. Seniors are generally in good health and are able to live independently.
  • Reverse Mortgage
    A financial instrument that enables elderly homeowners to convert the equity in their homes to monthly income or a line of credit.
  • Revocable Trust
    A trust in which a Grantor reserves the right to revoke or change. To protect the final wishes of the Grantor, a trust can become irrevocable upon the death of the Grantor.
  • Senior Case Management
    This service is offered many times from the local senior center as a means of reaching out to those seniors who are homebound or those who are restricted in some way from resources. Usually this service is free and it provides a few visits or phone calls to the older relative. It also offers assistance with getting connected to additional resources and low cost services within the community.
  • Senior Center
    A community facility for the elderly. Senior centers provide a variety of activities for their members including any combination of recreational, educational, cultural or social events. Also, some centers offer nutritious meals and limited health care services.
  • Senior Companion Services
    Companion services offer a variety of support for seniors in their homes. Personal companions generally do not provide medical services and are not trained as home health aides or nurses. They do provide daily living services such as driving the senior to doctor's appointments, shopping errands, and social engagements. They may assist with paying bills, light secretarial work, meal preparation, light housework, reading, or simply conversation. Senior companions may work on a part-time, full-time, or round the clock schedule, depending on the client's needs. Companions offer personal contact for seniors who may otherwise be left alone during the day, and they are able to keep in touch with family members if there are any concerns about the senior's health or well being.
  • Senior Group Home
    Senior group homes are small, private homes, often located in residential neighborhoods that provide assisted living services for a small number of seniors who live together. Residents share in the daily living responsibilities and support services provided by at least on supervisor who usually lives on-site. Senior group home residents typically require limited medical care, but meals, housekeeping, and personal care services may be provided. Residents benefit from the close-knit community atmosphere of this long-term living arrangement.
  • Skilled Nursing Care
    Skilled care that must be given or supervised by Registered Nurses. Examples of skilled nursing care are intravenous injections, tube feeding, and changing sterile dressings on a wound. Any service that could be safely done by an average non-medical person without the supervision of a Registered Nurse is not considered skilled care.
  • Skilled Nursing Facility
    Skilled nursing facilities provide residential care and are usually licensed under state or local authorities to provide 24-hour skilled nursing care and rehabilitation services to its residents. Skilled nursing facilities or nursing homes provide a protective environment for people who do not need to be in a hospital setting, but who can no longer safely live on their own. These facilities are Medicare and Medicaid eligible, and offer intensive, specialized care for their residents.
  • Social Security
    The comprehensive federal program of benefits providing workers and their dependents with retirement income, disability income, and other payments. Individuals qualify for Social Security retirement benefits as early as age 62 if they have held a job and paid Social Security taxes for at least 10 years.
  • Speech Therapist
    A rehabilitation professional who provides therapy to overcome speech and communication problems, such as speech difficulties following a stroke. A speech therapist may also provide assistance for managing swallowing problems.
  • Spend Down
    Under the Medicaid program, a method by which an individual establishes Medicaid eligibility by reducing gross income through incurring medical expenses until net income (after medical expenses) meets Medicaid financial requirements. A resident spends down when he/she is no longer sufficiently covered by a third-party payor (usually Medicare) and has exhausted all personal assets. The resident then becomes eligible for Medicaid coverage.
  • Spousal Impoverishment
    The community property and assets of a community spouse of a nursing facility resident may be divided according to standards set by the Health Care Financing Administration and state law as a means of protecting the assets of the non-institutionalized spouse.
  • Sub-Acute Care
    Typically following a stay in a hospital, this is maintenance care for serious medical conditions that are not urgent or life-threatening. Hospitals typically do not provide sub-acute care on an ongoing basis. Sub-acute care may include long-term ventilator care or other procedures provided on a routine basis either at home or by trained staff at a skilled nursing facility.
  • Supplemental Security Income (SSI)
    A federal program that pays monthly checks to people in need who are 65 or older and to people in need at any age who are blind or disabled. The purpose of the program is to provide sufficient resources so they can have a basic monthly income. Eligibility is based on income and assets.
  • Telephone Reassurance
    Calls made by agencies or volunteers to an elderly person to check up on them and offer reassurance, contact and socialization. The calls are typically made at a predetermined time each day.
  • TTY
    A text telephone system that allows a hearing-impaired user to type messages to another person and read responses on a small screen. Similar to today's text messaging, a "read only" conversation can exist between two people who each use TTY equipment. Otherwise, a non-hearing-impaired caller can use a relay service where a special operator acts as a go-between to translate the speaker's words into text and text print into voice communication.
  • Turn Q 2H
    Turn every two hours. A nursing home resident who is unable to move himself/herself for a physical or mental reason must be turned frequently to a different position to prevent skin breakdown and other physical problems.
  • Utilization Review
    A cost control device that requires any participating hospital or nursing home to evaluate the appropriateness of Medicare and Medicaid patients' admission to and continued stay in the institution. Such a review is conducted by a utilization review committee composed of physicians and other health professionals who must review 1) the medical necessity of the admission and 2) the medical necessity of continued institutionalization.
  • Veterans Administration (VA)
    The Department of Military and Veterans Affairs administers a variety of programs to assist veterans and their families.
  • Viatical Settlements
    Viatical settlements refer to situations where an individual sells the benefits of their life insurance policy to a third party at a discount in order to get cash to pay for costly health care services. Viatical settlement companies may pay 60 percent of the face value of a policy to a person with a life expectancy of two years or less or as much as 80 percent to an individual with a life expectancy of six months or less. The industry generally uses the term "Viatical Settlement" to refer to a transaction involving a terminally- or chronically-ill insured and a "Life Settlement" to refer to a transaction involving an insured who is not terminally or chronically ill, generally over the age of 65.
  • Visiting Nurse (Private Duty Nurse)
    A visiting nurse service provides registered nurses to administer health care to seniors in their own homes. Visiting nurse agencies may provide a wide range of services, both medical and non-medical. Visiting nurses evaluate and manage their patient's care at home, working with their physicians to ensure that all medical needs are being met. Visiting nurse services allow seniors to remain in their homes, even when they become ill or physically disabled. Most visiting nurse services are covered by third party insurance, including Medicaid, Medicare, private insurance, and HMOs.
  • Visiting Physician (House Calls)
    Visiting physician services recall the "old-fashioned" tradition of doctor's housecalls. For many seniors who are ill or who have severe physical limitations, visiting a doctor's office can be extremely difficult. A visiting physician service may be the best solution for these patients. Visiting physicians can provide a broad range of medical care, from routine exams to more comprehensive treatment in the patient's home. Visiting physicians are usually accompanied by a medical assistant or nurse, as well as portable diagnostic equipment. Visiting physicians work closely with other caregivers to monitor and manage all aspects of the patient's medical care.
  • Vital Signs
    Temperature, Pulse, Respiration and Blood Pressure.