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The terminology surrounding health care and senior care in particular at times, can cause you to feel confused and overwhelmed.  Always Best Care has created a  list of common terms to help you through this process.  However, understanding what type of care is right for your loved one can be a daunting task.  For over a decade Always Best Care has been helping our seniors through this process.  Let Always Best Care guide you through the health care maze.  Our Care Coordinators are local and ready to assist you.  Call Always Best Care today for your free no obligation consultation or visit us at to find the office nearest you.

Use this glossary of terms to help understand some of the terms relating to senior care giving and services.

Abuse
Abuse is any situation that creates potential harm to an individual - emotional or physical. Also, see Adult Protective Services in this Glossary. Advantage List: List of health service providers that agree to give particular insurance company policyholders a preset discount.

Accreditation:
A seal of approval given by a governing body to a housing and/or service provider.  To become accredited, the community or provider must meet specific requirements set by the accreditation entity and is then generally required to undergo a thorough review process by a team of evaluators to ensure certain standards of quality.  The accrediting organizations are not government agencies or regulatory bodies.  Examples of some accreditation bodies for the senior housing and care industry include CCAC (Continuing Care Accreditation Commission), CARF (Commission on Accreditation of Rehabilitation Facilities) and JCAHO (Joint Commission on Accreditation of Healthcare Organizations).

Activities of Daily Living (ADLs):
Everyday activities such as bathing, grooming, eating, toileting, and dressing.

Acute Illness:
A serious illness such as a heart attack or stroke that develops rapidly with pronounced symptoms. The illness can be of short duration such as influenza.

Adaptive Devices:
A variety of devices that are used to increase, maintain, or improve the functional capabilities of individuals, providing the assistance needed to stay at home. These devices may help with vision, hearing, mobility, communication or other needs, and include wheelchairs, walkers, touch-sensitive light switches, phone amplifiers, stair lifts, chairs with lifts and computers. May also be known as Assistive Technology.

ADA(Americans with Disabilities Act):
Law passed by Congress in 1980, establishing a clear and comprehensive prohibition of discrimination on the basis of disability.

Administrator:
Generally, a licensed professional who manages the day-to-day operation of a care facility such as a nursing home or assisted living facility.

Adult Day Care:
Daily structured programs in a community setting with activities and health-related and rehabilitation services to elderly who are physically or emotionally disabled and need a protective environment.  This care is provided for during the day, the individual returning home for the evening.

Adult Day Health Services:
A program that provides medically necessary services in an ambulatory care setting to persons who are nonresidents of the facility, and who, due to their physical and/or cognitive impairment, require such services supportive to their community living that cannot be provided elsewhere. The facility must be licensed by the Department of Health and Senior Services and clients must meet eligibility criteria established by the Department.

Adult Protective Services (APS):
Adult Protective Services includes the 24-hour, 365 days a year access to assistance and/or referral with reports of physical, sexual or emotional abuse, neglect by caretaker, self-neglect, exploitation and abandonment.

Alzheimer's Care Center:
A treatment center that specializes in providing care for those with Alzheimer's disease with more of the care geared towards supervision of the patient in a safe and controlled environment. (from LTCInsurance)

Aging in Place:
Concept which advocates allowing a resident to choose to remain in his/her living environment despite the physical and or mental decline that may occur with the aging process of aging.

Alzheimer's:
Degenerative age-related disease that impairs an individual's cognitive ability. Symptoms may include forgetfulness, wandering, and inability to recognize others. The disease is caused by neuron dysfunction and death in specific brain regions responsible for cognitive functions. Both genetic and environmental factors likely play a role in the development of Alzheimer's. Click here to learn more.

Ambulatory:
Describes ability to ambulate, walk around, not bedridden or hospitalized.

Assisted Living:In general, state-licensed program offered at a residential community with services that include meals, laundry, housekeeping, medication reminders, and assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The exact definition will vary from state to state, and a few states do not license assisted living facilities. Generally regarded as one to two steps below skilled nursing in level of care. Approximately 90 percent of the country's assisted living services are paid for with private funds, although some states have adopted Medicaid waiver programs. Might also be referred to as Personal Care, Board and Care, Residential Care, Boarding Home, etc., although some states differentiate between their definition of "Assisted Living" and these other terms (e.g., Washington state recognizes and licenses "Assisted Living" facilities as well as "Boarding Homes"; Although licensed by the State of Washington, a Boarding Home does not meet the higher physical plant and service requirements necessary to be considered an Assisted Living facility) . Click here to learn more.

Assessment:
A process used by care managers to gather information about an individual to determine his or her functional needs and/or eligibility for services. Information collected may include health status, financial status, ability to perform activities of daily living, mental status, etc.

Attorney-in-fact:
In legal terms, the person who is granted power-of-attorney. See-Power-of Attorney for more detail.

Beneficiary:
The recipient of benefits, as funds or property, from an insurance policy/program or will.

Caregiver:
The primary person in charge of caring for an individual with Alzheimer's disease, usually a family member or a designated health care professional.

Care Plan:
The detailed formulation of a program of action that addresses a consumer's needs.

Case management:
A term used to describe formal services planned by care professionals.

Charge Nurse:
An RN or LPN who is responsible for the supervision of a unit within a nursing facility. The charge nurse schedules and supervises nursing staff and provides care to facility residents.

Children of Aging Parents (CAPS):
Children of Aging Parents is a nonprofit, charitable organization whose mission is to assist the nation's caregivers of the elderly or chronically ill with reliable information, referrals and support. CAPS strives to heighten public awareness that the health of the family caregivers is essential to ensure quality care of the nation's growing elderly population.

Chore Service:
Chore services are semi-skilled home repairs and maintenance tasks performed to enhance the health and safety of the individual in the home. These services are provided through the local Area Agency on Aging, volunteer programs, or youth groups to help older people live safely and comfortably in their own homes.

Congregate Housing:
See Independent Living (may be also referred to as Supportive Housing).
Congregate Meals
Nutritious meals provided at least five days a week in local Senior Citizen Centers throughout the State. Meals are usually served around noon, and in some areas meals may be available at other times of the day. Besides providing nutrition, congregate meals provide needed socialization for older adults.

Continuing Care Retirement Community (CCRC):
Housing planned and operated to provide a continuum of accommodations and services for seniors including, but not limited to, independent living, congregate housing, assisted living, and skilled nursing care. A CCRC resident contract often involves either an entry fee or buy-in fee in addition to the monthly service charges, which may change according to the medical services required. Entry fees may be partially or fully refundable. The fee is used primarily as a method of privately financing the development of the project and for payment for future healthcare. CCRCs are typically licensed by the state. See also Life Care Community.

Continuum of Care:
Full spectrum of care available at Continuing Care Retirement Communities which may include Independent Living, Assisted Living, Nursing Care, Home Health, Home Care, and Home and Community Based Services.
Convalescent Home: See Nursing Home.

Counseling:
This is a service that helps consumers adjust to personal crises, change in personal roles, and to learn effective ways to control personal and family stress.

Dementia:
Progressive neurological, cognitive, or medical disorder that affects memory, judgment, and cognitive powers.

Dependent Care Tax Credit:
Federal income tax credits for certain home care services and adult day care services. Check with your local IRS office or a tax advisor for details.

Diabetes:
A disease that impairs the ability of the body to use sugar resulting in the loss of sugar through urine, and an increase in the level of sugar levels in the blood.

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 his/her wishes.

Durable Power of Attorney:
A power of attorney that is enforceable even if the principal becomes disabled or incapacitated.

Developmental Disability (DD):
Affliction characterized by chronic physical and mental disabilities, which may include: cerebral palsy, retardation, thyroid problems, seizures, quadriplegia.

Director of Nursing (DON):
A DON oversees all nursing staff in a nursing home, and is responsible for formulating nursing policies and monitoring the quality of care delivered, as well as the facility's compliance with federal and state regulations pertaining to nursing care.

Elder Abuse:
Elder abuse refers to any situation in which an elderly individual may suffer emotional or physical abuse from another individual.

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.

Estate:
The term used to represent all of an individual or couple's personal assets.

Estate Planning:
A plan for what will happen to an individual or couple's assets and liabilities after death.

Executor:
The person named in a will to carry out the distribution of an estate.
Financial Counseling Programs: Help seniors with managing their finances, bills, and completing Medicaid, Medicare or insurance forms.

Geriatric Assessment:
An evaluation of an older person's physical, psychological, and social condition by a professional team of specialists. This team makes recommendations to the older person, family, and primary care doctor. Geriatric assessments are offered in geriatric evaluation centers and are generally associated with hospitals.

Geriatrician:
A medical doctor with special education and training in the diagnosis, treatment, and prevention of disabilities in older people.

Geriatric Social Worker:
A licensed professional whose expertise enables him/her to assist the elderly and their families to understand and cope with the social, emotional, and psychological aspects of aging. The social worker may assist the individual/family to access services, and then assist them to use the resources effectively.

Gerontologist:
A professional who specializes in the mental and behavioral characteristics of aging.

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.

Handicap Parking:
Special parking for handicapped individuals. If you are interested in handicapped parking placards, contact Motor Vehicle services at  1-888-486-3339  1-888-486-3339 .

Home Delivered Meals:
Hot and nutritious meals delivered to homebound persons who are unable to prepare their own meals and have no outside assistance. Also, see Meals on Wheels in this glossary.

Homemaker/Home Health Aid Service:
A trained person, working under supervision, providing personal care, household cleaning, cooking, grocery shopping, laundry, transportation, for an elderly or disabled person.

HMO:
A Health Maintenance Organization (HMO) is an organized system for providing comprehensive health care in a specific geographic area to a voluntarily enrolled group of members.

Home Health Care:
Provision of medical and nursing services in the individual's home by a licensed provider.

HIPAA (The Health Insurance Portability and Accountability Act of 1996):
This act became a law on January 1, 1997. The act states the requirements that a long term care policy must follow in order that the premiums paid may be deducted as medical expenses and benefits not paid be considered as taxable income.

Hospice Care:
Care and comfort measures provided to those with a terminal illness and their families-  it can include medical, counseling, and social services.  Most hospice care is furnished in-home, while specialized hospices or hospitals also provide this service.

Hospice:
Usually a combination of at-home and hospital care of the terminally ill that combines medical and social services. It is designed to help both the patient and the family. Hospice care emphasizes pain control, symptom management, and emotional support rather than the use of life-sustaining equipment.

Independent Living:
Multi-unit senior housing development that may provide supportive services such as meals, housekeeping, social activities, and transportation (Congregate Housing, Supportive Housing, Retirement Community). Independent Living typically encourages socialization by provision of meals in a central dining area and scheduled social programs. May also be used to describe housing with few or no services (Senior Apartment).

Incontinence:
The loss of voluntary control over bladder or bowel functions.

Informal Support:
An individual willing to provide a service to a dependent person without reimbursement, e.g., family member or neighbor.

Informed Consent:
Following disclosure of the risks and options, the permission given by a person with mental capacity prior to receiving medical treatment.

Instrumental Activities of Daily Living (IADLs):
Day-to-day tasks such as preparing meals, shopping, managing money, taking medication, and housekeeping.

Irrevocable Living Trust:
Irrevocable living trusts are similar to revocable living trusts, except that you cannot revoke (that is, change or end) the trust after you have established it. In addition to having the same benefits as a revocable trust, an irrevocable trust also may provide savings on the estate taxes, and may prevent the loss of government benefits for a loved one.

Joint Ownership:
Joint ownership, used for a variety of purposes, can have positive or negative effects on access to jointly owned property. Your decision to hold property jointly should be based on your trust in the person with whom you hold joint ownership, and your needs and intentions with regard to the property.

Kitchenette:
Each facility may have its own definition of a kitchenette, but generally one includes a sink, cabinet space, and a mini-refrigerator, maybe a microwave. In contrast, a full kitchen would usually have a burner unit, sink, cabinets, full-size refrigerator, and possibly a microwave or stove.

Level of Care:
Refers to the outcome of an assessment designed to determine the most appropriate setting for the delivery of long-term care to an elderly person.

Licensed Practical Nurse (LPN):
LPNs are trained to administer technical nursing procedures as well as provide a range of health care services, such as administration of medication and changing of dressings. One year of post high school education and passage of a state licensing exam is required.

Life Care Community:
A Continuing Care Retirement Community (CCRC) which offers an insurance type contract and provides all levels of care.  It often includes payment for acute care and physician's visits. Little or no change is made in the monthly fee, regardless of the level of medical care required by the resident, except for cost of living increases.

Long-Term Care:
Provision of services to persons of any age who are afflicted with chronic health impairments.

Living Trust:
A trust created during the life of the grantor used in estate and tax planning. See revocable and/or irrevocable living trust in this glossary.

Living Will/Advance Directive for Healthcare:
A written document prepared by a competent adult that may be used when the individual becomes incapacitated by illness or injury, and is unable to speak for him/herself. It directs caregivers to either use, or not use, extraordinary means to sustain life.

Long-term Care Insurance:
Privately issued insurance policy which covers the cost of nursing home care, assisted living, and home health care. Premiums are based on age, health, length of deductible period, amount paid, and duration of benefits. Currently pays only two percent of national nursing home costs.

Managed Care:
There is currently no standard definition of managed care, but it can best be described as a combination of insurance and a health care delivery system. The basic goal of managed care is to coordinate all health care services received to maximize benefits and minimize costs. Managed care plans use their own network of health care providers and a system of prior approval from a primary care doctor in order to achieve this goal. Providers include: specialists, hospitals, skilled nursing facilities, therapists, and home health care agencies.

Meals-on-Wheels:
Meals delivered on a regular schedule -- daily, Monday to Friday, and in some counties -- including weekends, to housebound elderly or elderly people unable to cope with meal preparation, for little or no cost. Also, see Home Delivered Meals in this glossary.

Medicaid:
A jointly funded medical financial Federal-State health insurance assistance program, offering benefits to individuals with limited financial resources, the disabled, and the elderly. There are income eligibility criteria which must be met to qualify for Medicaid. Medicaid accounts for about 52 percent of the nation's care costs, and is the source of payment for almost 70 percent of residents in nursing homes. The person must have exhausted nearly all assets and be in a nursing facility that participates in this program. Medicaid can reimburse Nursing Facilities for the long-term care of qualifying seniors, and in some states, Medicaid pays for Assisted Living care through Medicaid waivers.

Medicare:
Nationwide medical insurance program administered by the Social Security Administration for individuals 65 and over and certain disabled people, regardless of income. Provides for hospital and nursing facility care (Part A) and physician services, therapies, and home health care (Part B).

Medical Director:
A staff medical director assumes overall responsibility for the formulation and implementation of all policies related to medical care. The medical director also coordinates with an individual's personal physician to ensure that the facility delivers the care that is prescribed. In some instances, the medical director may be a resident's primary physician.

Medications Management / Medication Administration:
Formalized procedure with a written set of rules for the management of self-administered medicine, as in an assisted living setting. A program may include management of the timing and dosage for residents, and could include coordination with a resident's personal physician. The resident must take the medication him or herself. For instance, the facility can remind the resident that she needs to give herself the medicine injection, but the facility cannot perform the actual injection itself.

Medigap Insurance:
Private health insurance policies that supplement Medicare coverage, covering health care costs above those covered by Medicare Part A or Part B. Does not provide benefits for long term care, covering primarily hospital and doctor bills.

Non-Ambulatory:
Inability to ambulate, walk around, and usually bedridden or hospitalized.

Not-for-Profit:
Status of ownership and/or operation characterized by government by community-based boards of trustees who are all volunteers. Board members donate their time and talents to ensure that a not-for-profit organization's approach to caring for older people responds to local needs. Not-for-profit homes and services turn any surplus income back into improving or expanding services for their clients or residents.  Many not-for-profit organizations are often associated with religious denominations and fraternal groups.  Not-for-profits may also interact with Congress and federal agencies to further causes that serve the elderly.

Nurse Assistant:
A Nurse Assistant provides the most personal care to residents, including bathing, dressing, and toileting. Must be trained, tested, and certified to provide care in nursing facilities that participate in the Medicare and Medicaid programs. Nurse assistants work under the supervision of a Registered Nurse or Licensed Practical Nurse.

Nursing Home:Facility licensed by the state that provides 24-hour nursing care, room and board, and activities for convalescent residents and those with chronic and/or long-term care illnesses. One step below hospital acute care. Regular medical supervision and rehabilitation therapy are mandated to be available, and nursing homes are eligible to participate in the Medicaid program.  May be referred to as Nursing Facility or Convalescent Home. See also Skilled Nursing Facility. Click here to learn more.

Occupational Therapy:Process to help individuals relearn activities of daily living, generally administered by a licensed therapist.

Ombudsman:
A person available through the Office of the Ombudsman for the Institutionalized Elderly (OOIE),  Department of Health and Senior Services, to investigate complaints made by or on behalf of older persons in long term care facilities, such as nursing facilities or assisted living facilities. This program advocates and protects the rights of residents in long-term care facilities by investigating complaints, mediating and resolving disputes, and initiating corrective actions.

Ophthalmologist:
A medical doctor who is trained to diagnose and treat diseases of the eye and provide total eye care.

Optometrist:
A doctor of optometry who examines eyes for both health and vision problems, and can prescribe corrective glasses.

Patient Bill of Rights:
A list of principles 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.

Personal Care Assistance Program (PCA):
Personal Care services provided through home health agencies and include personal care, bathing, meal preparation, assistance with activities of daily living (ADL) and light housekeeping.

Personal Emergency Response System (PERS):
Equipment that monitors the safety of older people in their homes through signals electronically transmitted over the telephone and received at an emergency-monitoring center.

SES or vision therapy to restore and maintain good vision.

Physical Therapy:
Process that includes individualized programs of exercise to improve physical mobility, often administered following a stroke, fall, or accident. Physical therapists plan and administer prescribed physical therapy treatment programs for residents to help restore their function and strength.

Power of Attorney (POA):
Any person of capacity, 18 or older, can designate another person to act on his/her behalf. The power of attorney can be limited to certain specific responsibilities or it can cover large general areas of decision-making regarding financial affairs.

Primary Caregiver:
The individual who has the main responsibility for helping an older person. The individual usually is the one who makes decisions and organizes care and services.

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.

Private Geriatric Care Managers:
Specially trained in geriatric care management, Geriatric Care Managers provide case management services on a fee-for-service basis to individual clients.

Prosthetic Device (Prosthesis):
An artificial device that is used to replace a missing part or enhance a functional part of the body.

Quality care:
Term used to describe care and services that allow recipients to attain and maintain their highest level of mental, physical, and psychological function, in a dignified and caring way.

Real Estate:
These housing options offer home ownership opportunities for adults 55 years of age and older, or sometimes 62 years and older. Some communities offer rental programs and rent-to-own options. The types of residences you may find are: Single Family Homes, Cottages and Patio Homes, Condos and Townhouses, Manufactured Homes, Gold Communities and Gated Communities.

Registered Nurse (RN):
Graduate trained nurse who has both passed a state board examination and is licensed by a state agency to practice nursing. The RN plans for resident care by assessing resident needs, developing and monitoring care plans in conjunction with physicians, as well as executing highly technical, skilled nursing treatments. A minimum of two years of college is required in addition to passage of the state exams.

Rehabilitation:
Therapeutic care for persons requiring intensive physical, occupational, or speech therapy.

Residential Care:See Assisted Living.

Respite Care:
Temporary relief from duties for caregivers, ranging from several hours to days. May be provided in-home or in a residential care setting such as an assisted living facility or nursing home.

Reverse Mortgages:
A reverse mortgage enables elderly homeowners to convert the equity in their homes to monthly income or a line of credit. For information, contact the nearest HUD office.

Revocable Living Trust:
A revocable living trust allows you to transfer ownership of your property to a separate entity called a trust. The trust is managed according to the rules you establish in the trust document for the benefit of the beneficiaries named in the trust.

Support group:
Facilitated gathering of caregivers, family, friends, or others affected by a disease or condition for the purpose of discussing issues related to the disease.

Senior Citizen Policies:
Insurance policies for those over the age of 65. In many cases these policies are in combination with coverage provided by the government under the Medicare Program.

Senility:
A term used to refer to the mental and physical deterioration of old age. Not a medical term. Also, see Dementia in this Glossary.

Senior Centers:
These centers provide services to senior citizens, 60 and over. They provide: social activities, congregate meals, health screenings, educational programs, and exercise programs.

Senior Apartment:
Age-restricted multiunit housing with self-contained living units for older adults who are able to care for themselves. Usually no additional services such as meals or transportation are provided.

Social Security:
The comprehensive federal program of benefits providing workers and their dependents with retirement income, disability income, and other payments.

Speech Language Pathologist:
A licensed health care professional, trained at the master's or doctoral level, which provides diagnostic and treatment services to individuals with speech, language, and hearing problems.

Subsidized Housing:
Rental assistance is available through Federal Government to low income elderly people and families.

Surrogate Decision Maker:
A person appointed by the consumer to act in his/her place.

Tax Counseling for the Elderly (TCE):
TCE is designed primarily for persons 60 years or older, particularly those who are confined to their residences or retirement communities. IRS-trained volunteers from non-profit organizations provide free tax counseling and basic income tax return preparation to senior citizens. TCE sites can be found by contacting Area Agencies on Aging or through AARP.

Telecommunications Device for the Deaf (TTY, TDD):
TTY and TDD enable both hearing and speech impaired individuals to connect any phone utilizing one of the local MRC (Message Relay Centers). In addition to telephone equipment, specialized software is available for converting computers to communication devices for the hearing and visually impaired.

Telephone Reassurance Program:
Daily phone contact from a volunteer to a disabled or elderly person is provided to check on their safety and to provide personal contact.

Trustee:
A legal term referring to a person who holds legal title to property in order to administer it for a beneficiary.

Veterans Administration (VA):
The New Jersey Department of Military and Veterans Affairs administers a variety of programs to assist veterans and their families.

Visiting Nurse:
A trained professional nurse who visits patients in their homes to monitor vital signs, the physical condition, and carry out a physician's treatment plan.

Visual Acuity:
The ability of the eye to perceive the detail of objects in the direct line of sight. Visual acuity is measured by viewing standardized letters of varying sizes on a chart and is expressed as a ratio, e.g., 20/20.

Volunteer Income Tax Assistance (VITA):
VITA involves IRS-trained volunteers who provide free tax assistance at community locations


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