Seniors A2Z

Senior Care Glossary

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AAA (Area Agency on Aging)
Created by the federal Older Americans Act (OAA), these agencies plan, coordinate and administer state programs for Americans age 60 and older.

Accessibility
See Environmental Accessibility

Accreditation
A seal of approval given by an autonomous governing body to a community or service provider.

Active Adult Retirement Community
Senior retirement communities typically having a minimum age (of 55+) for residents; focused on active, independent adults who wish to partake of various activities (sports and exercise, clubs, special interest groups, etc.)

Activities of Daily Living (ADLs)
ADL is an abbreviation for “activities of daily living” such as bathing, dressing, eating, etc. An aide may be needed to assist with ADLs, but these costs are not usually covered by Medicare.

Acute Care Facilities
Facilities providing short-term care and rehab for illness and disability; typically hospitals and nursing homes.

ADA (Americans with Disabilities Act)
Passed by Congress in 1980, this law establishes a clear and comprehensive prohibition of discrimination on the basis of disability.

Adaptability
Use and design of space that addresses the problems of physical changes over a period of time, allowing for easy adaptability as needed.

Administrator
A licensed professional who manages the day-to-day operations of a care facility such as a nursing home, hospital, or assisted living facility.

Adult Day Care Center
A structured program for the elderly which offers activities, meals, and sometimes health and rehabilitative services, in a supervised setting; transportation is sometimes included in the fee.  There are two types of Adult Day Care: Non-Medical Day Care (offering daytime respite for the caregiver who typically needs to hold down a job or otherwise needs time in which they cannot offer supervision for an aging individual needing some level of supervision at all times) and Medical (offering the additional health-related services of doctors, nurses and other certified health professionals).

Adult Guardian
A person appointed by a court to perform tasks of caring for an incapacitated adult's financial affairs and/or personal needs. There are three types of guardians with varying degrees of authority: Plenary Guardian with total authority over personal and property matters, the Guardian of the Person has authority over matters such as medical decisions and residential questions, and the Guardian of the Estate has authority only over property.

Adult Foster Care
When an individual becomes a resident in the home of a non-relative.  Monthly fees are charged for room, board and some level of socialization.

Advanced Directives
A means for an individual to accept or refuse medical care; advanced directives can protect a person’s rights even if they become mentally or physically unable to communicate their wishes. Living Wills and Durable Power of Attorney for Health Care are two examples.

Advantage List
List of health service providers who agree to give a particular insurance company’s policyholders a pre-set discount.

Advocacy Assistance
Programs that seek to influence legislative or regulatory actions to benefit specific interest groups.

Aging in Place
The concept that an elderly person may choose to remain in his or her residence regardless of the physical and or mental decline that may occur with the aging process of aging.  (Also see NORCs)

Alternate Family Care
See Board and Care Homes

Alzheimer’s Disease
One of the most common of dementia disorders, it is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking, and behavior. Gradual memory loss, lessening ability to perform routine tasks, disorientation in time and space, and personality change are a few of the symptoms.

Ambulatory
The ability to walk freely & independently; not bedridden.

AOA
U.S. Administration on Aging, part of the Department of Health and Human Services.

Assisted Living Facilities (ALFs)
A general term for living arrangements in which some services such as meals, laundry, or medication reminders, are available to residents where residents usually pay a regular monthly rent along with additional fees for specific services.  Occasionally, some facilities have some additional levels of medical health support to help in addressing immediate, non-acute, short-term needs.

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Balance Billing
A term which refers to health care providers charging patients for amounts above the Medicare-approved charge. In some states, including Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island and Vermont, balance billing is illegal.

Bed hold
Some State Medicaid programs may pay to “reserve” a nursing home bed if a resident is temporarily hospitalized. Medicare does not pay to hold a bed.

Board and Care Homes
A group living arrangement offering room, board and socialization for people who cannot live independently but do not require nursing home services. These institutions offer a wider range of services than independent living options, including assistance with some daily living activities. In some cases, private long-term care insurance and medical assistance programs will help pay for this type of facility.  Often also referred to as Alternate Family Care and Residential Healthcare Facilities.

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Capitation
A method of compensation for health care services under which doctors and other providers are paid a fixed monthly fee for each HMO member under their care, rather than for each service or treatment they perform.

Caregiver
The primary person in charge of caring for an individual, usually a family member or a designated health care professional.

Case Manager (Care Manager, Geriatric Care Manager)
A social worker or healthcare professional who evaluates, plans, locates, coordinates and monitors services with an older person and the family. The National Association of Professional Geriatric Care Managers specifies that a care manager should have "a graduate degree in the field of human services or a substantial equivalent,” and be certified or licensed at the independent practice level of his or her state.”

Centers for Medicare and Medicaid Services (CMS)
The federal agency that runs the Medicare, Medicaid, and Children's Health Insurance Program.

Certified Elder Law Attorney (CELA)
See Elder Law Attorney

Certified Nursing Assistant (CNA)
Typically found in home care environments.

Certified Senior Advisors (CSAs)
Financial-oriented advisors relating specifically to senior issues, typically in the areas of insurance, financial concerns, real estate, etc.  Certification comes from additional training focusing on issues from the senior perspective.

Charge Nurse
An RN (Registered Nurse) or LPN (Licensed Practical Nurse) responsible for the supervision of a unit within a nursing facility.

Chore/Housekeeping Services
Services include yard and house maintenance, home and appliance repair, housekeeping, meal preparation, shopping and transportation. No personal care is provided; not covered by Medicare.

Community Spouse's Resource Allowance (CSRA)
An amount of resources that states must protect for the spouse of an institutionalized person seeking Medicaid coverage. 

Congregate Food Programs
See Nutrition Services

Congregate Housing
Similar to independent living, congregate housing usually provides convenience or supportive services such as meals, housekeeping, and transportation.

Conservator
Person appointed by the court to act as the legal representative of a person who is mentally or physically incapable of managing his or her own affairs.

Consumer Services
Programs that provide for the education and protection of individuals who purchase, use, maintain and dispose of products and services.

Continence
The ability to control bladder and bowel functions.

Continuum of Care
Services available to assist individuals throughout the course of a disease.

Continuing Care Retirement Communities (CCRCs)
Housing communities that provide different levels of care based on the needs of the residents, from independent living to skilled nursing care. Residents can move to different facilities based upon health and needs. May require a large payment prior to admission and also charge monthly fees.

Convalescent Home
See Nursing Home.

Co-payment
The portion of a medical expense that is the member's financial responsibility; HMOs generally have fixed low co-payments of about $5-$10.

Crisis Response Systems
See Emergency Response Systems

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Deductible
The amount an insurance policyholder must pay toward covered services before insurance payments begin. HMO’s do not usually require deductibles.

Dementia
The loss of intellectual functions such as thinking, remembering and reasoning to the extent that a person’s daily functioning is affected. A group of symptoms, rather than a separate disease, often found in persons suffering from Alzheimer’s Disease, Multi-infarct Dementia, Huntington’s Disease, Pick’s Disease, Creutzfeldt-Jakob Disease, and Parkinson’s Disease.

Dementia Facilities
Facilities which house seniors with varying degrees of memory loss from memory impairment diseases such as Alzheimer’s, typically provide room and board, social activity, ongoing supervision.  Focus on retaining memory through regular stimulation activities is a standard.

Depression
A psychiatric disorder, symptoms include sadness, inactivity, feelings of hopelessness, and sometimes suicidal tendencies. When dementia and depression are present together, intellectual deterioration may be exaggerated.

Delirium
A state of temporary, acute mental confusion that comes on suddenly; symptoms include anxiety, disorientation, tremors and hallucinations. It can occur in persons suffering from short-term illnesses. Alcohol or drugs (including prescribed medications) also may cause confusion.  Delirium may be life-threatening and requires immediate medical attention.

Developmental Disability
A chronic physical and mental disability such as cerebral palsy, retardation, seizures, and quadriplegia.

Director of Nursing (DON)
Oversees the nursing staff in a nursing home; responsible for formulating nursing policies and monitoring quality of care.

Discharge Planning
Usually performed by a social worker, for the patient who is about to be discharged from a hospital or nursing home, to facilitate a smooth transition from one level of care to another.

Durable Medical Equipment (DME)
Reusable medical equipment for home use such as walkers, wheelchairs, or hospital beds.

Durable Power of Attorney
See Power of Attorney.

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Elder Abuse and Neglect Programs
Programs designed to assist and protect older persons who are either institutionalized or reside in the community and who might be subjected to or vulnerable to abuse and neglect.  Often run by state initiatives and support.

Elder hostels
Educational and travel programs designed for active seniors.

Elder Law Attorney
Any attorney who practices in the areas of law of particular interest to older adults.  Sometimes referred to as a CELA (Certified Elder Law Attorney).

Emergency Response Systems
A system which allows for 24-hour monitoring and response to medical or other emergencies, often also referred to as Crisis Response Systems, Reassurance Assistance, and Telephone Reassurance.

Employee Assistance Programs (EAP)
Programs offered by some employers as non-financial benefit, usually includes counseling services, and referrals to service providers.

Enrollment Area
The particular geographic area of plan coverage specified by an HMO.

Employment Services
Programs specifically designed to assist older adults in find employment opportunities.

Enteral Feeding
The delivery of liquid feedings through a tube.

Environmental Accessibility
A space designed to provide the greatest amount of use by a person with a disability.

Estate Planning
Plans made to determine what happens to your property upon your death.

Estate Recovery
Because Medicaid imposes stringent limits on the income and assets of recipients, Federal law mandates that states attempt recovery of expenses paid on behalf of those recipients from their estates under certain circumstances.

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Federally Qualified HMO
An HMO that has met certain standards established by the federal government regarding quality of care, financial soundness, member services, etc.

Fee-for-service
Method of payment under which providers are paid for each service performed.

Financial Counseling Programs
Aids seniors in managing their finances, bills, and completing Medicaid, Medicare or insurance forms.  Sometimes provided at Senior Centers.  State services typically provide some level of support.  Available through financial professionals, typically for a fee.  Some Professional Organizers will provide bill paying, bill management and insurance form completion services, typically for a fee.

Fronto-Temporal Dementia (FTD)
Rare form of dementia, affecting the parts of the brain responsible for language, behavioral skills and emotional responses. (Includes Pick’s disease.)

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Gatekeeper
An HMO primary care physician or nurse practitioner who is responsible for referring member patients to specialists or other services.

Geriatric Assessment
An evaluation of the functioning of an elderly person; can include both physical and cognitive needs.

Geriatric Care Managers
See Case Manager

Group Homes
See Board and Care Homes

Group Practice HMO
An HMO that contracts with medical groups to provide healthcare to its members.

Guardianship
See Adult Guardian.

Guardian of the Estate
See Adult Guardian

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Health Care Power of Attorney
See Advanced Directives.

Health Care Transitional Facility
A program designed to provide a broad range of health care outside of a hospital setting, including rehabilitation centers, nursing homes or other settings.

Health Center
Facilities that provide a wide range of outpatient health care, such as immunizations, laboratory and radiology services and diagnostic and exam services. Often targeted to low-income clients, with payment based upon income.

Health Supportive Products
Equipment, supplies or products for the treatment of illness, disabilities or injuries, i.e.: wheelchairs, walkers, potty chairs, etc.  (Also see Durable Medical Equipment, DME)

HIPAA (The Health Insurance Portability and Accountability Act of 1996)
States the requirements 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.

HMO (Health Maintenance Organization)
A health plan that both pays for and provides, or arranges to provide, access to comprehensive medical services. HMOs are reimbursed for services on a fixed monthly basis.

Home and Community Care
A variety of services that assist ill or disabled people to remain in their own home as long as possible; some examples include Meals on Wheels, visitation programs, shopper services or adult day care, and respite care. Medicare, private insurance or Medicaid may pay some home care costs.

Home Care Services
Light housekeeping and personal care provided at home.  Typically, non-medical services, in nature (unless appropriate professionals are hired for medical support activities).

Homebound
A person who is unable to leave home or cannot leave home without considerable assistance.

Home Health Agency
An agency which provides home care services such as skilled nursing care, physical therapy, occupational therapy, speech therapy, and care by home health aides.

Home Health Aide
Provides support services such as personal care which do not require a licensed nurse. Medicare does not cover home health aides unless the person is also receiving skilled nursing care or other therapy.

Home Modification Services
See Environmental Accessibility

Hospice
Medical and social programs for terminally ill patients and families provided either at home or in a facility.

Hospitalist
A physician who is responsible for coordinating all diagnostic treatments and processes during a patient’s hospital stay and report on an inpatient’s conditions to his or her primary care physician.

Hospitals
A facility which provides medical care and treatment for illnesses, disabilities or injuries.

Housing
See Senior Housing

Huntington’s Disease
An inherited, degenerative brain disease which affects the mind and body, it generally begins in midlife. Symptoms include personality change, memory problems, and psychiatric problems.

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Incapacity
Can be mental or physical, temporary or permanent; a person can be incapacitated without being incompetent.

Income Cap States
States that do not have a medically-needy program serving nursing home residents. In states with income caps, individuals are not allowed to spend down to the Social Security income level to become eligible for Medicaid-covered nursing home care. Income cap states include Alabama, Alaska, Colorado, Delaware, Idaho, Mississippi, Nevada, New Mexico, Ohio, South Dakota and Wyoming.

Income Security Program
A program which aids eligible seniors with public assistance or helps to ensure that seniors receive Social Security, Medicare or other benefits.

Incompetence
A legal declaration that the person is incapable of handling assets and exercising certain legal rights.

Incontinence
The lack of ability to control bladder or bowel function.

Independent Living Facility
Affords elders the opportunity for independent living and social activities without the burden of home ownership.  Typically, residency is established on a monthly rental basis.  Often provides some degree of emergency response and medical aid in case of need.

Independent Practice Association (IPA)
HMOs that contract with individual physicians in private practice who provide care to HMO members within a private office setting.

Infusion Therapy
The intravenous (IV) administration of medications, fluid replacements, nutrition, chemotherapy, etc.

Intermittent Care
Skilled nursing and home health aide services furnished up to 28 hours per week for any number of days per week so long as they are less than 8 hours per day.

Instrumental Activities of Daily Living (IADLs)
Secondary level of activities (different from ADLs, such as eating, dressing, and bathing) such as cooking, writing, and driving.

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Legal Guardianship
See Adult Guardian

Legal Services
Programs that provide qualified legal advice to seniors or their caretakers or guardians.

Licensed Practical Nurse (LPN)
A person trained to administer technical nursing procedures and provide a range of health care services, such as administration of medication and changing of dressings.

Living Will
A document that makes known a person’s wishes regarding medical treatment at the end of life.

Long-Term Care Facilities
Facilities which provide nursing care to people who are unable to care for themselves, also used for short-term rehabilitation after hospitalization.

Long-Term Care Insurance
Private insurance designed to cover the costs of long-term care.

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Managed Care
A method of delivering and paying for health care through a system of networks of providers, such as HMO’s, preferred provider networks, and similar plans. Managed care seeks to ensure the quality and contain the cost of comprehensive medical care.

Medicaid
A joint Federally-funded and State-administered program that helps with medical costs for some people with low incomes. Programs vary from state to state.

Medicaid Waiver
Services provided in the home or community aimed at seniors who are at risk of institutionalization or seniors who are institutionalized who need help in returning to the community. Some of these services are reimbursable by Medicaid.

Medical Director
Coordinates with the patient’s personal physician to ensure that the facility delivers the prescribed care.

Medical Power of Attorney
See Power of Attorney

Medical Social Services
Assistance with social and emotional concerns one may have related to one's illness.

Medically Necessary
Services or supplies that are proper and needed for the diagnosis or treatment of a medical condition.  They must meet the standards of good medical practice in the local medical community, rather than for the convenience of the beneficiary or the doctor.

Medicare
A Federal program which provides health care coverage for people over 65 years old, certain younger people with disabilities, and people with End-Stage Renal Disease. Part A covers inpatient care, skilled nursing facility, hospice and short-term health care. Part B covers doctor services, outpatient hospital care, and durable medical equipment.

Medicare Supplemental Insurance
Private insurance (often called Medigap) that pays Medicare's deductibles and co-insurances. May also cover services not covered by Medicare.

Medications Management/Administration
Formalized procedure with a written set of rules for the management of self-administered medicine.

Medigap Policies
See Medicare Supplemental Insurance.

Mental Health Programs
Provides preventive, diagnostic and treatment services to assist people with emotional health issues.

Multi-Infarct Dementia
Also known as vascular dementia, it is a deterioration of mental capabilities caused by multiple strokes (infarcts) of the brain.

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Naturally Occurring Retirement Communities (NORCs)
Communities that age in place over time, with a great percentage of current residents that are considered senior, who wish to remain in their homes as they continue to age while retaining their social, healthcare, community networks.  Residents often pool resources and efforts together, form associations, etc. to help each other continue to have access to ongoing services for everyday life at their disposal.

Network
The doctors, clinics, health centers, medical group practices, hospitals, and other providers that an HMO or other managed care plan employs or contracts with to care for its members.

Non-Ambulatory
Inability to walk independently, usually bedridden or hospitalized.

Non-Medical Senior Housing
See Assisted Living Facility, Senior Housing

Nurse Assistant
A person who works under the supervision of a Registered Nurse or Licensed Practical Nurse to provide the most personal care to residents, including bathing, dressing, and toileting.

Nursing Home
A residence that provides room, meals, recreational activities, help with daily living and protective supervision to residents with physical or mental impairments; certified to provide different levels of care, from custodial to skilled nursing.  Also referred to as Convalescent Home.

Nutrition Services
Programs aimed at assisting seniors or the disabled to meet nutritional needs, including free or low-cost food, meals delivered to the home (example “Meals of Wheels”), congregate group meals (often provided at Senior Centers) and food stamp coupons.

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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 Therapy
Helps a person to perform daily activities independently.

Ombudsman
Ombudsmen visit nursing homes regularly and are a source of information on local long-term care. Ombudsmen can be resident advocates, investigate complaints, or mediate disputes.

Opt-out
An option available in some types of managed care networks, such as point-of-service plans, in which members can seek treatment from providers outside the network and pay more to do so.

Out-of-Pocket Costs
Costs for medical services not covered by an insurer or an HMO.

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Paraprofessional
A trained aide who assists a professional person.

Parkinson’s Disease
A progressive disorder of the central nervous system. Symptoms include tremors, stiffness in limbs and joints, speech impediments, and difficulty in initiating physical movement.

Personal Support Services
See Home Care Services

Physical Therapy
The treatment of disease or injury, by physical and mechanical means. Physical therapists plan and administer prescribed physical therapy treatment programs to help restore function and strength.

Plenary Guardian
See Adult Guardian.

Pourover Will
The person writing the will (the testator) provides that designated assets will be paid to a previously established trust.

Power of Attorney
A (general) power of attorney is a written agreement between two people where the principal designates the agent to act on his behalf (represent them) for and in whatever situations the agreement specifies.  A Durable Power of Attorney is a similar agreement but represents medical situations specifically where the principal becomes disabled in such a manner that they are unable to communicate and the agent steps in to act on the principal’s behalf.  (Durable Power of Attorney is sometimes also referred to as Medical Power of Attorney.)

Prescription Programs
Programs that assist individuals in obtaining prescriptions at reduced or no cost. Participation is based on need.

Professional Organizer
Individual focused on removing clutter and disorganization from environments while eliminating stress and introducing organization and process.  Often involved with helping the elderly and their families deal with a senior’s bill paying, bill management, estate physical down-sizing and clean-up activities.

Program for All-Inclusive Care for the Elderly (PACE)
A program designed to assist elderly persons who are living at home but are eligible for nursing home care. Utilizes services at adult day care along with case management providers. Participants must regularly attend adult day care.

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Quality care
Care and services that allow recipients to attain and maintain their highest level of mental, physical, and psychological function.

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Reassurance Assistance
See Emergency Response Systems.

Registered Nurse (RN)
A nurse who has received a minimum of two years of college training, passed a state board examination and is licensed by a state agency to practice nursing.

Rehabilitation
Therapeutic care for persons requiring intensive physical, occupational, or speech therapy in order to restore to the patient to a former capacity.

Remainderman
A person or other entity designated in a trust as the beneficiary entitled to the principal of the trust after the income-paying stage comes to an end.

Representative Payee
A representative who acts as a surrogate on behalf of an individual who is not capable of making cognitive decisions. Handles the individual’s cash benefit checks such as Social Security or Supplemental Security Income. A representative payee can be a public agency, nonprofit organization, bank or an individual.

Residential Healthcare Facilities
See Board and Care Homes

Respiratory Therapy
Respiratory therapy consists of exercises and/or treatments that are designed to help patients regain lung function.

Respite Care
Provides caregivers with temporary relief from tasks associated with care giving. Can include overnight care.

Reverse Mortgage
Allows senior citizens to obtain a loan based on the equity in their home. Under most of these mortgages the loan, interest and other costs do not have to be paid back until the owner vacates the property through a move or death.

Roth IRA
A nondeductible individual retirement account, similar, yet with several significant differences, to the traditional IRA. These include eligibility and distribution differences.

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Security Assistance Programs
See Emergency Response Systems

Senior Apartment
Age-restricted, multi-unit housing for older adults who are able to care for themselves. Usually no additional services such as meals or transportation are provided.  Often referred to as low-income, affordable or subsidized housing.

Senior Centers
Geographically-based local centers for senior individuals focused on providing social activity and informational support for local seniors.  Often provide some level of congregate meal programs.

Senior Citizen Policies
Insurance policies for those over the age of 65, often combined with coverage provided by the government under the Medicare Program.

Senior Housing
This term spans numerous options for seniors, typically dependent on an elder’s physical level of activity, level of mobility, state of mind, etc.  Most commonly referred to options (listed with generally increasing levels of dependence) are:  Retirement Communities (55+, Active Adult), Independent Living Facilities, Assisted Living, Alternate Family Care, Dementia Facilities, Nursing Homes and Hospice.  Various types of temporary senior housing (example, Adult Day Care and Rehab Centers) offer alternative solutions to specific situations and needs.

Skilled Nursing Care
A level of care which must be furnished under direct supervision of licensed nursing personnel and the general direction of a physician. Includes the assessment, observation and management of a treatment plan as well as direct services to a patient. 

Skilled Nursing Facility/SNF
A facility which provides intensive nursing and rehabilitative care to patients.

Special Needs Trust
See Supplemental Needs Trust

Speech Therapy
The treatment of speech or communication disorders. Physical exercises designed to improve muscle strength and speech practice to improve clarity are two examples of speech therapy techniques.

Supplemental Needs Trust
Also known as a Special Needs Trust, this is an irrevocable trust created for a disabled beneficiary and intended to supplement government benefits. The beneficiary cannot control trust distributions.

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.

Supportive Services
Programs that are designed to enable seniors or the disabled to socialize and reduce personal isolation.

Sub acute Care
Care that is necessary due to a condition or illness that is not severe enough to be acute and is not chronic.

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Telephone Reassurance
See Emergency Response Systems

Terminally ill
An illness, disease or injury where recovery is no longer reasonably expected.

Testator
The person who creates a will.

Transportation Assistance
Programs that assist seniors or the disabled with transportation needs.

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Universal Design
Design that makes products or buildings usable by people with disabilities to the greatest possible extent.

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Visitability
A minimum level of access needed to allow a person in a wheelchair access to the first floor of a home.

Volunteer Services
Volunteer opportunities specifically aimed at older adults, such as Foster Grandparents; may include a small stipend for volunteers who meet financial or other criteria.

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Wellness Programs
Programs designed to educate people on healthy lifestyles and habits.  Most commonly administered and presented by professionals such as chiropractors, holistic therapists, massage therapists, etc.

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