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Glossary for Aging-Related Terms

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A

Accelerated Death Benefit
A feature of a life insurance policy that lets you use some of the policy's death benefit prior to death.

Activities of Daily Living (ADLs)
Describes daily activities including dressing, bathing, eating, toileting, transferring out of a bed or chair, and walking. Inability to perform one or more ADLs is often used as eligibility criteria for long term care services.

Adult Day Care
Community-based group programs designed to meet the needs of functionally and/or cognitively impaired adults. Adult day centers provide a caring, home-like setting for individuals who, for their own safety and well-being, can no longer be left at home alone. Adult day centers offer protected settings which are normally open five days a week during business hours and include a mixture of health, social and support services. Specialized programs for individuals with Alzheimer's disease or related disorders also exist.

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/or other professionals for adults who are experiencing a decrease in physical, mental, and social functioning and require tailored medical and/or psychiatric supervision. Such centers normally offer a wide range of therapeutic and rehabilitative activities as well as social activities, meals, and transportation.

Adult Protective Services
Adult Protective Services (APS) strive to insure the safety and well-being of elders and adults with disabilities who are in danger of being mistreated or neglected, are unable to take care of themselves or protect themselves from harm, and have no one to assist them. In most states, APS caseworkers are the first responders to reports of abuse, neglect, and exploitation of vulnerable adults. Most APS programs serve both older and younger vulnerable adults. In some states, APS is responsible only for cases involving older adults (eligibility may be based on age, incapacity or vulnerability of the adult). A few APS programs serve only younger adults ages 18-59.

Advance Directive
A document that becomes effective when someone is terminal and death is imminent, or is in a persistent vegetative state. It states what "life sustaining" procedures are to be withheld or withdrawn.

Alzheimer's Disease
A progressive neurological disease that affects brain functions, including short-term memory loss, inability to reason, and the deterioration of language and the ability to care for oneself. An estimated 3% of people between the ages of 65 and 74 have Alzheimer's, rising to about half those age 85 and over. Currently, Alzheimer's disease is incurable.

Assisted Living Facilities (ALF)
A residential apartment complex which caters to older adults by providing built-in care services and 24-hour on-call assistance. These residential settings maximize independence, but do not provide skilled nursing care. Most ALFs do not accept public financing and rely on private pay from residents or their families.

Assistive Equipment
This term refers to a range of products and technology designed to help elders or people with disabilities lead more independent lives. Examples include special telephones for people with hearing impairments, walking aids, elevated toilet seats, communication devices, etc.

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B

Bed reservation/Bed Hold
If someone resides in a nursing home, assisted living facility, or hospice facility, and leaves that facility, the Federal Program will pay for actual charges to hold a space to enable that person to return to that facility. Benefits for bed reservations are limited to 30 days per calendar year.

Beneficiary
The individual or organization who is entitled to the benefits or proceeds of a will, trust or insurance policy.

Board and Care Home
A small to medium-sized group residence that provides residents with a private or shared room, meals, and includes some assistance with activities of daily living, but not skilled nursing.

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C

Care Management Services
A service in which a professional, typically a nurse or social worker, assists in planning, arranging, monitoring, or coordinating long term care services.

Care Manager
A professional who finds and coordinates appropriate social and medical services for elders or persons with a disability and their families. Sometimes referred to as a "case manager." See Provider

Caregiver
Individuals (typically family members or friends) who provide unpaid assistance to see that the physical, psychological, and/or social needs of another person are met.

Catheter
A medical devise used to control urinary incontinence using a receptacle bag.

Center for Medicare and Medicaid Services (CMS)
The Centers for Medicare and Medicaid Services (CMS) administers the Medicare program and works in partnership with the States to administer Medicaid, the state Children's Health Insurance program (SCHIP), and health Insurance portability standards.

Certified Nursing Assistant (C.N.A)
Nursing Assistants help nurses in nearly every aspect of nursing care in hospitals, clinics, home health, assisted living, private homes, and doctor's offices. In hospitals, Nursing Assistants also provide daily care to patients, such as helping with meals, baths, exercises, and treatments. Nursing Assistants are responsible for recording vital signs (pulse, respiration, blood pressure, and temperature), recording fluid intake and outputs, weights, and recording other observations. They must be familiar with normal values for vital sign measurements and observations and report normal and abnormal findings to a Registered Nurse or Licensed Practical Nurse.

Chaplain
A member of the clergy who conducts religious services for an institution.

Chronic Care
Ongoing provision of medical, health, social, psychological, and spiritual care services that enable persons with serious and persistent conditions to optimize their functional independence and well-being. A disease or condition is one that lasts over a long period of time and typically cannot be cured, often associated with disability.

Codicil
An amendment to a will made in writing and attached to the original document.

Cognitive Impairment
A deficiency in a person's short or long term memory, orientation as to person, place and time, deductive or abstract reasoning, or judgment. Typically related to an illness or injury (e.g., Alzheimer's disease, stroke or traumatic brain injury).

Community Based Services
Services designed to help older and functionally impaired people stay independent and remain in their own homes (e.g., adult day care, senior centers, day respite programs).

Community Support Facility
Refers to residential care facilities (rest homes) licensed to provide care to individuals with mental health problems

Companionship Services
Companions visit isolated and homebound elders for conversation, reading, and light errands. May also be termed "friendly visitor" services.

Continence
An activity of daily living - The ability to maintain control of bowel and bladder function. Or, when unable to maintain control these functions, the ability to perform associated personal hygiene (including caring for catheter or colostomy bag).

Continuing Care Retirement Community
Typically refers to a residential campus that provides a continuum of care -- from private apartments to assisted living to skilled nursing care -- all in one location. The primary advantage of this model is that an individual or couple does not need to relocate if health care needs change over time.

Cueing
Directing or supervising the actions of a person with a cognitive impairment (e.g., showing the person how to eat, giving visual or verbal reminders for dressing or toileting).

Culture Change
Culture change in long term care is an ongoing transformation based on person-directed values that restores control to elders and those who work closest with them. This transformation includes changing core values, choices about the organization of time and space, relationships, language, rules, objects used in every day life, rituals, contact with nature, and resource allocation.

Custodial Care
Assistance with activities of daily living and related non-medical care. Medicare specifically prohibits reimbursement for custodial care services in-home or in a nursing home

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D

Dementia
The medical term for a group of symptoms that describes a loss of intellectual ability, including loss of mental processes (e.g., vocabulary, abstract thinking, judgment, memory loss, physical coordination) that interfere with daily activities. The symptoms can be brought on by degenerative diseases (e.g., Alzheimer's, Huntington's and Parkinson's diseases), vascular diseases or stroke, metabolic disorders (thyroid, liver kidney dysfunction or certain vitamin deficiencies), AIDS, drugs and alcohol, or psychiatric disorders. Some dementing disorders may respond to treatments, others do not.

Depression
A reversible psychiatric disorder characterized by an inability to concentrate, difficulty sleeping, feelings of hopelessness, fatigue, the "blues," and guilt.

Diabetes
A disorder in which the body cannot convert foods properly into the energy needed for daily activities. Diabetes tends to get passed on genetically but factors other than heredity are responsible as well. There are two main types of diabetes. Type I, or insulin-dependent, is the more severe for of the disease. Type II, or adult onset, is the more common form and accounts for more than 85% of all cases. Diabetes cannot be cured, but it can be controlled. Control requires carefully regulating one's diet, regular exercise, and, if necessary, insulin.

Director of Nursing (DON)
Provides the administration and supervision of nursing and related medical services

Discharge Planner
A nurse or social worker who assists patients and families in transitioning from the hospital to another setting. Services may include assistance in locating home care services, rehabilitation, or nursing home care. The third activity of daily living - Putting on and taking off all items of clothing and any necessary braces, fasteners or artificial limbs

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E

Elder Abuse
Legal definitions of elder abuse vary from state to state, however, most often it is defined as when a person 60 years of age or older or who is suffering from the infirmities of aging has been subjected to Physical Abuse; Material Abuse; Neglect or Self-neglect. Emotional Abuse is also sometimes considered a category of elder abuse.

Elder Law
Laws regarding the rights of elderly people

Eldercare Locator (800-677-1116)
is a nationwide, directory assistance service designed to help older persons and caregivers locate local support resources for aging Americans. Eldercare Locator is a public service of the Administration on Aging, U.S. Department of Health and Human Services and is administered by the National Association of Area Agencies on Aging and the National Association of State Units on Aging.

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F

Formal care
Care which is provided by a home health aide or homemaker arranged or supervised by a home care agency, or provided by a nurse or therapist

Friendly Visitor
Community-based or volunteer services that offer home visits by non-skilled people for home-bound elders or people with disabilities.

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G

Geriatric Assessment Team
A multidisciplinary team of health care professionals, usually led by a geriatrician, that provide coordinated diagnostic services to older adults.

Geriatric Care Manager
A professional, usually a social worker or nurse with experience in geriatric care, who performs an individual assessment, establishes a care plan and oversees an elder's care.

Geriatrician
A physician who specializes in the care of the elderly, primarily those who are frail and have complex medical and social problems.

Gerontology
The study of older people and the aging process

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H

Health Insurance Portability and Accountability Act (HIPAA)
Federal health insurance legislation passed in 1996 that allows, under specified conditions, long term care insurance policies to be qualified for certain tax benefits.

Health-Care Provider
A person trained and licensed to give health care. A health-care provider is also a place licensed to provide health care. Examples include doctors, nurses, and nursing homes

Home Care
Provides a range of supportive services in the home from intensive medical support to assistance with activities of daily living to housekeeping. This type of care can include nurses, social workers, occupational therapists, physical therapists, and other rehabilitation services.

Home Health Aides
Individuals who provide care to older adults or people with disabilities at home. Training or certification may vary for home health aides, but typical services include assistance with activities of daily living, managing medications and some household tasks.

Homebound
When a person is generally unable to leave home independently, due to health problems.

Homemaker Services
Services delivered at home which do not include hands-on care including shopping, laundry, light cleaning, meal preparation, and transportation assistance. Also referred to as home chore services.

Homeshare
A cost-effective living arrangement in which a group of older adults share a house or apartment. Sometimes this is done with a person who functions as a light caregiver and who may also make some of the meals.

Homeshare
A cost-effective living arrangement in which a group of older adults share a house or apartment. Sometimes this is done with a person who functions as a light caregiver and who may also make some of the meals.

Hospice
A place where the terminally ill are cared for.

Hospice Care
Services and care at home (or in a health facility) for terminally ill individuals and their families. Hospice care primarily manages pain and discomfort. People cannot enter Hospice care until their projected final 6 months of life.

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I

Incontinence
The inability of the body to control urination or bowel movements or both.

Independent Living Centers
Community-based resource centers for individuals with disabilities of all types. Centers across the U.S. offer information about public benefits and local resources, support, and advocacy with the goal of maximizing the ability of disabled persons to live independently.

Independent Practice Association
An independent group of physicians who contract with a health maintenance organization to provide services for their members.

Independent Provider
A home care worker who is hired privately, outside of a home care agency.

Informal care
Care provided by an unlicensed caregiver whose services are not arranged and supervised by a home care agency.

Instrumental Activities of Daily Living (IADLs)
A measure of independent functioning often used at assessment. IADLs include ability to shop, prepare meals, manage money, and perform housekeeping duties.

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L

Living Will
A legal document that voices your medical decisions if you are unable to speak for yourself as a result of medical incapacitation.

Long Term Care Ombudsman Programs
Federally-funded services in all 50 states charged with investigating and resolving complaints made by or on behalf of residents of nursing homes, board and care homes, and other residential care facilities. The program promotes policies and practices aimed at improving the quality of life, health, safety, and rights of these residents.

Long-Term Care (LTC)
Includes a wide range of services at home, in the community and in residential care facilities, including nursing homes. Long term care includes health and social services, rehabilitative, therapeutic, skilled nursing, and other supportive, palliative care or supervision provided over an extended period of time.

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M

Meals on Wheels
A nationwide program of home-delivery of hot lunches. Usually operates Monday through Friday.

Medicaid
A joint federal-state program which covers health services for low-income individuals and families. Coverage and eligibility requirements vary from state to state. Medicaid is the primary payer of nursing home care. In addition, many states offer some level of home and community-based long-term care services for eligible individuals. Such additional services are at the option of the state and are not mandated by Federal law.

Medical Model of Care (see also Traditional Nursing Home)
The medical model of care focuses on the eradication of illness through diagnosis and effective treatment.

Medicare
The federal health insurance program for: people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD). Medicare coverage provides for acute hospital care, physician services, brief stays in skilled nursing facilities, and short-term skilled home care related to a medical problem. Medicare coverage is determined by the nature of services required by the patient, not the specific diagnosis. Coverage is restricted to medical care, and does not include prescription drugs or custodial care at home or in nursing homes.

Minimum Data Set (MDS):
A uniform set of elements extracted from the Resident Assessment Instrument (RAI) which is a standardized tool for assessing the functional capacity of residents of long term care facilities. On December 23, 1997, the Centers for Medicare and Medicaid Services (CMS) published the fine rule, which established the guidelines for the use of the data set and specified the data elements included in the assessment instrument. Long term care facilities are required to complete and transmit MDS data to the designated state agency for all residents as a condition of participation in the Medicare and Medicaid programs.

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N

Nurse
A person trained to take care of the sick, injured, or disabled under the supervision of a doctor

Nursing Home
A generic term for a Skilled Nursing Facility (SNF).

Nutrition or Congregate Meal Programs
Nutritional programs that provide lunches for older adults Monday through Friday in central locations such as senior centers, community centers, or schools.

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O

OBRA '87 Nursing Home Reform Act
The Federal Nursing Home Reform Act or OBRA `87 created a set of national minimum set of standards of care and rights for people living in certified nursing Some of the most important resident provisions include:

Occupational Therapist
A rehabilitation professional who assists individuals to compensate for functional limitations as a result of an injury, illness or disability by learning skills and techniques needed to perform activities of daily living and optimize independence.

Older Americans Act (OAA)
Federal legislation dating back to the 1965 that established the federal Administration on Aging, funds certain aging-related services administered by state-level departments on aging and helped create a nationwide network of community-based support services for older adults. The OAA established the Area Agencies on Aging and has provisions covering senior nutrition, housing, in-home care and other services. The OAA must go through Congressional budget reauthorization to ensure funding for new and existing programs.

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P

Palliative Care
Any form of medical care or treatment that concentrates on reducing the severity of the symptoms of a disease or slows its progress rather than providing a cure. It aims at improving quality of life, and particularly at reducing or eliminating pain.

Paratransit Services
Provide specialized transportation (e.g., wheel chair accessible van or mini-bus) for seniors and/or people with disabilities. Services may offer transportation to senior centers, medical care, shopping malls, or specific appointments.

Parkinson's Disease
Parkinson disease is a brain disorder. It occurs when certain nerve cells (neurons) in a part of the brain called the substantia nigra die or become impaired. Normally, these cells produce a vital chemical known as dopamine. Dopamine allows smooth, coordinated function of the body's muscles and movement. When approximately 80% of the dopamine-producing cells are damaged, the symptoms of Parkinson disease appear

Pastoral care
Pastoral care is the ministry of care and counseling provided by pastors, chaplains and other religious leaders to members of their group (church, congregation, etc). This can range from home visitation, to formal counseling by pastors who are licensed to provide pastoral counseling.

Person centered care or Person-first
Honoring the person before the task. These practices provide the basis for: creating a daily life worth living; striving to nurture the mind as well as the spirit; and promoting growth and development for all.

Personal Emergency Response System (PERS)
An electronic device that enables the user to contact help in case of a fall or other medical emergency. A number of private companies offer PERS systems which link the user with designated contact persons and local emergency services on a 24-hour basis.

Personal care
Care to help an individual meet personal needs such as bathing, dressing and eating.

Physical Therapist
A rehabilitation professional who utilizes various therapies to assist individuals in maximizing mobility, and restoring strength and body movement following an illness, injury (e.g., stroke, fall, back injury, etc).

Power of Attorney for Health Care
A document allowing others to make health care decisions when one is not able to. Authorized by state law, this document allows you to designate another person (known as your attorney-in-fact) to have powers, which you specify in the document. It can be limited to health care decisions, or for general financial management, health and medical care, emergencies, etc.

Pre-Existing Condition
An illness or disability for which one was treated or advised within a certain time period (typically 6-12 months) before applying for a new insurance policy. A pre-existing condition clause would prohibit coverage of the particular condition during the designated time period.

Pre-Existing Condition
An illness or disability for which one was treated or advised within a certain time period (typically 6-12 months) before applying for a new insurance policy. A pre-existing condition clause would prohibit coverage of the particular condition during the designated time period.

Primary Care Physician
Under a health maintenance organization or point-of-service plan, a primary care physician is the first contact for health care. A primary care physician (usually a general practitioner) is often used as a "gate keeper" to make referrals to health care specialists, as necessary.

Primary Caregiver
The person (usually the spouse or adult child) that takes on the main or day-to-day responsibility of caring for the physical, psychological, and/or social needs of another person.

Provider
Any health care professional (e.g., doctor, nurse or home care worker) or institution (hospital, clinic, or nursing home) that provides health care or related social services.

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R

Registered Nurse (RN)
A nurse who has completed a two- to four-year degree program in nursing, and provides direct patient care for acutely or chronically ill patients. RNs may further specialize in a particular area. For example, psychiatric nurses are RNs.

Residential Care Facility
A generic term for a group home, specialized apartment complex or other institution which 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.

Respite Care
Temporary or intermittent care for individuals with disabilities, illnesses, dementia or other health concerns to give relief to caregivers from the demands of ongoing care. Respite care can be provided at home, in the community (e.g., adult day care centers or special respite programs) or overnight in a facility

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Sandwich Generation
Refers to those individuals caring for both their children and their parents simultaneously.

Senior Center
Community-based programs that provide a variety of services, including social activities, nutrition, and educational and recreational opportunities for older adults.

Skilled Nursing Care
Health-care services given by or under the supervision of licensed nurses and also under the general direction of a doctor.

Skilled Nursing Facility (SNF)
A residential care setting offering a protective, therapeutic environment for individuals who require rehabilitative care or can no longer live independently because of chronic physical or mental condition requiring round-the-clock skilled nursing care. SNFs must be licensed by the state and are subject to certain state and federal regulations.

Social Adult Day Care
A category of adult day care which focuses on socialization and therapeutic recreation. There is typically no health monitoring or nursing oversight.

Social Model of Care
The social model of health places emphasis on changes that can be made in society and in people's own lifestyles to make the population healthier. It defines illness from the point of view of the individual's functioning within their society rather than by monitoring for changes in biological or physiological signs.

Social Work
Organized work intended to advance the social conditions of a community, and especially of the disadvantaged, by providing psychological counseling, guidance, and assistance, especially in the form of social services.

Social Worker
Someone employed to provide social services (especially to the disadvantaged)

Speech Therapist
Rehabilitation professionals who provide therapy to overcome speech and communication problems, such as speech difficulties following a stroke. Speech therapists may also provide assistance for managing swallowing problems.

Sub-Acute Care
Specifies a level of maintenance care where there is no urgent or life-threatening condition which requires medical treatment. 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.

Substantial Assistance
This describes a situation where hands-on, stand-by help is required to perform activities of daily living.

Substantial Supervision
The presence of a person directing and watching over another who has a cognitive impairment.

Support Group
A gathering of people with a common experience (e.g., a disease, disorder, caregiving, etc.) where one can share one's thoughts, feelings and concerns and receive information and support from other group members. Groups may or may not be facilitated by an expert. Many support groups are now available on-line via the Internet.

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T

Telephone Reassurance
Friendly calls provided by agencies or volunteers that offer reassurance, contact, and socialization to an elderly person at a predetermined time each day.

TimeSlips
TimeSlips is a storytelling method that frees people with dementia from the anxiety over memory by encouraging them to use their imaginations. Anne Basting, director of UWM's Center on Age & Community, developed TimeSlips with the aim of improving the quality of life of people with dementia. Hundreds of poetic stories have emerged from the storytelling workshops thus far, and studies suggest it significantly improves communication among people with dementia.

Title 19 or Medicaid Services
Medicaid is a program that pays for medical assistance for certain individuals and families with low incomes and resources. This program became law in 1965 and is jointly funded by the Federal and State governments (including the District of Columbia and the Territories) to assist States in providing medical long-term care assistance to people who meet certain eligibility criteria. Medicaid is the largest source of funding for medical and health-related services for people with limited income. Medicaid is a program that pays for medical assistance for certain individuals and families with low incomes and resources. This program became law in 1965 and is jointly funded by the Federal and State governments (including the District of Columbia and the Territories) to assist States in providing medical long-term care assistance to people who meet certain eligibility criteria. Medicaid is the largest source of funding for medical and health-related services for people with limited income.

Toileting
An activity of daily living -- getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene related tasks

Traditional Nursing Home (see also Medical Model of Care)
These facilities provide care to people who can't be cared for at home or in the community. Nursing homes provide a wide range of personal care and health services. For most people, this care generally is to assist people with support services such as dressing, bathing, and using the bathroom, for people who can't take care of themselves due to physical, emotional, or mental problems.

Transferring
An activity of daily living -- the ability to move in or out of a bed, chair or wheelchair.

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V

Ventilator Care
Indicates facility provides care to ventilator-dependent individuals.

Vulnerable Adult
A person who is being mistreated or is in danger of mistreatment and who, due to age and/or disability, is unable to protect himself or herself.

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