Elder Care Glossary

Use this glossary to understand terms commonly used in the elder care industry.

A – B

Activities of Daily Living (ADL): ADL are the daily activities that a person must to be able to perform in order to live independently. These include bathing; grooming; dressing; getting on and off the toilet, which is referred to as toileting; eating; walking, sometimes called ambulation; transferring and incontinence care.

Acute Care: Medical care designed to treat and/or cure an acute condition. Treatment is usually provided by a doctor in a hospital.

Acute Condition: Usually refers to a severe life-threatening medical event, such as a heart attack, stroke, illness or injury that requires immediate medical attention.

Adult Day Care: A facility offering seniors who suffer from health problems and/or Alzheimer’s disease the benefit of a supervised safe environment, medical care, activities and opportunities for socialization. Some adult day care centers follow a medical model, and others are structured on a social model. Day care programs that follow a medical model range from those that provide skilled nursing and rehabilitative therapies to others that focus more on preventative health care. Programs based on a social model meet the needs of individuals with dementia. Adult day care also provides respite for the caregiver. Typically, the adult day care program will provide the transportation to and from the adult day care site. Availability varies by area.

Alzheimer’s Disease: A progressive, degenerative disease of the brain that results in loss of memory, thought processing, reasoning and language abilities, emotional regulation and changes in behavior.  Alzheimer’s disease eventually affects physical functioning and leads to death.

Assisted Living Facility: A residential living facility that offers a safe, supervised living environment for those who need some assistance to live independently. Residents live in their own apartments. The facility offers communal meals, activities and supportive services. Staff is available 24 hours a day, 7 days a week. Residents can come and go on their own if they are able to do so.

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C

Certified Nursing Assistant (CNA): Also referred to as a Nurse’s Aide, CNAs are paraprofessionals who are usually required to have a high school diploma, complete 4-6 weeks of an approved training course and pass a state exam.

Chronic Condition or Illness: Chronic conditions and illnesses are not immediately life threatening. They can be controlled and managed with treatment, but not cured. They can also become life threatening if not controlled and managed. Examples are diabetes, chronic obstructive pulmonary disease (COPD) and high blood pressure.

Chronic Obstructive Pulmonary Disease (COPD): This is a progressive disease that damages the lungs and makes it hard to breathe. The two main types of COPD are chronic bronchitis and emphysema.

Cognition: Refers to mental processes, such as memory and language ability, decision making and the ability to regulate emotions.

Continence: The ability to control bladder and bowel functions.

Continuing Care Retirement Community (CCRC): Continuing Care Retirement Communities (CCRCs) combine independent living, assisted living and nursing home care under one umbrella and allow residents to ‘age in place.’ Typically, the independent living units in a CCRC consist of cottages, townhouses or apartments. Independent living is just that. Residents come and go as they please. Most CCRCs offer meal plans, housekeeping and laundry services, organized activities, exercise facilities and classes, religious services, transportation, a beauty salon and healthcare options. The skilled nursing and assisted living units offer the same services that all such facilities provide.

Custodial Care: This term refers to the non-skilled, personal care assistance provided by a caregiver to help a person to perform the activities (ADL) and tasks (IADL) that are necessary for independent living.

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D – G

Deficit: Impairment of function.

Dementia: Dementia refers to a set of symptoms, such as memory loss, difficulty with language, decision making and reasoning. Alzheimer’s disease is the most commonly diagnosed disease that causes some or all of these symptoms. However, there are others, such as Lewy body dementia, vascular dementia, and frontotemporal dementia,

Director of Nursing (DON): The acronym, DON, is often used to refer to the Director of Nursing in a nursing home.

Durable Medical Equipment (DME): Durable medical equipment includes hospital beds, wheelchairs, scooters, bath lifts, Hoyer lifts and other assistive and adaptive devices. The purchase or rental of this kind of equipment makes it easier to care for people at home.

Emergency Response System: Technology used to signal for help in an emergency. Some systems are relatively simple, such as medical alert devices that use a bracelet or necklace with a button to press for help in case of emergencies. Others are more complex and include motion detection systems and home monitors that communicate with designated persons. Some technology allows medical personnel to monitor a patient’s health status. Alert systems are also used in facilities to monitor residents who wander or are fall risks.

Formal Caregiver: The term refers to a caregiver, often a homemaker, certified nursing assistant (CNA) or home health aide, for whom care giving is a job.

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H

Home Care: Personal care services provided in the home.

Home and Community Based Services (HCBS): These programs offer services for Medicaid-eligible individuals who qualify for a nursing home level of care but who can remain at home with support; programs vary by state. Support includes personal care assistance, home delivered meals, adult day care, transportation, legal assistance and other services.

Home Health Aide (HHA): The term is used loosely to refer to a personal care worker. There is no formal educational requirement to become a home health aide. In most states, home health aides receive on-the-job training. However, some states require a formal training course and certification obtained by passing a standardized test.

Home Health Care: Home health care is a Medicare benefit that consists of skilled nursing, therapeutic care, homemaker services, medical social services provided by a Medicare certified agency, for homebound individuals, as well supplies and medical equipment. Examples of home health care include wound care, medication management, IV administration, physical, occupational, speech and respiration therapies, as well as assistance with bathing, usually on a short term basis. However, home health care also includes home-administered dialysis and other ongoing treatments. The key terms to keep in mind are homebound patient, physician ordered and intermittent care. Home health care must be ordered and overseen by a physician. Services are based on a care plan developed by the physician that has specific goals for improvement or maintenance of function.

Home Modification: Home modifications include grab bars in the bathroom, chair rails, lighting, wheelchair ramps or lifts and chair lifts, and are designed to increase safety and convert a traditional home into one that can accommodate a person with functional limitations.

Homemaker: A non-licensed caregiver who provides personal care and assistance with the tasks of daily living, such as light housekeeping, laundry, meal preparation and shopping.

Hospice: Hospice care offers services that address the physical, psychological and spiritual needs of a patient and their family at the end of life and can be provided at home or in a hospice facility, nursing home, intermediate care facility or hospital. A hospice team typically consists of a nurse, doctor, therapist, social worker, CNA, chaplain and volunteers. Hospices rely on volunteers to visit and read to patients. Some offer music therapy to soothe patients.

Individuals with a prognosis of 6 months or less to live are eligible for hospice. Although eligibility for hospice care requires a doctor’s prognosis of 6 months or less to life, many people in hospice live longer. A physician can re-certify the patient as eligible for additional benefit periods. In addition, there are people in hospice who recover. However, hospice care is not designed to be curative. The goal of hospice is to provide patients with the highest quality of life possible at the end of life. Relief of symptoms, such as pain and breathing difficulty, as well as patient and family psychological and spiritual counseling, are major foci of hospice care. Hospice services may include physical, occupational and speech therapies and personal care, such as bathing assistance. Another hospice benefit is respite care for a family caregiver.

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I – L

Impairment: Diminishment, abnormality or loss of function.

Incontinence: The inability to control bladder and bowel functions.

Informal Caregiver: The term refers to a non-paid caregiver, often a family member.

Instrumental Activities of Daily Living (IADL): IADL are the daily tasks that a person must be able to perform in order to live independently. These include driving or the ability to use transportation, grocery shopping, errands, housekeeping, laundry, meal preparation, medication management, using a telephone or other household device and daily money management.

Long-term Care (LTC): Long-term care includes skilled, therapeutic and personal care services and supports that may be needed by a person whose physical and/or mental condition limits their ability to function independently.

Long-term Care Insurance: Insurance that specifically covers long-term care costs. Policy terms, benefits and premiums differ based on the coverage choices selected.

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M – P

Medicaid: A health care program for eligible, low income individuals, funded by both the Federal Government and the State, but administered by the state. Medicaid pays for both medical and long-term care.

Medicare: Federal health care program for those 65 and over, the blind, disabled and certain other qualifying individuals. Medicare offers only limited coverage for long-term care.

Nursing Facility: A nursing home that is Medicaid-certified and can admit Medicaid patients.

Nursing Home: This term is used broadly. All nursing homes provide room, board, housekeeping and laundry services, as well as assistance with personal care. Some nursing homes offer specialized care, such as for dementia patients or those with brain injuries or on a ventilator. Others concentrate on providing skilled care for those recuperating from a surgery or other acute medical event. However, most nursing facilities offer a combination of therapeutic, skilled nursing and custodial or personal care.

Occupational Therapy: Occupational therapy is rehabilitative and strives to help individuals with functional limitations improve their ability to perform the activities (ADL) and tasks (IADL) of daily living.

Palliative Care: Palliative care is medical care to relieve or reduce physical and psychological symptoms, such as pain, nausea, breathing difficulty, stress and depression, that are the result of a disease and/or its treatment. Palliative care is often confused with hospice care. Like hospice care, palliative care is holistic. Palliative care is provided by a team of professionals, doctors, nurses, social workers and other specialists, to address both the physical and psychological needs of patients. However, palliative care differs significantly from hospice care. Palliative care patients are not necessarily end-of-life patients. They do not require a diagnosis of six months or less to live in order to receive care and they can continue with curative treatment for their underlying disease. For example, a cancer patient undergoing chemotherapy or radiation might also be receive palliative care to alleviate accompanying pain, nausea and depression caused by the disease and its treatment.

Personal Care: Refers to the non-skilled assistance provided by a caregiver to help an individual with functional limitations perform activities (ADL) and tasks (IADL) that are necessary for independent living.

Physical Therapy: Physical therapy is rehabilitative and strives to improve an individual’s physical ability to move and function through exercise, equipment, massage and other treatment.

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R – Z

Respite Care: Care designed to provide relief for primary caregivers on a short term basis.

Skilled Care: Provided by professionals, such as physicians, nurses, physical, occupational and speech therapists, medical social workers and others. Skilled care must be ordered by a physician. The services that are provided are based on an assessment that establishes goals for improvement and/or maintenance of function. Medical insurance and Medicare cover skilled care according to the terms of coverage.

Skilled Nursing Care: Care that is directed by a physician and provided by a licensed nurse, such as wound care or intravenous therapy,

Skilled Nursing Facility (SNF): Nursing home that is Medicare-certified and, therefore, able to admit Medicare patients.

Speech Therapy: Therapy that strives to improve an individual’s ability to speak and communicate. Therapists use exercises and audio-visual aides.

Toileting: One of the activities of daily living that involves getting to and from as well as on and off a toilet and the ability to manage relevant personal hygiene.

Transferring: Transferring is the act of moving from one position to another, such as from lying down to a sitting or standing position or from a wheelchair to a toilet, chair or bed.