Glossary
AARP (American Association of Retired Persons) – A nonprofit, nonpartisan organization dedicated to helping older Americans achieve lives of independence, dignity and purpose. Contact information: 601 E. St., NW Washington, DC 20049 202-434-2277, www.aarp.org.
Administration on Aging (AoA) – The Administration on Aging (AoA), an agency in the U.S. Department of Health and Human Services is the official Federal agency dedicated to policy development, planning and the delivery of supportive home and community-based services to older persons and their caregivers. The AoA administers the Older Americans Act and works through the national aging network of State Units on Aging, Area Agencies on Aging, Tribal and Native organizations representing 300 American Indian and Alaska Native Tribal organizations, and two organizations serving Native Hawaiians, plus thousands of service providers, adult care centers, caregivers, and volunteers.
Adult Care Home or Adult Foster Care – Also called board and care home, or group home, adult care homes are residences which offer housing and personal care services for 3 to 16 residents. Services such as meals, supervision, and transportation are usually provided. It may also be a single family home. They are licensed as adult family home or adult group home.
Advance Directive – (also called Health Care Directive, Advanced Health Care Directive, Living Will, or Health Care Directive) Legal document used to specify whether you would like to be kept on artificial life support if you become permanently unconscious or are otherwise dying and unable to speak for yourself. It also specifies other aspects of health care you would like under those circumstances.
Aging in Place – The act of living in one’s own home – wherever that might be – for as long as confidently and comfortably possible. Livability can be extended through the incorporation of universal design principles, telecare and other assistive technologies.
Alzheimer’s Disease – Progressive, degenerative form of dementia that causes severe intellectual deterioration; first symptoms are impaired memory, which is followed by impaired thought and speech and finally complete helplessness.
Area Agency on Aging (AAAs) – Under the Older Americans Act, the Administration on Aging distributes funds for various aging programs through state agencies on aging, which in turn fund local area agencies on aging. Area Agencies on Aging address the concerns of older Americans at the local level. They play an important role in identifying community and social service needs and assuring that social and nutritional supports are made available to older people in communities where they live. In most cases, Area Agencies on Aging do not provide direct services. Instead, they subcontract with other organizations to facilitate the provision of a full range of services for older people.
Assisted Living – Residential living arrangement that provides individualized personal care, assistance with Activities of Daily Living, help with medications, and services such as laundry and housekeeping. Facilities may also provide health and medical care, but care is not as intensive as care offered at a nursing home. Types and sizes of facilities vary, ranging small homes to large apartment-style complexes. Levels of care and services also vary. Assisted living facilities allow people to remain relatively independent.
Caregiver – A caregiver is a family member, partner, friend, or neighbor who helps care for an elderly individual or person with a disability who lives at home.
Certified Elder Law Attorney (CELA) – Certified Elder Law Attorneys must meet stringent qualifications regarding licensure, practice, integrity and good standing, substantial involvement, continuing legal education, peer review and professional references, and a challenging examination.
Community Spouse’s Resource Allowance (CSRA) -The CSRA is an amount of resources that states must protect for the spouse of an institutionalized person seeking Medicaid coverage. It is determined by application of a formula, or through a fair hearing, or by court order. The CSRA may not be counted in determining the eligibility of an individual seeking Medicaid.
Continuing Care Retirement Communities (CCRCs) – Retirement complex that offers a range of services and levels of care. Residents may move first into an independent living unit, a private apartment or house, on the campus. The CCRC provides social and housing-related services and often also has an assisted living unit and an on-site or affiliated nursing home. If and when residents can no longer live independently in their apartment or home, they move into assisted living or the CCRC’s nursing home.
Do Not Resuscitate (DNR) order – Written order from a doctor that resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. A DNR order may be instituted on the basis of an Advance Directive from a person, or from someone entitled to make decisions on their behalf, such as a health care proxy. In some jurisdictions, such orders can also be instituted on the basis of a physician’s own initiative, usually when resuscitation would not alter the ultimate outcome of a disease. Any person who does not wish to undergo lifesaving treatment in the event of cardiac or respiratory arrest can get a DNR order, although DNR is more commonly done when a person with a fatal illness wishes to die without painful or invasive medical procedures.
Durable Power of Attorney for Health Care – Legal document that gives someone else the authority to act on your behalf on matters that you specify. The power can be specific to a certain task or broad to cover many financial duties. The power can be given to start immediately or upon mental incapacity. To be valid the document must be signed by you before you become disabled.
Elder Abuse or Neglect – Elder abuse is a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. The specificity of laws varies from state to state, but broadly defined, abuse may be physical, emotional, sexual, exploitation, neglect, and abandonment.
End of Life Care – Doctors and caregivers provide care to patients approaching the end of life that is focused on comfort, respect for decisions, support for the family, and treatments to help psychological and spiritual concerns.
Formulary – A list of drugs covered by an insurance plan.
Guardian or Conservator – A person appointed or designated legally to manage the property or financial affairs and to exercise the rights of another person.
Health Care Directive -(also called Advanced Directive, Advanced Health Care Directive, Living Will, or Health Care Directive) Legal document used to specify whether you would like to be kept on artificial life support if you become permanently unconscious, or are otherwise dying and unable to speak for yourself. It also specifies other aspects of health care you would like under those circumstances.
Home Health Agencies – A public, or private, agency certified by Medicare that specializes in providing skilled nurses, homemakers, home health aides, and therapeutic services such as physical therapy in an individual’s home.
Home Health Aide – A home care worker who provides personal care, help with transfers, walking, exercise; household services that are essential to health care; and assistance with medications. Also called a Certified Nurse Assistant or Nurses’ Aide.
Hospice Care (Palliative Care) – Short-term, supportive care for the terminally ill (life expectancy of six months or less) that focuses on pain management, and emotional, physical, and spiritual support for the patient and family. It can be provided at home, in a hospital, nursing home, or a hospice facility. Hospice care is typically paid for by Medicare and is not usually considered long-term care.
Independent Living Communities – A residential living setting for elderly or senior adults who are very independent and have few medical problems. Residents live in fully equipped private apartments or cottages from studios to large two-bedroom units that may be rental-assisted or market-rate depending on the community. Social activities and fine-dining meals are often available and residents can select the services they want, often at an additional fee.
Living Will – (also called Health Care Directive, Advanced Health Care Directive, Living Will, or Health Care Directive) Legal document used to specify whether you would like to be kept on artificial life support if you become permanently unconscious or are otherwise dying and unable to speak for yourself. It also specifies other aspects of health care you would like under those circumstances.
Long Term Care Facilities – Institutions that provide nursing care to people who are unable to care for themselves and who may have health problems ranging from minimal to serious. Facilities may provide short-term rehabilitative services as well as chronic care management.
Long Term Care Insurance – Specific type of insurance policy designed to offer financial support to pay for necessary long-term care services.
Long Term Care – Variety of services and supports to meet health or personal care needs over an extended period of time.
Medicaid Waiver Programs – Medicaid programs that provide home-care and community-based alternatives to nursing home care. These programs have the potential to reduce overall Medicaid costs by providing services in innovative ways, or to groups of people not covered under the traditional Medicare program. These programs are often approved on a demonstration basis, and generally have limited slots available.
Medicaid – Joint Federal and state public assistance program for financing health care for the poor. It pays for health care services for those with low incomes or very high medical bills relative to income and assets. It is the largest public payer of long-term care services.
Medicare – Federal program organized under the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965. It provides hospital and medical expense benefits for those individuals over age 65, or those meeting specific disability standards. Benefits for nursing home and home health services are limited.
Medicare Advantage Plan – See Medicare Part C.
Medicare Part A – Medicare Part A pays for in-patient hospital stays, skilled nursing home care, home health care, and hospice care.
Medicare Part B – Medicare Part B pays for doctor’s services, out-patient hospital care, and other services not covered by Medicare Part A.
Medicare Part C – Option under Medicare that gives consumers a choice of plans including managed care and fee-for-service plans. Options consist of: traditional fee-for service, HMOs , HMOs with POS, PPOs, PSOs, private fee-for-service , religious/fraternal benefit society plans, and medical savings accounts. Current Medicare beneficiaries are not required to change plans unless they so desire. If you have one of these plans, you don’t need a Medigap policy. Medicare Part C is also known as a Medicare Advantage Plan.
Medicare Part D – A government supported health insurance plan that helps cover prescription drug costs for qualified individuals who are entitled to Medicare Part A and/or B. Beginning January 1, 2006, private health insurance companies have offered these plans to Medicare recipients.
Medicare Supplemental Insurance – Medicare Supplemental Insurance is private insurance (often called Medigap) that pays Medicare’s deductibles and co-insurances and may cover services not covered by Medicare.
Medigap Insurance – (also called Medicare Supplement Insurance) Private insurance policy that covers gaps in Medicare coverage.
National Association of Insurance Commissioners (NAIC) – Membership organization of state insurance commissioners. One of its goals is to promote uniformity of state regulation and legislation related to insurance.
Occupational Therapy (OT) – A clinical program aimed at improving fine motor skills and adaptive skills for people with disabilities or injuries.
PACE (Program for All-Inclusive Care for the Elderly) – PACE combines medical, social, and long-term care services for frail people to help people stay independent and living in their community as long as possible, while getting the high-quality care they need. PACE is available only in states that have chosen to offer it under Medicaid. To be eligible, you must be 55 years old or older, live in the service area of the PACE program, be certified as eligible for nursing home care by the appropriate state agency, and be able to live safely in the community.
Palliative Care – see Hospice Care
Parkinson’s Disease – A degenerative disorder of the central nervous system that often impairs the sufferer’s motor skills and speech, as well as other functions.
Physical Therapy – A clinical program aimed at improving motor skills, particularly gross motor skills.
Power of Attorney – A legal document authorizing one person to act as another person’s attorney or agent. You can give a specific power of attorney to someone such as your accountant to represent you on tax matters with the IRS.
Retirement Communities – Retirement Communities provide shelter and support services to older adults who are nearly or totally independent. The level of services may include housekeeping, meal preparation, recreational and social activities, and transportation. Communities are in apartment, town house, or condominium settings. Provides minimal or no assistance with health care, and does not increase care as needs arise. May require a buy-in or entrance fee.
Reverse Mortgage – New type of loan based on home equity that enables older homeowners (62+) to convert part of the equity in their homes into tax-free income without having to sell the home, give up title, or take on a new monthly mortgage payment. Instead of making monthly payments to a lender, as with a regular mortgage, a lender makes payments to you. The loan, along with financing costs and interest on the loan, does not need to be repaid until the homeowner dies or no longer lives in the home.
Skilled Nursing Facility (SNF) or Nursing Homes – (also called Long-Term Care Facility or Convalescent Care Facility) Licensed facility that provides general nursing care to those who are chronically ill or unable to take care of daily living needs.
State Health Insurance Assistance Program (SHIP) – A state program funded by Medicare to give free local health insurance counseling and assistance to people with Medicare. SHIP volunteers are trained to provide counseling on the insurance needs of senior citizens.
Supplemental Security Income (SSI) – Program administered by the Social Security Administration that provides financial assistance to needy persons who are disabled or aged 65 or older. Many states provide Medicaid, without further application, to persons who are eligible for SSI.
VA Benefits – VA Benefits are services or monetary credits allowed to veterans for housing and care.