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24-hour Controlled Access: Facility
provides control of all points of entry/exit
24-hrs a day for the security of the residents.
Accreditation: A seal of approval given
by an autonomous governing body to a community
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 independent
accrediting organizations are not government
agencies or regulatory bodies. Some examples of
accreditation bodies for the senior housing and
care industry include CARF (Commission on
Accreditation of Rehabilitation Facilities),
CCAC (Continuing Care Accreditation Commission),
and JCAHO (Joint Commission on Accreditation of
Healthcare Organizations).
ACHCA: The American College of Health
Care Administrators (ACHCA) aspires to be the
leading force in promoting excellence in
leadership among long-term care administrators.
Founded in 1962, ACHCA is a non-profit
membership organization which provides superior
educational programming, certification in a
variety of positions, and career development for
its members. Guided by the vision that dynamic
leadership forges long term health care services
that are desired, meaningful, successful, and
efficient, ACHCA identifies, recognizes, and
supports long term care leaders, advocating for
their mission and promoting excellence in their
profession.
Activities of Daily Living (ADLs):
Physical functions that an independent person
performs each day, including bathing, dressing,
eating, toileting, walking or wheeling, and
transferring into and out of bed.
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.
Adaptive / Assistive Equipment: An
appliance or gadget that assists user in the
operation of self-care, work or leisure
activities.
Administration on Aging: An agency of the
U.S. Department of Health and Human Services.
AOA is an advocate agency for older persons and
their concerns at the federal level. AOA works
closely with its nationwide network of State and
Area Agencies on Aging (AAA).
Administrator: In most cases, a licensed
professional who undertakes the duty of managing
day-to-day operations of a senior housing
facility such as a skilled nursing facility or
assisted living facility.
Adult Day Care: Structured programs with
stimulating social activities as well as
health-related and rehabilitation services for
the elderly who are physically or emotionally
disabled and need a protective environment. The
participant is usually brought to the care
facility in the morning and leaves in the
evening. Transportation may be provided.
Adult Day Health Care: Provision of care
and services in a residential health care
facility or approved extension site, on an
outpatient basis, under the medical direction of
a physician. Services are in accord with a
comprehensive assessment of care needs and
individualized health care plan.
Adult Family Home: Facility that provides
a more private, home-like setting, typically in
a residential neighborhood and serves a limited
number of residents who receive care from
live-in caretakers. Group meals are served and
help is given with ADLs. Usually housekeeping
and laundry is taken care of and some activities
are provided. Amenities and nursing services
vary widely in these facilities, so it’s best to
check each location for specifics. (Also called
Group Home, Personal Care Home, Board and Care
Home, Residential Care Facility and Adult Foster
Care.)
Advanced Directives: A written statement
of an individual's preferences and directions
regarding health care. Advanced Directives
protect a person's rights even if he or she
becomes mentally or physically unable to choose
or communicate his or her wishes.
Cancer: Disease that develops when cells
in the body begin to grow out of control. Normal
cells grow, divide and die. Instead of dying,
cancer cells continue to grow and form new
abnormal cells. Cancer cells often travel to
other body parts where they grow and replace
normal tissue. This process, called metastasis,
occurs as the cancer cells get into the
bloodstream or lymph vessels. Cancer cells
develop because of damage to DNA. DNA is in
every cell and directs all its activities. When
DNA becomes damaged the body is able to repair
it. In cancer cells, the damage is not repaired.
People can inherit damaged DNA, which accounts
for inherited cancers. Many times, DNA becomes
damaged by exposure to something in the
environment, like smoking.
Caregiver: Any individual who takes care
of an elderly person or someone with physical or
mental limitations.
Case management: A term used to describe
formal services planned by care professionals
who help the patient or the family determine and
coordinate necessary health care services and
the best setting for those services.
Catheter: A hollow flexible tube for
insertion into a body cavity, duct or vessel to
allow the passage of fluids or distend a
passageway. Its uses include the drainage of
urine from the bladder through the urethra or
insertion through a blood vessel into the heart
for diagnostic purposes.
Center for Medicare and Medicaid (CMS):
Formerly the U.S. Health Care Financing
Administration, CMS is the part of the
Department of Health and Human Services that
finances and administers the Medicare and
Medicaid programs. Among other responsibilities,
CMS establishes standards for the operation of
nursing facilities that receive funds under the
Medicare or Medicaid programs.
Certificate of Medical Necessity: A
document completed and signed by a physician to
certify a patient's need for certain types of
durable medical equipment (i.e. wheelchairs,
walkers, etc.).
Certified Home Health Care: An entity
that provides, at a minimum, the following
services which are of a preventative,
therapeutic, health guidance and/or supportive
nature to persons at home and/or at a senior
housing facility: nursing services; home health
aide services; medical supplies, equipment and
appliances suitable for use in the home;
therapies such as physical, occupational,
speech/language pathology and respiratory
therapy; nutritional services and social work
services.
Certified Nursing Assistant (CNA):
Provides personal care to residents or patients,
such as bathing, dressing, changing linens,
transporting and other essential activities.
CNAs are trained, tested, certified and work
under the supervision of an RN or LPN.
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 the nursing staff and provides
care to facility residents.
Chronic Obstructive Pulmonary Disease (COPD):
A group of chronic respiratory disorders
characterized by the restricted flow of air into
and out of the lungs. The most common example is
emphysema.
Cognitive Impairment: A diminished mental
capacity, such as difficulty with short-term
memory.
Colostomy: A removable, disposable bag
that attaches to the exterior opening of a
colostomy (stoma) to permit sanitary collection
and disposal of bodily wastes.
Concierge Service: Facility provides
concierge service similar to that found in a
hotel. Concierge will typically run errands,
schedule transportation, help out with
activities, etc.
Congestive Heart Failure (CHF): A common
type of heart disease characterized by
inadequate pumping action of the heart.
Congregate Housing: Similar to
independent living except that it usually
provides convenience or supportive services like
meals, housekeeping and transportation in
addition to rental housing.
Continuing Care Retirement Community (CCRC):
A residential community for the remainder of
one's life, with a choice of services and living
situations. Seniors can move between Independent
Living, Assisted Living and Nursing Home Care
based on changing needs at each point in time.
These communities allow seniors to "age in
place," with flexible accommodations that are
designed to meet their health and housing needs
as they change over time. It is different than
other senior homes in that residents entering
CCRCs sign a long-term contract (often a
lifetime contract) that provides for housing,
services and nursing care, usually all in one
location, enabling seniors to remain in a
familiar setting as they grow older. (Also
called Life-Care Facility and Life-Care
Community.)
Continuum of Care: Care services
available to assist individuals throughout the
course of a disease. This may include
Independent Living, Assisted Living, Nursing
Care, Home Health, Home Care and Home and
Community Based Services.
Convalescent Home: See Skilled Nursing
Facility.
Custodial Care: Board, room and other
personal assistance services (including
assistance with activities of daily living and
taking medicine) that may not include a skilled
nursing care component.
Dementia: Describes a group of symptoms
that are caused by changes in brain function.
Dementia symptoms may include asking the same
questions repeatedly; becoming lost in familiar
places; being unable to follow directions;
getting disoriented about time, people and
places; and neglecting personal safety, hygiene
and nutrition. People with dementia lose their
abilities at different rates. Dementia is caused
by many conditions. Some conditions that cause
dementia can be reversed and others cannot. The
two most common forms of dementia in older
people are Alzheimer’s disease and multi-infarct
dementia (sometimes called vascular dementia.)
These types of dementia are irreversible, which
means they cannot be cured.
Reversible conditions with symptoms of dementia
can be caused by a high fever, dehydration,
vitamin deficiency and poor nutrition, bad
reactions to medicines, problems with the
thyroid gland or a minor head injury. Sometimes
older people have emotional problems that can be
mistaken for dementia. Feeling sad, lonely,
worried or bored may be more common for older
people facing retirement or coping with the
death of a spouse, relative or friend. Adapting
to these changes leaves some people feeling
confused or forgetful. Emotional problems can be
eased by supportive friends and family, or by
professional help from a doctor or counselor.
(NIA, NIH)
Depression (Depressive Disorder): An
illness that involves the body, mood and
thoughts. It affects the way a person eats and
sleeps, the way one feels about oneself and the
way one thinks about things. A depressive
disorder is not the same as a passing blue mood.
It is not a sign of personal weakness or a
condition that can be willed or wished away.
People with a depressive illness cannot merely
"pull themselves together" and get better.
Without treatment, symptoms can last for weeks,
months or years. Appropriate treatment, however,
can help most people who suffer from depression.
Developmental Disability (DD): Refers to
a serious and chronic disability, which is
attributable to a mental or physical impairment
or combination of mental and physical
impairments. Those affected have limitations in
three or more of the following areas: self-care,
receptive and expressive language, learning,
mobility, self-direction, capacity of
independent living, economic self-sufficiency.
Afflictions included in this category include
cerebral palsy, retardation, thyroid problems,
seizures and quadriplegia.
Diabetes: Disease in which the body does
not produce or properly use insulin. Insulin is
a hormone that is needed to convert sugar,
starches and other food into energy needed for
daily life. The cause of diabetes continues to
be a mystery, although both genetics and
environmental factors such as obesity and lack
of exercise appear to play roles.
Dialysis: A treatment that removes waste
and fluid from the body when kidneys no longer
work well enough to keep the body healthy. When
kidneys go below 15% of their normal function,
dialysis or kidney transplant is necessary to
remove waste and fluid from the body.
Director of Nursing (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.
Dual Eligibles: Someone who is qualified
for both Medicaid and Medicare.
Durable Power of Attorney for Health Care
(DPAHC): A legal document in which a
competent person gives another person (called an
attorney-in-fact) the power to make healthcare
decisions for him or her if unable to make those
decisions. A DPA can include guidelines for the
attorney-in-fact to follow in making decisions
on behalf of the incompetent person.
Dysphagia: A swallowing disorder often
depicted by difficulty in oral preparation for
swallowing. The person has difficulty moving
material from the mouth to stomach.
Emergency Call System: Facility provides
some or all units with an emergency call system
such as call buttons in important locations in
the unit.
Emphysema: One of the two most common
forms of chronic obstructive pulmonary disease
(COPD), which are disorders that persistently
obstruct bronchial airflow in and out of the
lungs. Emphysema is marked by an abnormal
accumulation of air in the lung's many tiny air
sacs, a tissue called alveoli. As air continues
to collect in these sacs, they become enlarged
and may break or be damaged and form scar
tissue. The result is labored breathing and an
increased susceptibility to infection. The other
common COPD is bronchitis.
Enriched Housing: A licensed adult care
facility established and operated for the
purpose of providing long-term residential care
to five or more adults, primarily persons 65
years of age or older, in community-integrated
settings resembling independent housing units.
Such programs must provide or arrange for the
provision of room, board, housekeeping, personal
care and supervision.
Family-Style Food: Facility has set-meals
and meal times that are served family style in a
group dining setting.
Financial Counseling Program: Helps
seniors with managing their finances, bills and
completing Medicaid, Medicare or insurance
forms. (from LTC Insurance)
Foot Care: Facility provides assistance
to residents with foot care such as nail
clipping, applying ointments, etc.
Fully-Fenced and Gated: Facility is fully
fenced and gated for purposes of controlled
entry and exit.
Full-Service Kitchen: Facility provides
units with a full-service kitchen for seniors
who can live independently and operate a kitchen
safely.
Health Care Directive: A written legal
document that allows a person to appoint another
person (agent) to make health care decisions
should he or she be unable to make or
communicate decisions.
Health Care Power of Attorney: The
appointment of a health care agent to make
decisions when the principal becomes unable to
make or communicate decisions.
Heart Disease: Any disorder that affects
the heart's ability to function normally. The
most common cause of heart disease is narrowing
or blockage of the coronary arteries, which
supply blood to the heart itself. This happens
slowly over time and is known as Coronary Artery
Disease or CAD.
Heart Failure (HF) (Congestive Heart Failure):
The inability of the heart to pump enough blood
to meet the needs of the body’s other organs.
This can cause fluid to build up in the body,
which is seen as swelling (edema), most commonly
in the lower legs and ankles. Heart failure (HF)
also reduces the kidneys' ability to dispose of
sodium and water, making edema worse. Fluid can
also collect in the lungs and interfere with
breathing, causing shortness of breath. HF is
almost always a chronic, long-term condition,
although it can sometimes develop suddenly. It
may affect the right side, the left side, or
both sides of the heart. Most areas of the body
can be affected when both sides of the heart
fail. In HF, the failing heart keeps working,
but inefficiently. The most common causes of HF
are coronary artery disease (CAD), previous
heart attack and hypertension (high blood
pressure).
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 are considered as taxable income.
HMO (Health Maintenance Organization): An
organization that, for a prepaid fee, provides a
comprehensive range of health maintenance and
treatment services (including hospitalization,
preventive care, diagnosis, and nursing).
Home Health Services: Skilled nursing
care and medical services provided in a home
setting. Services may be provided by a nurse,
therapist (occupational, speech or physical),
social worker or home health aide. (Also called
Home Health Agency or HHA.)
Hospice Care (Palliative Care): Care
provided to enhance the life of a person in the
end stages of life rather than the use of heroic
lifesaving measures. Today, many senior housing
facilities and acute care settings offer hospice
services. Hospice care, typically offered in the
last six months of life, emphasizes comfort
measures and counseling to provide social,
spiritual and physical support to the dying
patient and his or her family.
HUD Subsidy: HUD (Housing and Urban
Development) is a federal program that provides
affordable independent housing for the elderly
and disabled. Most individuals that qualify for
HUD must pay approximately 30% of their monthly
income to rent. HUD takes care of the remaining
70%. Eligibility requirements may include
income, assets and age. (Also called HUD Senior
Housing.)
Incompetence: Determined by a legal
proceeding. Requires that the individual is
incapable of handling assets and exercising
certain legal rights.
Incontinent: Partially or totally unable
to control bladder and/or bowel functions.
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. Generally referred to as elderly
housing in the government-subsidized
environment. (Also called Senior Apartments,
Elderly Housing, Congregate Care and Senior
Housing.)
Instrumental Activities of Daily Living
(IADLs): Secondary level of activities
(different from ADLs, such as eating, dressing,
and bathing) important to daily living, such as
cooking, writing and driving.
Intermediate Care Facility/Mentally Retarded
(ICF/MR): A licensed facility with the
primary purpose of providing health or
rehabilitative services for people with mental
retardation or people with developmental
disabilities.
IV / Infusion Therapies: The way that
liquid solutions or liquid medications are
administered directly into the blood stream
through an intravenous catheter inserted in a
vein in the body. Infusion therapies can include
total parenteral nutrition, antibiotics or other
drugs, blood and chemotherapy.
Kitchenette: Facility has small,
limited-service kitchen in some units so the
residents can prepare their own meals.
Appliances vary, so check with each facility for
specifics.
Licensed Nursing Care: Care provided by
registered nurses (RN), licensed practical
nurses (LPN), delegation nurses and nurses’
aides. Some facilities such as Nursing Homes and
Skilled Nursing Facilities are designed for
those who need 24-hour nursing care and have
on-site medical teams that set them apart from
other types of senior housing. Part-time
licensed nursing care may also provided at
Assisted Living and Adult Family Home facilities
and can be contracted to serve Independent
Living Communities.
Licensed Practical Nurse (LPN): LPNs are
trained to administer technical nursing
procedures as well as provide a range of
healthcare 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) that 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. (Also
called Life-Care Facility and Continuing Care
Retirement Community or CCRC.)
Living Will: A legal document in which a
competent person directs in advance that
artificial life-prolonging treatment not be used
if he or she has or develops a terminal and
irreversible condition and becomes incompetent
to make healthcare decisions.
Long-Term Care: Care given in the form of
medical and support services to persons who have
lost some or all of their capacity to function
due to an illness or disability.
Long-Term Care Facilities: A range of
institutions that provide health care to people
who are unable to manage independently in the
community. Facilities may provide short-term
rehabilitative services as well as chronic care
management.
Long-Term Care Insurance: An insurance
policy designed to help alleviate some of the
costs associated with long-term care. Benefits
are often paid in the form of a fixed dollar
amount (per day or per visit) for covered
expenses and may exclude or limit certain
conditions from coverage.
Managed Care: Can best be described as
the partnership of insurance and a healthcare
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 healthcare 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 healthcare
agencies.
Massage Therapy: The manipulation of
muscle and connective tissue to enhance the
function of those tissues and promote relaxation
and well being. Therapeutic massage can ease
tension and reduce pain. Massage therapy is a
form of physical therapy. It can be highly
effective for reducing the symptoms of
arthritis, back pain, carpal tunnel syndrome and
other disorders of the muscles and/or nervous
system.
Medicaid: The federally supported, state
operated public assistance program that pays for
health care services to people with a low
income, including elderly or disabled persons
who qualify. Medicaid pays for long term nursing
facility care, some limited home health
services, and may pay for some assisted living
services, depending on the state.
Medical Director: The medical director
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. A staff medical director assumes
overall responsibility for the formulation and
implementation of all policies related to
medical care.
Medicare: The federal program providing
primarily skilled medical care and medical
insurance for people aged 65 and older, some
disabled persons and those with end-stage renal
disease.
Medicare Part A: Hospital insurance that
helps pay for inpatient hospital care, limited
skilled nursing care, hospice care and some home
health care. Most people get Medicare Part A
automatically when they turn 65.
Medicare Part B: Medical insurance that
helps pay for doctors' services, outpatient
hospital care and some other medical services
that Part A does not cover (like some home
health care). Part B helps pay for these covered
services and supplies when they are medically
necessary. A monthly premium must be paid to
receive Part B.
Medicare Supplemental Insurance: This is
private insurance (often called Medigap) that
pays Medicare's deductibles and co-insurances
and may cover services not covered by Medicare.
Most Medigap plans will help pay for skilled
nursing care, but only when Medicare covers that
care.
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. In most cases, the medication cannot
be administered by staff; the resident must take
the medication by him/her self. However, if
licensed nursing staff is available, injections
can be arranged for residents.
Medigap Insurance: A term commonly used
to describe Medicare supplemental insurance
policies available from various companies.
Medigap is private insurance that may be
purchased by Medicare-eligible individuals to
help pay the deductibles and co-payments
required under Medicare. Medigap policies
generally do not pay for services not covered by
Medicare.
Memory Loss: Unusual forgetfulness that
can be caused by brain damage due to disease,
injury or severe emotional trauma. Can be known
as impaired memory or amnesia. The cause
determines whether memory loss comes on slowly
or suddenly and whether it is temporary or
permanent. Normal aging may result in trouble
learning new material or requiring a longer time
to recall learned material. However, it does not
lead to dramatic memory loss unless diseases are
involved.
Mental Health Counseling: A collaborative
effort between a counselor and a patient to:
help patients identify goals and potential
solutions to problems that cause emotional
turmoil; seek to improve communication and
coping skills; strengthen self-esteem; and
promote behavior change and optimal mental
health.
Multiple Sclerosis (MS): A chronic,
unpredictable neurological disease that affects
the central nervous system (CNS). The CNS
consists of the brain, spinal cord and the optic
nerves. Surrounding and protecting the nerve
fibers of the CNS is a fatty tissue called
myelin, which helps nerve fibers conduct
electrical impulses. In MS, myelin is lost in
multiple areas, leaving scar tissue called
sclerosis. These damaged areas are also known as
plaques or lesions. Sometimes the nerve fiber
itself is damaged or broken. Myelin not only
protects nerve fibers, but also makes their job
possible. When myelin or the nerve fiber is
destroyed or damaged, the ability of the nerves
to conduct electrical impulses to and from the
brain is disrupted, and this produces the
various symptoms of MS.
Music Therapy: The use of music in
therapy; the therapeutic use of music. Music can
be used to aid in relaxation and to restore,
maintain and improve emotional, physical,
physiological and spiritual health and well
being.
National Association of Insurance
Commissioners (NAIC): A national
organization made up of state officials who are
in charge of regulating insurance. They have
considerable influence and strive to promote
national uniformity in insurance regulations.
(from LTC Insurance)
Non-Ambulatory: Inability to walk
independently, 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: Work under the
supervision of a Registered Nurse or Licensed
Practical Nurse. 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.
Nursing Facility (NF): Licensed to
provide custodial care, rehabilitative care
(such as physical, occupational or speech
therapy) or specialized care for Alzheimer's
patients. Additionally, nursing facilities offer
residents planned social, recreational and
spiritual activities. See ‘Skilled Nursing
Facility’
Occupational Therapist: Evaluate, treat
and consult with individuals whose abilities to
cope with the tasks of everyday living are
threatened or impaired by physical illness or
injury, psychosocial disability or developmental
deficits. Occupational therapists work in
hospitals, rehabilitation agencies,
long-term-care facilities and other health-care
organizations.
Occupational Therapy: A creative activity
prescribed for its effect in promoting recovery
or rehabilitation. This is done to help
individuals relearn activities of daily living
and is generally administered by a licensed
therapist.
Ombudsman: A
public/government/community-supported program
that advocates for the rights of all residents
in senior housing facilities. Volunteers visit
local facilities weekly, monitor conditions of
care and try to resolve problems involving
meals, finances, medication, therapy, placements
and communication with the staff.
Osteoporosis: Disease in which bones
become fragile and more likely to break. If not
prevented, or if left untreated, osteoporosis
can progress painlessly until a bone breaks.
These broken bones, also known as fractures,
occur typically in the hip, spine and wrist.
Parkinson’s Disease: A chronic,
progressive disorder of the central nervous
system (CNS) that belongs to a group of
conditions called motor system disorders.
Parkinson's is the direct result of the loss of
cells in a section of the brain called the
substantia nigra. Those cells produce dopamine,
a chemical messenger responsible for
transmitting signals within the brain. Loss of
dopamine causes critical nerve cells in the
brain, or neurons, to fire out of control,
leaving patients unable to direct or control
their movement in a normal manner.
Patient Assessment: Also called resident
assessment. A standardized tool that enables
senior housing facilities to determine a
patient's abilities, what assistance the patient
needs and ways to help the patient improve or
regain abilities. Patient assessment forms are
completed using information gathered from
medical records, discussions with the patient
and family members and direct observation.
Personal Care: Involves services rendered
by a nurse's aide, dietician or other health
professional. These services include assistance
in walking, getting out of bed, bathing,
toileting, dressing, eating and preparing
special diets.
Pet Therapy: Animal-assisted therapy
(AAT), also known as pet therapy, utilizes
trained animals and handlers to achieve specific
physical, social, cognitive, and emotional goals
with patients. Studies have shown that physical
contact with a pet can lower high blood pressure
and improve survival rates for heart attack
victims. There is also evidence that petting an
animal can cause endorphins to be released.
Endorphins are chemicals in the body that
suppress the pain response. These are benefits
that can be enjoyed from pet ownership, as well
as from visiting therapeutic animals.
Physical Therapy: Services provided by
specially trained and licensed physical
therapists in order to relieve pain, restore
maximum function, and prevent disability or
injury. These can include massage, regulated
exercise and treatments involving water, light,
heat and electricity.
Power of Attorney: A legal document
allowing one person to act in a legal matter on
another's behalf pursuant to financial or
real-estate transactions.
Pre-Admission Screening: An assessment of
a person's functional, social, medical and
nursing needs to determine if the person should
be admitted to nursing facility or other
community-based care services available to
eligible Medicaid recipients. Trained
pre-admission screening teams conduct
screenings.
Private Funds (Private Pay Patients):
Patients who pay for their own care out of
private funds, either their own, from family or
from another third party such as an insurance
company. The term is used to distinguish
patients from those whose care is paid for by
governmental programs (Medicaid, Medicare, and
Veterans Administration).
Program of All-Inclusive Care for the Elderly
(PACE): Programs that serve individuals with
long-term care needs by providing access to the
entire continuum of health care services,
including preventive, primary, acute and
long-term care. A basic tenet of the PACE
philosophy is that it is better for both the
senior with long-term care needs and the
healthcare system to focus on keeping the
individual living as independently as possible
in the community for as long as possible.
Prospective Payment System (PPS): Method
by which skilled nursing facilities are paid by
Medicare.
Provider: Someone who provides medical
services or supplies, such as a physician,
hospital, x-ray company, home health agency or
pharmacy.
Psychotropic Drugs: Antidepressants,
anti-anxiety drugs, and anti-psychotic drugs
used for delusions, extreme agitation,
hallucinations or paranoia. They are often
referred to as mind or behavior altering drugs.
Qualified Medicare Beneficiaries (QMB): A
federally required program where states must pay
the Medicare deductibles and co-payments as well
as Part B premiums for Medicare beneficiaries
who qualify, based on income and resources.
Quality Assurance Director: Coordinates
quality assurance programs and policies for the
facility. This person is responsible for quality
assurance only and must be a licensed nurse.
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 manner.
Reasonable and Necessary Care: The amount
and type of health services generally accepted
by the health community as being required for
the treatment of a specific disease or illness.
Registered Nurse (RN): Graduate trained
nurse who has both passed a state board
examination and is licensed by a state agency to
practice nursing. A minimum of two years of
college is required in addition to passage of
the state exams. 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.
Rehabilitation: Therapeutic care for
persons requiring intensive physical,
occupational or speech therapy in order to
restore to the patient to a former capacity.
Resident Assistant (RA): Generally work
in assisted living residences and provide direct
personal care services to residents but they are
not certified CNAs. Depending on the state, this
position is also available in some nursing
facilities.
Residential Care Facility: Group living
arrangements that are designed to meet the needs
of people who cannot live independently but do
not require nursing facility services. These
homes offer a wider range of services than
independent living options. Most provide help
with some of the activities of daily living. In
some cases, private long-term care insurance and
medical assistance programs will help pay for
this type of service. (Also called Board and
Care Home.)
Resident Care Plan: A written plan of
care for nursing facility residents developed by
an interdisciplinary team that specifies
measurable objectives and timetables for
services to be provided to meet a resident's
medical, nursing, mental and psychosocial needs.
Respiratory Therapy: Assists patients
with breathing difficulties to reduce fatigue
and increase tolerance in performing daily
activities.
Respite Care: Scheduled short-term care
provided on a temporary basis to an individual
who is normally cared for by family or support
groups at home. The goal of scheduled short-term
care is to provide relief (respite) for the
caregivers while providing supervised and/or
nursing care for the individual. Respite care is
also used while transitioning persons from
in-patient hospital stay to home.
Restaurant-Style Food: Facility offers
restaurant-style dining where residents can
select items from a menu.
Restorative Therapy: Therapy services
that are performed with a reasonable expectation
that the individual’s function will improve
significantly in a reasonable and predictable
period of time, based upon an assessment of the
individual’s restoration potential made by a
physician or mid-level practitioner in
consultation with the licensed therapist.
Therapy services are not restorative therapy if
the individual’s expected restoration potential
would be insignificant in relation to the extent
and duration of services required. Therapy
services are no longer restorative therapy if at
any time after commencement of treatment, it is
determined that the reasonable expectation of
significant improvement in function will not
materialize. (from Montana Medicaid Therapy
Service Provider Manual)
Seek Exits: A tendency to look for ways
to exit the building that is part of the
“wandering” trait associated with dementia and
Alzheimer’s disease. It is important that
seniors who exhibit this trait be cared for in
facilities that have locked doors and, if
possible, alarms on exits that will alert staff
if someone exits the facility.
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. (Similar to Independent Living.)
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.
Senior Housing: Independent living units,
generally apartments. Any supportive services,
if needed, are through contract arrangement
between tenant and service provider.
Skilled Nursing Care: Nursing and
rehabilitative care that can be performed only
by, or under the supervision of, licensed and
skilled medical personnel.
Skilled Nursing Facility: A facility that
is staffed with 24-hour on-site licensed
professionals for the care of the frail elderly
who require a high level of medical care and
assistance. Services include medical care,
psychosocial and personal services. Residents
typically share a room and take group meals in a
dining area unless they are too ill to
participate. Activities are also available for
those who can participate. Some facilities have
special units for Alzheimer’s residents and for
short-term rehabilitative stays for those
recovering from an illness or accident. (Also
called Convalescent Care, Nursing Center and
Long-Term Care Facility.)
Speech Therapy: This type of service
helps individuals overcome communication
conditions such as aphasia, swallowing
difficulties and voice disorders. Medicare may
cover some of the costs of speech therapy after
client meets certain requirements.
Stroke (Apoplexy, Cerebrovascular Accident):
An interruption of blood flow to the brain
causing paralysis, slurred speech and/or altered
brain function. It may be caused by a blood clot
blocking circulation or by bleeding into brain
tissue causing tissue damage. A stroke can
happen when a blood vessel carrying blood to the
brain is blocked by a blood clot. This is called
an ischemic stroke. A hemorrhagic stroke occurs
when a blood vessel breaks open due to trauma or
an aneurysm ruptures causing blood to leak into
the brain.
Sub-Acute Care: A level of care designed
for the individual who has had an acute event as
a result of an illness and is in need of skilled
nursing or rehabilitation but does not need the
intensive diagnostic or invasive procedures of a
hospital.
Sub-Acute Care Facilities: Specialized
units often in a distinct part of a nursing
facility. Provide intensive rehabilitation,
complex wound care and post-surgical recovery
for persons of all ages who no longer need the
level of care found in a hospital.
Subsidized Senior Housing: A program that
accepts Federal and State money to subsidize
housing for older people with low to moderate
incomes.
Sundown Syndrome: Also known as
Sundowning or Sundowner’s. An ailment that
causes symptoms of confusion after "sundown."
These symptoms appear in people who suffer from
Alzheimer's disease or other forms of dementia.
Not all patients who suffer from dementia or
Alzheimer's exhibit Sundowner's symptoms,
however. Conversely, some people exhibit
symptoms of dementia all day, which grow worse
in the late afternoon and evening, while others
may exhibit no symptoms at all until the sun
goes down.
Supplemental Security Income (SSI): A
federal program that pays monthly checks to
people in need who are 65 years or older or who
are blind or otherwise disabled. The purpose of
the program is to provide sufficient resources
so that any one who is 65 or older, blind or
otherwise disabled can have a basic monthly
income. Eligibility is based on income and
assets.
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.
Tax Qualified: The tax deductibility of
long-term care insurance premiums depending upon
meeting the federal government's threshold of
personal adjusted gross income.
Total Parenteral Nutrition (TPN):
Typically administered through a large vein in
the body because of its high concentration of
ingredients. Individuals who are unable to eat
or who do not receive enough calories, essential
vitamins and minerals from eating can receive
enough nutrients from TPN to maintain their
weight. This type of nutrition requires a
doctor's order.
Traumatic Brain Injury (TBI): Usually the
result of a sudden, violent blow to the head.
Such a blow can launch the brain on a collision
course with the inside of the skull. The skull
itself can often withstand a forceful external
impact without fracturing. The result — an
injured brain inside an intact skull — is known
as a closed-head injury.
Urostomy Pouch: A pouch that is worn to
collect urine if a patient has had a urostomy.
This is a surgery done to create an opening in
the abdomen that urine passes through. This is
performed when a bladder has to be removed or
isn't functioning properly.
VA Benefits: Benefits allowed to veterans
for housing and care.
Ventilator: Also known as a respirator,
is a machine that pushes air into the lungs
through a tube placed in the trachea (breathing
tube). Ventilators are used when a person cannot
breathe on his or her own or cannot breathe
effectively enough to provide adequate oxygen to
the cells of the body or rid the body of carbon
dioxide. |
