The abandoning of an elderly person by the person responsible for their care and/or well-being.
Accelerated Death Benefits
The payment of the death benefit when the insured, usually a terminally ill person, is still alive in order to cover the costs of long term care services.
An apartment within a single-family house. This provides a separate personal living space for senior people who want to stay in their homes and a source of assistance and care from a friend, neighbor, or loved one.
A process of formal recognition that certifies a senior housing or service provider. An accreditation means that a provider has been thoroughly evaluated and meets set requirements and quality standards
Activities Of Daily Living (ADLs)
Activies carried out on a daily basis normally performed for self-care such as personal hygiene, toilet functions, eating, dressing and undressing, and moving around.
The necessary treatment provided for a brief but severe medical condition from which a patient is expected to recover and be able to resume normal daily living activities. Most acute patients aged 65 and older are covered by Medicare.
ADA (Americans With Disabilities Act)
A wide-ranging civil rights law, passed by Congress in 1980, that prohibits discrimination based on disability.
A device or modified appliance used to assist with daily living activities for self-care, work or leisure.
Administration On Aging (AOA)
The AOA is an Agency of the U.S. Department of Health and Human Services is a federal level advocate for older persons and their concerns.
A person responsible for the day-to-day management and operation of a health care or assisted living facility.
Adult Day Care
A non-residential service providing daily structured programs in a community setting. The programs usally consist of activities and health-related rehabilitation services for ederly persons in need a protective environment. These services are provided during the day, with the elderly person returning home in the evening.
Written instructions detailing an individual's preferences and directions regarding health care in the event that they are no longer able to make decisions due to illness or incapacity.
Age-Associated Memory Impairment
Not to be confused with forms of dementia, Age-Associated Memory Impaiment is a normal mild memory loss that increases with age.
Aging In Place
An idea that allows a senior to live in his or her home for as long as possible.
An incurable, age-related, degenerative and terminal disease that impairs an individual's cognitive ability. Alzheimer's is the most common form of dementia and is caused by neuron dysfunction and death in specific brain regions responsible for cognitive functions. Generally diagnosed in people over 65 years of age, symptoms may include forgetfulness, wandering, and inability to recognize others.
An assisted living residence or nursing facility with special amenities, either separate units and/or a program, to accommodate residents with Alzheimer's disease or other cognitive impairments. Programs usually feature specially designed secure environments with structured activities and greater staff-to-resident ratios.
The ability to be mobile, walk around, not confined to a bed or hospital.
An acquired language disorder; characterized by the loss of the ability to understand language and/or express oneself.
A disroder of motor planning; characterized by the loss of the ability to execute or carry out a complex or skilled movement due to deficiencies in cognition.
Area Agency On Aging (AAA)
A national network of State and local programs that provides seniors with information and referral services to help with their needs including; in-home services, counseling, legal advice, adult day care, skilled nursing care/therapy, transportation, personal care, respite care, nutrition and meals.
The process of documenting, usually in measurable terms and performed by a physician, a person's mental, emotional, and social capabilities.
Assignment Of Benefits
Long-term care insurance policy provision which allows the insured person (or his/her authorised agent) to assign payments of all or a share of their benefits directly to their health care provider(s).
A living arrangement in which people with special needs, especially older people with disabilities, reside in a facility that provides help with everyday tasks such as bathing, dressing, and taking medication. Generally, these are state-licensed programs whose exact definition and coverage will vary from state to state.
Assisted Living Activities
An Elderly Care Facility should have a wide range of activities but also have a set routine of activities. Sometimes having new and different activities can be fun but maintaining some routine is very helpful. Bridge, dominoes, and bingo are among the routine activities typically found at an assisted living facility. It is important to make sure that these are routine activities in the facility you are looking at. Social Activity is only as fun as it is encouraged among the residence at a care facility. Going above and beyong would mean that the assisted living activities director cares deeply for the residence and her job. He or she will work very hard to make sure the activities are fun and respectful to the residence. A patient and considerate activities director are important qualities to look for. You don't just want someone who is just trying to make their next pay check but cares nothing for the residants.
A selection of equipment and products intended to allow elders and/or people with disabilities to live more independently. Examples include walking aids, communication devices, elevated toilet seats, and special telephones for people with hearing impairments.
Healthcare professionals specializing in identifying, diagnosing, and treating of hearing impairment or hearing loss.
A reservation that places a nursing home bed on hold while a resident is away for a short period; such as being temporarily hospitalized or on therapeutic leave.
More properly known as pressure ulcers or decubitus ulcers, bed sores are skin lesions caused by poor circulation due to prolonged pressure to body parts.
Confined to a bed because of age or illness; bedridden.
A person or entity named in a will, trust, insurance policy, retirement plan or other financial contract who is entitled to receive the benefits or proceeds. Persons who are covered by Medicare are also called beneficiaries
The length of time, in years, during which a benefit will be paid by an insurance policy. Buyers usually have a choice when deciding on a benifit period from many long-term care insurance policies.
An event or events that must occur before an insured person can receive benefits under a long-term care insurance policy.
A payment from an insurance policy made to an insured individual or to his or her assigned beneficiary, such as another person or a health care provider.
Board And Care Homes
Facilities that offer a group living environment for seniors or individuals with disabilities who may need help with some activities of daily living, but do not require the services of a nursing facility. Payment assistance for this type of living may be available through private long-term care insurance and medical assistance programs.
A person physically entrusted with the care of another person when that person is no longer able to fulfill that role.
A person, usually a nurse or social worker, who assesses, organizes and monitors long-term care services for patients.
Prepared or approved by a doctor, a care plan is a document that outlines the basic care and services a patient needs for his or her individual health problem.
A person or persons who provides every day direct care in an elderly living environment. Often times they are certified professionals who may assist with the activities of daily living.
Education and instruction provided to family caregivers. This training is usually conducted by way of workshops and conferences and is designed to increase confidence and the ability handle difficult situations.
The formal process designed though care professionals that evaluates, plans, and makes possible the services to meet an individuals health needs.
A prepared process used to assess a establish patients' needs for health care resources within a nursing facility. The evaluation is based upon a medical and psychiatric analysis, as well as a patients functional ability to perform activities of daily living (ADLs).
Assistance given by a person or an agency in the construction, execution and monitoring of an individual’s care plan.
A tubular medical device inserted into a body cavity or vessel to allow the transfer of fluids. Commonly used with a receptacle bag to manage urinary incontinence.
Center For Medicare And Medicaid (CMS)
A component of the Department of Health and Human Services, CMS funds and governs the Medicare and Medicaid programs; which includes setting operating standards for nursing facilities receiving funds under these programs. The CMS was formerly known as the U.S. Health Care Administration.
Certificate Of Medical Necessity
A piece of paper certified by a doctor that substantiates a patient’s need of a piece of durable medical equipment, such as a wheelchair or walker.
A health care facility or agency that meets Medicare and Medicaid requirements. Only certified facilities and agencies are covered by Medicare, Medicaid and some insurance policies.
Certified Home Health Care
Intermittent health care and support services to individuals who need intermediate and skilled health care in their home. These services can include: nursing services; home health aide services; medical supplies, and at least one additional service such as, nutritional services and social work services.
Certified Nursing Assistant (CNA)
Individuals who are trained and certified to assist patients with the activities of daily living under the supervision of a Registered Nurse.
A nurse in charge of a nursing facility unit. This is a Registered Nurse or Licensed Practical Nurse, in charge of nursing schedules, nursing staff and overall resident care.
Chronic Illness Or Condition
A disease that is persistant, long-lasting and can’t be cured. When applied to disability, it can mean a lasting medical condition that requires a long period of care.
Chronic Obstructive Pulmonary Disease (COPD)
A persistent, long lasting breathing condition distinguished by restricted air flow due to airways in the lungs being partly blocked. COPD includes chronic bronchitis, emphysema or both.
Chronically Ill Individual
A person who has been certified by a licensed health care practitioner, within the preceding 12-month period, as being unable to perform at least two activities of daily living due to a loss of functional capacity for a period of not less than ninety consecutive days or a person that requires substantial supervision due to severe cognitive impairment.
A supplement or amendment, provided in writing, to a will
The mental process of knowing; including using abilities like awareness, perception, reasoning, and judgment.
Refers to the ability to use the mental process of knowing; including using abilities like awareness, perception, reasoning, and judgment.
The decline of cerebral facility, such as forgetfulness, disorientation and the ability to complete simple tasks, to the degree in which an individual is in need of extensive supervision. Alzheimer’s disease and senile dementia are examples of cognitive impairment.
The remaining principle after deductable and insurance amounts are applied to a health bill. For Medicare, it is the proportion of the Medicare approved amount a patient must pay (after the deductible). For other insurance, it is the remaining percentage that is unpaid. For example, if the insurance company pays 75 percent of the bill after the deductable, then the remaining 25 percent is the patients coinsurance.
Also referred to as Supervision Respite, this service provides home based care of seniors while the family caregiver is on a short term absence.
Congestive Heart Failure (CHF)
A condition in which the heart is unable to pump an adequate amount of blood to the tissues.
Congregate Meal Programs
Nutritional programs that provide lunches in various community locations for older adults Monday through Friday.
The voluntary control of excretory functions and/or the ability to perform personal hygiene such as caring for a catheter or colostomy bag. This is normally identified as an activity of daily living.
Continuing Care Retirement Communities (CCRCs)
Assisted Living housing communities which provide care at different levels. Care options can range from independent living apartments to skilled nursing and is based upon the needs of the residents. As an individual’s needs change, he or she can be moved from level to another and keep on being a part of his or her CCRC’s community. CCRCs charge monthly fees, and usually require an endowment (a significant payment) prior to admission.
Continuum Of Care
A term that refers to the entire range of care offered at Continuing Care Retirement Communities. The Continuum of Care options may include Independent Living, Assisted Living, Skilled Nursing Care, Home Care, and other services
Coordination Of Benefits
A health insurance provision that specifies tells which health plan, or insurance policy, pays first if two sources of health coverage cover the same benefits. Federal law may make the determination if one of the sources is Medicare.
A payment defined in a insurance policy and paid by an insured person each time a specific medical service is accessed. Examples include small fees for office visits and prescriptions.
Covered Benefit Or Service
Health items or services fully or partially paid as part of an insurance policy or plan
Benefit or service fully or partially paid for as part of a health plan.
Assisting the actions of a person who is cognitively impaired. This may consist of showing and reminding a person how to perform the activities of daily living, such as eating, dressing and toileting.
Custodial Care (Personal Care)
Care for individuals who need assistance with non-medical activities of daily living. Professional training is not required to administer this type of care. Custodial care is not covered by Medicare and Medicaid coverage is extremely small.
The daily dollar amount an individual chooses as the base benefit for his or her long-term care insurance. The daily benefit is computed based upon eligibility and is derived from one of the following methods: Expense-Incurred Method, Indemnity Method, or Disability Method.
An amount defined in a policy and paid by an insured person, usually on an annual basis, before insurance or Medicare benefits are applied.
A progressive loss of mental ability affecting memory, judgment and cognitive powers severe enough to interfere with the normal activities of daily living.
One who relies on another for financial support, usually a spouse or a child. A child being any natural or legally adopted child under the age of 18 and residing at the same residence or any child over the age of 18 that has been legally certified as handicapped.
Persons who need health care and are between the ages of 18 and 64.
A mental state of altered mood characterized by sleeping difficulties and feelings of sadness, despair, and discouragement. One of the most undiagnosed conditions among elderly patients, depression is reversible with proper medical attention.
Developmental Disability (DD)
A substantial handicap of indefinite duration characterized by chronic physical and mental disabilities such as mental retardation, autism, cerebral palsy, epilepsy, or other neuropathy.
Diagnostic Related Groups (DRGs)
A system to classify hospital cases based upon resources consumed. The resulting DRG classification code is used to determine a the amount Medicare will reimburse a hospital for individual in-patient services.
Director Of Nursing (DON)
A director of nursing (DON) is responsible for the performance of a nursing staff in a health care facility. The position requires extensive nursing experiences and the ability to direct and motivate others. A DON is in charge of setting nursing polices, overseeing the quality of care and ensuring the facility complies with federal and state regulations.
A person, usually a social worker, who aids hospital patients in transitioning from a hospital setting to another form of health care such as home care or a long-term nursing facility.
Part of a nursing facility that acts as a separate unit with beds reserved only for people whose care is covered by a distinct source. One example may be people who are covered by Medicare.
Do Not Resuscitate (DNR)
A written legal document that states resuscitation should not be attempted on a patient. This can also apply to the application of artificial life support.
Donning and removing clothing and any related items such as braces or fasteners. This is normally identified as an activity of daily living.
A person who qualifies for multiple insurance coverage, such as both Medicaid and Medicare
Durable Medical Equipment (DME)
Medical equipment that is reusable. Wheelchairs, walkers and hospital beds are examples of Durable Medical Equipment (DME) which, in some cases, can be paid by Medicare with a doctor’s approval.
Durable Power Of Attorney For Health Care (DPAHC)
This is a type of advance directive in which an individual generates a legal document giving another individual the power to make health care decisions in the event they are unable to make those decisions for themselves.
A medical condition in which a person has difficulty swallowing.
The action of feeding oneself. This means getting food from a plate, cup or bowl and into the body. This is normally identified as an activity of daily living.
Swelling which is caused by a collection of fluid in the tissues.
A program design to inject life into nursing facilities through the concept of involving the residents with children, plants, and animals as a part of daily facility life.
By definition, the term Elder is a surname that means older than you. In the United States, Americans tend to interchange the term with senior citizen which typically refers to people in the 65-and-over age group.
A umbrella term used to describe one or more of the following: physical, sexual, financial or emotional abuse of an elderly person (65 or older). The term can also refer to the Isolation, neglect and self-neglect of an elderly person.
Elder Abuse Hotline
If Elder Abuse is suspected, the phone number to call is (877) 477-3646 [4-R-SENIORS]. For emergency’s call 911 or your local law enforcement agency.
Typically, elder care is considered custodial care, the type of care not covered by Medicare. Elder care encompasses a wide range of services than can be administered in various settings that homes, assisted living facilities and skilled nursing facilities. Elder care is usually provided over a long period of time and includes health-related services as well as supervision and a wide range of personal and social services.
A period of time an individual must make premium payments on an insurance policy before benefits can be paid. Typically, no benefits are paid during an elimination period unless specifically noted in the policy.
Emergency Response Systems
An automatic response system for medical, or other, emergencies triggered by electronic monitors on a person or in a home.
End Stage Renal Disease (ESRD)
Also referred to as chronic kidney disease (CKD) stage 5, this is a severe loss of kidney function with poor life expectancy without dialysis or a kidney transplant.
An adult care facility licensed to provide long-term residential care to five or more adults, for the most part senior citizens (65 years or older), in community type settings similar to independent housing units.
A term meaning all of a person's property, entitlements and obligations at the time of his or her death.
. It is a tax on the total value of the money and property of an individual who has died.
An exception in an insurance policy specific to a health condition, situation, service or expense that is not covered by the policy.
A legal term referring to a person or an organization named by a will, or by a court, to carry out the directions of the will.
Fee For Service
When doctors and other health care providers charge for each visit or service provided.
An itemized list of acceptable charges (or established allowances) for specific health care services including medical, dental, or other services. The schedule usually corresponds to the standard or maximum charges, by a doctor or an insurance provider, for the listed procedures.
A tubular medical device used to drain urine. A tube is inserted into the bladder and the urine is drawn through the tube and collected in a plastic receptacle bag.
An insurance policy trial period (usually 30 days) in which a person can change his or her mind and cancel for any reason. If a policy is cancelled during this period, all premiums are refunded and no claims are paid.
Geriatric Care Manager
A health care professional trained to work with seniors. Care Managers assist individuals and their families in creating and implementing a care plan to meet the individual’s medical and financial needs.
A doctors who specializes on medicine that focuses on health care of the elderly and to prevent and treat diseases associated with getting old.
A subspecialty of medicine that focuses on health care of the elderly and to prevent and treat diseases associated with getting old.
Allows people not capable of eating by mouth to take nourishment through a tube surgically connected to an opening in the stomach.
This is the time period past the deadline for which a person’s premium is due. Policies remain active but will be terminated if premiums are not paid be the end of the grace period, typically 30 days.
This refers to a policy that an insurance company cannot cancel, regardless of changes to the health, employment or martial status of the insured.
An individual designated by a court to be legally responsible for the care of another individual.
A court order restriction of an elder’s legal rights based on incompetence. Anther person is appointed by a court and charged with the duty of managing the elder’s legal dealings.
Personal physical aid that a person requires in order to carry out a normal every day task.
Health Care Directive
Written instructions allowing an individual to designate another individual to be his or her agent in regards to health care decisions.
Health Care Power Of Attorney
This is a type of advance directive in which an individual generates a legal document giving another individual the power to make health care decisions in the event they are unable to make or communicate those decisions for themselves.
Health Maintenance Organization (HMO)
A type of controlled care system that provides a form of health care coverage throughout the United States fulfilled by doctors, hospitals and other providers enrolled in the specific HMO system. The system is an agreement by the health care professionals to provide health care for a specific amount of money. Most people who are 65 years or older use an HMO associated with Medicare.
HIPAA (The Health Insurance Portability And Accountability Act Of 1996)
Made into law on January 1, 1997, this act lists the requirements that a long term care policy must follow in order for paid premiums to be considered deductable medical expenses and for benefits not paid to be considered taxable income.
Home Care Services
Assistance given to persons in their own home. This assistance can either be in the form of household activities such as cooking , cleaning or doing laundry or it can be in the form of health care activities required for daily living or necessary medical procedures.
Home Health Agency (HHA)
An organization that makes medical services available to individuals in their own living environment. Services providers may include: Nurses, therapist, social workers, or home health aides.
Home Health Aides
Persons who provide every day care to individuals in their own living environment. State requirements vary, but services are considered to be non-medical and usually relate to performing daily living activities, doing minor household chores and medication management.
Home Health Care (Home Care)
Assistance given to persons in their own home. This assistance can either be in the form of house care activities such as cooking , cleaning or doing laundry or it can be in the form of health care activities required for daily living or necessary medical procedures.
When a person is confined to his or her home, usually for medical reasons.
Household activities such as cooking, cleaning, laundry and shopping that are performed by another person because the homeowner is unable to perform them. In most states, homemakers are not certified to perform hands-on care.
Type of care which focuses on comforting and improving the quality of life for persons diagnosed with a terminal illness. Hospice care is typically provided in a person’s home but can be provided in a specialized hospice or hospital.
The evaluation of an individual from their house instead of in a different setting
The loss of voluntary control over excretory functions (urination, bowel movements or both).
Could also be known as Congregate Housing or Senior Apartments. A multi-unit housing facility provided for people who have reached a certain age (usually 65 or older). Services for these types of developments can vary greatly, depending on its arrangement. The facility may provide supportive services such as meals, housekeeping, social activities, and transportation or the facility may contain little or no services at all.
When a person is admitted as a patient to a hospital (or other health facility) and stays overnight or for a longer additional amount of time.
To commit or place a person into an institution. Usually happens in situations in which persons are no longer able to care for themselves because of mental illness or health problems.
The complete separation of a person from all contact with what is real.
Infusion therapy deals with all aspects of intravenous fluid and medication administration. Fluids and/or medications are administered directly into the blood stream through an intravenous tube inserted into a vein. Some examples of Infusion therapy treatment include; antibiotics, include total parenteral nutrition, hydration, pain management, and cancer chemotherapy.
A mini-kitchen that typically contains a sink, a small refrigerator, a microwave, a little bit of cabinet space and a few dishes.
Length Of Stay
The period of time that a person resides as a patient in a hospital.
When the state Insurance Commissioner grants permission for a standardize raise in premiums for an entire class of insurance.
Licensed Health Care Practitioner
In individual who meets the requirements set by the U.S. Treasury Department, such as a doctor of medicine, registered nurse, licensed social worker, or any other health care professional.
Licensed Practical Nurse (LPN)
LPN’s provide a large portion of patient care in a variety of settings such as hospitals, long term care facilities and home care. LPN’s need one year of post high school education and are required to pass a state license exam.
Life Care Community
A life-care community, also known as a Continuing Care Retirement Community (CCRC), is a type of retirement community which provides all levels of care in a single residence. In Addition, CCRC’s offer an insurance type of contract with a consistent monthly fee regardless of medical care required.
The total lifetime policy benefits obtainable by an insured person.
Limited Payment Option
An insurance option in which premiums are only paid for a set time period. Once the last premium is paid, the policy is considered paid-in-full for the remaining length of the policy. During the set period in which premiums are being paid, this policy option is more expensive than a continuous payment policy option.
Living trusts, either revocable or irrevocable, are created during a person’s lifetime to consolidate assets or to save money on taxes. All living trusts are designed to avoid probate proceedings and may be used to regulate assets if the owner becomes incapacitated.
A type of advance directive in which an individual generates a legal document giving specific instructions for treatment in the event he or she can no longer make decisions due to illness or becoming incapacitated.
Long Term Care (LTC)
This refers to the entire range services, both medical and supportive, available for people with a chronic illness or condition and are in need of such service for an extended length of time.
Long Term Care Insurance
Insurance coverage designed to assist with long-term medical and non-medical expenses. Some of these policies can offer be a source of potential tax benefits.
Long Term Care Ombudsman Programs
A nationwide network of services designed to solve problems between resident patients and long term care facilities. These are independent and federally-funded services.
A variety of techniques used to combine insurance with health care in order to reduce the cost of health benefits while improving the quality of care.
Mandated reporters are professionals who have regular contact with disabled persons and/or senior citizens, such as health care professionals, social workers, clergy members, law enforcement professionals and persons who have assumed care responsibility for an elderly or dependent person. These persons are required to report any observed or suspected cases of abuse (financial, physical, or other types) or evidence of neglect.
A health insurance assistance program that is jointly funded by Federal and State. The programs offers benefits to the elderly, the disabled and persons with limited financial resources; all of whom must meet eligibility requirements. Medicaid is the source of payment for almost 70 percent of residents in nursing homes and accounts for about 52 percent of the nation's total care costs.
A bed located in a nursing facility that has been certified as having met the federal standards required for recipients of Medicaid.
The person responsible for all medical care related policies, to include the setting of policies and ensuring they are carried out in an appropriate manner. At times, this could the require the coordination of facility care to that which is set by a resident’s primary physician.
Medical Records Director/Coordinator
The individual who plans and directs the personnel responsible for coordinating facility medical records and nursing clerical needs.
Establishing proof that a medical test or procedure was needed. Usually required in order for an insurer to make payment on a claim.
A US Government administered medical insurance program, governed by the Social Security Administration. This program provides health insurance coverage to people who are aged 65 and over, or people meeting other criteria, regardless of income.
Medicare Part A
Part of the Medicare program that most people automatically qualify for when they reach the age of 65. This insurance covers the cost of inpatient hospital stays, convalescent stays in a skilled nursing facility, hospice care and some home care.
Medicare Part B
Part of the Medicare program that requires a monthly premium to be received. This insurance covers the cost of medical services that Part A does not cover like doctors’ services, outpatient hospital care and some home health care. Part B usually requires proof of medically necessary.
Medicare Supplemental Insurance
Often referred to as Medigap, this is private insurance that pays for Medicare's deductibles and for services that Medicare may not cover. In addition, most Medicare Supplemental Insurance policies will assist with the cost for skilled nursing as long as it is covered by Medicare.
A bed located in a nursing facility that has been certified as having met the federal standards required for Medicare recipients in need of skilled nursing care.
An official process, used in an assisted living or similar setting, which produces a written set of rules for self-administered medicine. In keeping with the rules of this program, a facility may remind a resident but her or she must take the medicine by themselves.
Used as a supplement to Medicare, this is private health insurance that covers the cost of health care services not covered by Medicare Part A of Part B. This coverage is primarily intended for hospital and doctor bills, long term care benefits are not included.
A person who can no longer be depended on to protect themselves or others, or to even recognize the differences between right from wrong, due to the deterioration of mental facilities.
Nasogastric Tube (NG Tube)
A tube inserted into a patient’s nose that passes through the throat to the stomach used to feed a patient and/or remove stomach acids.
When a person is not able to walk. More often than not, the person is confined to a bed or hospital.
The day to day care for a person, such as all the Activities of Daily Living, that does not have to be administered by a Registered Nurse or a Physician.
These are benefits that come into affect after a long-term insurance policy has been in force for a predetermined period of time and cannot be forfeited if the Long-term insurance policy is allowed to lapse. Instead of being cancelled, the nonforfeiture benefits keep the policy in force, but typically in a reduced capacity (same benefit with a shorter period or same period with a reduced benefit).
Individual’s working under the supervision of a Registered Nurse or Licensed Practical Nurse, who provide most of the personal care and assistance with daily living activities to residents. A Nurse Assistant must be certified to provide care in nursing facilities that participate in the Medicare and Medicaid programs.
Nursing Facility (NF)
A "Nursing Facility" or "NF" is a nursing home certified to participate in, and be reimbursed by Medicaid. These are licensed facilities that provide custodial, rehabilitative, specialized care and therapy services for residents as well as offering a variety of organized social and recreational activities.
A state licensed facility that provides 24-hour nursing care and activities for residents. Nursing homes require that regular medical supervision and rehabilitation therapy be available, and nursing homes an option to participate in Medicare and/or Medicaid. All or part of a nursing home may participate in Medicare and/or Medicaid and if "certified" they are also subject to federal laws and regulations.
Nursing Home Abuse
This refers to elderly abuse associated with a nursing home or a licensed board and care facility and can be one or more of the following: physical, sexual, financial or emotional abuse of an elderly person (65 or older). The term can also refer to the Isolation, neglect and self-neglect of an elderly person. All cases of suspected abuse and fraud associated with nursing homes or licensed care facilities are to be referred to the Ombudsman Program. All other abuse should be referred to the Elder Abuse Hotline.
A licensed health care professional, specializing in rehabilitation, who teaches people to compensate for functional limitations. Occupational therapists assist people by teaching them skills and techniques used to carry out the activities of daily living and increase self reliance .
A process in which individuals relearn skills and techniques used to carry out the activities of daily living and increase self reliance. Occupational therapy is generally managed by a licensed occupational therapist.
Any place, institution or facility where a person is living and receiving care, that is not the residence they grew up in or lived in prior to moving to their present location. Typical examples include Nursing homes and Assisted Living Facilities.
The maximum yearly amount of money, in addition to his or her premiums, a person will be required to pay for his or her health insurance plan’s deductibles and coinsurance. Depending on the insurance policy, a maximum may be applied to an entire family or to each family member.
Outline Of Coverage
A description of policy benefits, exclusions and provisions that makes it easier to understand a particular policy and compare it with others.
When a patient receives care for a medical condition that does not require admission to a hospital or other medical facility.
A long insurance policy is considered paid-up after it has been in force for a predetermined period of time and the policy holder stops paying his or her required premiums. At this point the policy holder may be entitled to nonforfeiture benefits, the calculation of which are based upon the total amount of premiums that have been paid to the policy.
Paratransit Services, which may also be known as Dial-a-Ride, provide special transportation services that are available for seniors and other people with disabilities. Most paratransit vehicles are equipped with wheelchair lifts or ramps to facilitate access and acts as an alternative mode of flexible passenger transportation to senior centers, medical care, shopping malls, or specific appointments.
Offered by only a few states, this is a type of long-term care policy that enables asset protection if a person applies for Medicaid after using up his or her policy’s benefits.
This is a standardized instrument which allows a nursing home to establish a patient's abilities. With this, they can determine what assistance the patient needs and decide upon a plan to help the patient improve or regain abilities. This is also referred to as a resident assessment.
Patients' Rights Advocate
A person who is charged with the responsibility of investigating and resolving violations or abuse complaints that have been received from mental health recipients against a licensed health or community care facility. Also acts as a representative for individuals who are unable or afraid to register a complaint. This includes representing the individual during the dispute resolution process and assist individuals with other problems experienced in the health care system.
Period Of Confinement
The time period for which a person receives care for an illness covered by his or her policy. This period is over when the person is release from care for a predetermined amount of time.
Personal Emergency Response System
An electronic device that enables a user, through the press of a button, to receive 24-hour help services that can be used in case of a fall or other medical emergency.
A licensed health care professional, specializing in rehabilitation, who makes use of various therapies to help people regain mobility, strength and body movement after an illness or injury.
A course of action that consist of individualized exercise programs designed to help people regain mobility, strength and body movement after an illness or injury. Physical therapy is generally managed by licensed physical therapists who plan and administer treatment programs for residents.
Power Of Attorney For Health Care
This is a type of advance directive in which an individual generates a legal document giving another individual the power to make health care decisions in the event they are unable to make those decisions for themselves. This document can contain specific instructions concerning which medical treatments should or should not be administered.
This is a personal evaluation that is conducted to determine if a person ought to be admitted to a nursing faculty or other Medicaid eligible long term care facility. Screenings are conducted by trained teams and will evaluate a person’s functional, social and medical needs.
Medical conditions that were known to be present prior to an insurance policy being taken out. Benefits for preexisting conditions may be limited on some long term care insurance policies.
Preferred Provider Organization (PPO)
A type of managed care plan. Members have a choice of using the healthcare providers in the PPO network or paying an additional cost to use healthcare providers outside of the PPO network. PPO plans have been made available to Medicare beneficiaries in 23 states.
Primary Care Physician
The doctor an individual will see first for most health problems. This doctor is trained in basic care and will make sure the individual will get the care he or she needs to stay healthy. This doctor may talk or refer you to other specialist as required. However, many health plans require that you consult your primary care physician before seeing any other doctors or healthcare providers.
An individual who accepts and takes on the primary every day duty of caring for the needs of another individual. This role is typically taken on by the spouse or adult child of the individual who requires care.
Private Pay Patients
These are patients who’s care is paid for from a private source instead of by a governmental program such as Medicaid, Medicare, and Veterans Administration. The private source can be the patient themselves, their family or another third party such as a private insurance company.
An individual or agency properly-licensed to provide health care or related social services.
A federally-funded (HUD funded) or state funded, independent living community that has limited assets and managed by a civic housing authority.
Qualified Long-Term Care Insurance Policy
Also referred to as a Tax-Qualified Long-Term Care Insurance Policy, this is a policy that conforms to federal law and may offer potential federal tax advantages.
Qualified Long-Term Care Services
The long-term or custodial care services designed to minimize or compensate for the loss of functioning due to age, disability or chronic illness and are provided in accordance with a plan of care approved by a licensed health care practitioner.
Qualified Medicare Beneficiaries (QMB)
Persons who qualify, based on income and resources, for additional Medicare benefits. In this case, states are required to pay Medicare deductibles, co-payments and Part B premiums.
Care and services that allow an individual to attain his or her highest functioning level as possible. Functioning level refers to the highest level of mental, physical, and psychological function, that can be achieved in a dignified and caring way.
Quality Elderly Care
Care and services that allow an elderly individual to attain his or her highest functioning level as possible while maintaining dignity and feeling cared for. Functioning level refers to the highest level of mental, physical, and psychological function, that can be achieved in a dignified and caring way.
Range Of Motion (ROM)
The movement of a limb or joint to the degree in which there is no pain.
Reasonable And Necessary Care
The acceptable type and amount of health services required for treatment of any specific illness, as recognized by the health community.
Registered Nurse (RN)
A nurse who has a minimum of two years of college, has passed a state board examination, and has been licensed to practice nursing by a state agency. The RN develops and monitors resident care plans and administers skilled nursing treatments as required.
Healing and restorative care for persons requiring rigorous therapy (physical, occupational, or speech).
When a long-term care insurance policy is restored to it previous effective state. In a case in which a policy lapses occurs due to a cognitive impairment on the behalf of the insured person, the policy can usually be retroactively reinstated to the date of lapse. Most states allow this type of reinstatement. The following restrictions usually apply: The insurance company must receive a reinstatement request within six months from the date of lapse, the insured must meet the cognitive impairment requirements set by the insurance company, and the insured must pay all premiums that are past due.
When a policy is retroactively canceled to its effective date by the insurance company.
An individual who resides in a long-term care facility. Residents may also be referred to as a patient, since nursing facilities are licensed health care facilities.
Resident Assistant (RA)
RAs are non certified individuals who work and provide direct personal care services and assistance to residents in an assisted living environment. This position may also be available in nursing facilities in some states.
Resident Care Plan
A specific written document that defines the plan of care for nursing facility residents that will meet all of a resident’s specific needs. The plan is developed by an interdisciplinary team and contains specific measurable objectives and time requirements for provided services.
Residential Care Facility
A common term for a long term care environment that provides supervision or assistance with activities of daily living. The environment can take the form of a group home, specialized apartment complex, assisted living facility, skilled nursing facility or any of a number of other types of institutions that provide care services where individuals live.
Respiratory therapy is a career field that involves the study and treatment of diseases that relate to the lungs or cardiovascular system. The primary goal is to assists patients with breathing difficulties, reduce fatigue and increase a patients tolerance in performing daily activities.
Respite care is also known as caregiver relief, as it can provide the impaired person's caregiver with needed time away from the patient. This type of care can last from several hours to several days and can be provided in-home or in a residential care setting.
An amendment or an add-on to an insurance policy that modifies the provisions of the policy.
A condition in which an individual fails to attend to their basic needs, such as personal hygiene, appropriate clothing, feeding, tending appropriately to any medical conditions, and reasonable financial management.
Multiunit living facilities that are maintained for the use of people who have reached retirement age. These are self-contained units for older adults who are able to care for themselves.
A senior center is a place in a community where seniors can gather for support, socialization, fitness and/or other services provided for older people.
A common and polite term which means elderly person and it implies or means that the person is retired.
Senior Citizen Policies
Insurance policies for individuals that are over the age of 65.
Independent living facilities, generally apartments, that are maintained for the use of people who have reached retirement age. These are self-contained units for older adults who are able to care for themselves. Any needed supportive services are aranged between the tenant and the service provider.
A term that refers to a person of old age.
A set of safety rails that are attached to a hospital-type of bed that are meant for patient protection.
A provision for 24-hour care and observation of individuals whose needs are usually critical enough where they need constant watching, but not serious enough where hospitalization is required.
Skilled Nursing Care
Any care service that must be done by, or under the supervision of, a Registered Nurse. Intravenous injections, tube feeding, and changing sterile dressings on a wound are examples of skilled nursing care.
Skilled Nursing Facility (SNF)
A skilled nursing facility is a location dedicated to the care of individuals in a residential type facility, in most cases a nursing home. These facilities specialize in the 24-hour care, have been certified by Medicare, and have the staff and equipment available to provide skilled nursing care and other related health services.
Special Care Units (SCUs)
Are facilities within nursing homes and residential care facilities that have special accommodations for persons with Alzheimer’s disease or related dementia. Special Care Units (SCUs) exist to better meet dementia residents' needs and to protect residents without dementia or Alzheimer’s.
A licensed health care professional, specializing in rehabilitation, who helps people overcome speech and communication problems, such as speech difficulties that arise after a person has a stroke. A speech therapist may also assist with difficulties related to swallowing.
A service designed to help people overcome speech and communication problems such as speech difficulty following a stroke, aphasia, swallowing difficulties and voice disorders. Some of the costs of speech therapy may be covered by Medicare as long as the patient meets requirements.
This is comprehensive care designed for persons who have an acute illness, injury, or serious medical condition that is not urgent or life-threatening. Typically following a stay in a hospital, sub-acute care may include long-term ventilator care or other routine procedures.
Sub-Acute Care Facilities
Special units in a nursing facility that provide comprehensive inpatient care for individuals who require short-term or rehabilitation services but no longer require the level of care provided by a hospital.
Subsidized Senior Housing
Subsidized senior housing is a form of housing which is made accessible through Federal and State government assistance to older people with low to moderate incomes.
Calls that are typically made at a predetermined time of day by agencies or volunteers to an elderly person. The purpose of these calls are to check up on the elderly person, while at the same time offering reassurance, contact and socialization.
Term Life Insurance
Life insurance coverage that covers a person for a predetermined period of time, usually for one or more years. It usually does not build in cash value and only pays a death benefit if the insured dies during the term.
The activities associated with going to and from the toilet and performing the related personal hygiene. This is normally identified as an activity of daily living.
A legal relationship whereby property is managed by one person or institution, referred to as the trustee, for the benefit of another person, referred to as the settlor.
The process of assessing the eligibility of a customer to receive insurance. Once a person is accepted, he or she is further classified in order to determine the proper premium.
Universal Life Insurance
Life insurance coverage that allows a person to periodically adjust premium payments and amount of his or her coverage.
Also known as a respirator, a ventilator is a machine designed to mechanically move breathable air into and out of the lungs, to provide the mechanism of breathing for a patient who is physically unable to breathe, or breathing insufficiently.
Waiver Of Premium
This is a provision in an insurance policy which stipulates when premiums do not have to be paid under certain specified conditions.
Whole Life Insurance
Life insurance coverage that covers a person for as long as he or she lives provided that premiums continue to be paid. This type of coverage typically builds in cash value.
A type of advance directive in which an individual disposes of property after death.