Important Definitions

KEY DEFINITIONS HELP YOU MAKE INFORMED DECISIONS

At Always Best Care Senior Services, we believe that an educated, informed consumer makes the best decisions.

Our objective is to help you make informed decisions about important health care issues and how they affect your daily life. Because we respect your right to make those decisions, our emphasis is on providing a variety of resources from a wide spectrum of viewpoints, not on simply presenting our own opinions.

We have pulled a variety of terms and phrases that are typically associated with senior housing and assisted living, and we are pleased to present definitions for each of these to you. If you have any questions about these definitions, or the activities, issues or places they describe, please contact the local Always Best Care office nearest you.

A

Accreditation

A Seal of approval given by a governing body to a housing and/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 accrediting organizations are not government agencies or regulatory bodies. Examples of some accreditation bodies for the senior housing and care industry include CCAC (Continuing Care Accreditation Commission), CARF (Commission on Accreditation of Rehabilitation Facilities), and JCAHO (Joint Commission on Accreditation of Health care Organizations).

Activities of Daily Living (ADLs)

Everyday activities such as (bathing, grooming, eating, toileting, and dressing).

Acute Illness

A serious illness such as a heart attack or stroke that develops rapidly with pronounced symptoms. The illness can be of short duration such as influenza.

Adaptive Devices

A variety of devices that are used to increase, maintain, or improve the functional capabilities of individuals, providing the assistance needed to stay at home. These devices may help with vision, hearing, mobility, communication, or other needs, and include wheelchairs, walkers, touch-sensitive light switches, phone amplifiers, stair lifts, chairs with lifts, and computers. May also be know as Assistive Technology.

Adult Day Health Services

A program that provides medically necessary services in an ambulatory care setting to people who are nonresidents of the facility, and who, due to their physical and/or cognitive impairment, require such services supportive to their community living that cannot be provided elsewhere. The facility must be licensed by the Department of Health and Senior Services and clients must meet eligibility criteria established by the department.

Aging in Place

Concept that advocates allowing a resident to choose to remain in his/her living environment despite the physical and/or mental decline that may occur with the process of aging.

Ambulatory

Describes the ability to ambulate, walk around, not bedridden or unable to walk.

Assessment

A process used by care managers to gather information about an individual to determine his or her functional needs and/or eligibility for services. Information collected may include health status, financial status, ability to perform activities of daily living, mental status, etc.

Assisted Living Community

In general, a state-licensed program offered at a residential community with services that include meals, laundry, housekeeping, medications reminders, and assistance with Activities of  Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The exact definition will vary from state to state, and a few states do not license assisted living facilities. They are generally regarded as one to two steps below skilled nursing in level of care. Approximately 90 percent of the country's assisted living services are paid for with private funds, although some sates have adopted Medicaid waiver programs. Might also be referred to as Personal Care, Board and Care, Residential Care, Boarding Home, etc., although some states differentiate between their definition of "Assisted Living" and these other terms (e.g., Washington state recognizes and licenses "Assisted Living" facilities as well as "Boarding Homes"; Although licensed by the State of Washington, a Boarding Home does not meet the higher physical plant and service requirements necessary to be considered an Assisted Living facility).

C

Care Plan

The detailed formulation of a plan of action that addresses a client's needs.

Caregiver

The primary person in charge of caring for an individual with care needs, usually a family member or a designated health care professional.

Case Management

A term used to describe formal services planned by care professionals.

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 nursing staff and provides care to facility residents.

Children of Aging Parents (CAPS)

Children of Aging Parents is a non-profit, charitable organization whose mission is to assist the nation's caregivers of the elderly or chronically ill with reliable information, referrals, and support. CAPS strive to heighten public awareness that the health of the family caregiver is essential to ensure quality care of the nation's growing elderly population.

Chore Service

Chore services are semi-skilled home repairs and maintenance tasks performed to enhance the health and safety of the individual in the home. These services are provide through the local Area Agency on Aging, volunteer programs, or youth groups to help older people live safely and comfortably in their own homes.

Congregate Housing

Congregate Housing is a shared living environment designed to integrate the housing and services needs of elders and younger disabled individuals. The goal of Congregate Housing is to increase self-sufficiency through the provision of supportive services in a residential setting. Congregate Housing is neither a nursing home nor a medical care facility.

Continuing Care Retirement Community (CCRC)

Housing planned and operated to provide a continuum of accommodations and services for seniors including, but not limited to, independent living, congregate housing, assisted living, and skilled nursing care. A CCRC resident contract often involves either an entry fee or buy-in fee addition to the monthly service charges, which may change according to the medical services required. Entry fees may be partially or fully refundable. The fee is used primarily as a method of privately financing the development of the project and for payment for future health care. CCRCs are typically licensed by the state. See also Life Care Community.

D

Diabetes

A disease that impairs the ability of the body to use sugar resulting in the loss of sugar through urine, and an increase of sugar levels in the blood.

Director of Nursing (DON)

A DON oversees all nursing staff in a home health care environment, and is responsible for formulating nursing policies and monitoring the quality of care delivered, as well as the home health care agency's compliance with federal and state regulations pertaining to nursing care.

G

Geriatric Social Worker

A licensed professional whose expertise enables him/her to assist the elderly and their family to understand and cope with the social, emotional, and psychological aspects of aging. The social worker may assist the individual/family to access services, and then assist them to use the resources effectively.

H

Home Delivered Meals

Hot and nutritious meals delivered to homebound people who are unable to prepare their own meals and have no outside assistance. Also see "Meals on Wheels."

Home Health Care

Provision of medical and nursing services in the individual's home by a licensed provider.

Homemaker/Home Health Aid Service

A trained person, working under supervision, providing personal care, household cleaning, cooking, grocery shopping, laundry, transportation, for an elderly or disabled person.

Hospice

Usually a combination of at-home and hospital care of the terminally ill that combines medical and social services. It is designed to help both the patient and the family. Hospice care emphasizes pain control, symptom management, and emotional support rather than the use of life-sustaining equipment.

Hospice Care

Care and comfort measures provided to those with a terminal illness and their families. It can include medical, counseling, and social services. Most hospice care is furnished in-home, while specialized hospices or hospitals also provide this service.

I

Independent Living Community

Multi-unit senior housing development that may provide supportive services such as meals, housekeeping, social activities, and transportation (Congregate Housing, Supportive Housing, Retirement Community). Independent living typically encourages socialization by provision of meals in a central dining area and scheduled social programs. May also be used to describe housing with few or no services (such as a Senior Apartment).

Instrumental Activities of Daily Living (IADLs)

Day-to-day tasks such as preparing meals, shopping, managing money, taking medication, and housekeeping.

K

Kitchenette

Each facility may have its own definition of a kitchenette, but generally one includes a sink, cabinet space, and a mini-refrigerator, maybe a microwave. In contrast, a full kitchen would usually have a burner unit, sink, cabinets, full-size refrigerator, and possible a microwave or stove.

L

Level of Care

Refers to the outcome of an assessment designed to determine the most appropriate setting for the delivery of long-term care to an elderly person.

Licensed Practical Nurse

LPNs are trained to administer technical nursing procedures as well as provide a range of health care 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.

Long-Term Care

Provision of services to people of any age who are afflicted with chronic health impairments.

Long-Term Care Insurance

Privately issued insurance policy that covers the cost of nursing home care, assisted living, and home health care. Premiums are based on age, health, length of deductible period, amount paid, and duration of benefits. Currently accounts for only two percent of payments to national nursing home costs.

M

Managed Care

There is currently no standard definition of managed care, but it can best be described as a combination of insurance and a health care 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 health care providers and a system of prior approval from a primary care doctor to achieve this goal. Providers include: Specialists, hospitals, skilled nursing facilities, therapists, and home health care agencies.

Meals-on-Wheels

Meals delivered on a regular schedule - such as daily, Monday to Friday, weekends, etc. - to housebound elderly or elderly people unable to cope with meal preparation, for little or no cost.

Medicare

Nationwide medical insurance program administered by the Social Security Administration for individuals 65 and over and certain disabled people, regardless of income. Provides for hospital and nursing facility care (Part A) and physician services, therapies, and home health care (Part B).

N

Non-Ambulatory

Inability to ambulate, walk around, and usually bedridden or hospitalized.

Nurse Assistant

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. Nurse assistants work under the supervision of a registered nurse or licensed practical nurse.

Nursing Home

Facility licensed by the state that provides 24-hour nursing care, room and board, and activities for convalescent residents and those with chronic and/or long-term care illnesses. One step below hospital acute care. Regular medical supervision and rehabilitation therapy are mandated to be available, and nursing homes are eligible to participate in the Medicaid program. May be referred to as skilled nursing facility or convalescent home.

O

Occupational Therapy

Process to help individuals relearn activities of daily living, generally administered by a licensed therapist.

P

Personal Care Assistance Program (PCA)

Personal care services provided through home health agencies and include personal care, bathing, meal preparation, assistance with activities of daily living (ADLs), and light housekeeping.

Personal Emergency Response System (PERS)

Equipment that monitors the safety of older people in their homes through signals electronically transmitted over the telephone and received at an emergency-monitoring center.

Physical Therapy

Process that includes individualized programs of exercise to improve physical mobility, often administered following a stroke, fall, or accident. Physical therapists plan and administer prescribed physical therapy treatment programs for residents to help restore their function and strength.

Primary Care Physician (PCP)

The doctor who is consulted first when a health problem occurs and on whom the patient relies for advice, referrals, and ongoing care.

Primary Caregiver

The individual who has the main responsibility for helping an older person. This individual usually is the one who makes decisions and organizes care and services.

Private Geriatric Care Managers

Specially trained in geriatric care management, geriatric care managers provide case management services on a fee-for-service basis to individual clients.

Q

Quality Care

Care and services that allow recipients to attain and maintain their highest level of mental, physical, and psychological function, in a dignified and caring way.

R

Registered Nurse

Graduate-trained nurse who has passed a state board examination and is licensed by a state agency to practice nursing. The RN plans for patient care by assessing patient needs, developing and monitoring care plans in conjunction with physicians, patients and patients’ families, as well as executing highly technical, skilled nursing treatments. A minimum of two years of college is required in addition to passage of the state exams.

Rehabilitation

Therapeutic care for people requiring intensive physical, occupational or speech therapy.

Residential Care for the Elderly (RCFE Home)

A residential care home for seniors, or RCFE, sometimes also known as a Board & Care Home, is typically a traditional home that has been converted to a care home and is licensed by the state to take care of seniors. Most RCFE's provide care for up to six seniors; however, they can be smaller or larger in size. RCFE homes were the first widely recognized form of assisted living, and they provide similar care but typically not as much social interaction. Residents of an RCFE Home have a private or shared room, and may have private or shared bathrooms. The rooms usually do not include a kitchen, since providing meals is a major function of the home. RCFE homes generally have some common areas for socializing, including a dining area and one or more other rooms that are mainly for informal contact. Some of the key characteristics of an RCFE home are:

• Activities of daily living (dressing, personal care, bathing, incontinence care)
• Meals served (usually communal style)
• 24-hour supervision (around the clock staff but not necessary Awake staff)
• Community Services (laundry, cleaning, etc.)
• Health services (medications management and dispensing, diabetes care)
• Overall health (physical, emotional)

 

Respite Care

Temporary relief from duties for caregivers, ranging from several hours to days. May be provided in-home or in a residential care setting such as an assisted living facility or nursing home.

S

Senility

A term used to refer to the mental and physical deterioration of old age. Not a medical term.

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.

V

Visiting Nurse

A trained professional nurse who visits patients in their homes to monitor vital signs, the physical condition, and carry out a physician's treatment plan.