Glossary of Terms
A | B | C | D | E | F | G | H | I | J | K | L | M
N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
activities of daily living (ADLs)
Basic personal activities, which include bathing, eating, dressing,mobility, transferring from bed to chair, and using the toilet.
Administration on Aging (AoA)
Federal agency that oversees Older American Act programs. Part of the U.S. Department of Health and Human Services.
adult day care
adult day services
Programs offering social and recreational activities, supervision, health services, and meals in a single setting to older adults with physical or cognitive disabilities. Typically open weekdays during standard business hours.
adult family home
(also called adult care homes, group home or board and care home)
Residence, which offers housing and personal care services for 3 to 16 residents. Services (such as meals, supervision, and transportation) are usually provided by the owner or manager. May be single family home. (Also licensed as an adult group home.)
adult protective services
Service, which seeks to protect the rights of frail older adults by investigating cases of abuse, neglect, and exploitation as mandated by law. Contact your local Area Agency on Aging or county department of human services for more information.
advance directive
Legal document in which people give others instructions about their preferences with regard to health care decisions in case they become incapacitated in some way. Types of advance directives are: living will and durable power-of-attorney for health care.
Area Agency on Aging (AAA)
A regional organization, which locally plans and coordinates state and Federal programs for older adults. AAAs exist in all states and provide similar services nation-wide. Typically AAAs provide information and referral, care management, meals on wheels, family caregiver support, employment programs and more.
assisted living
Residencies which provide a “home with services” and which emphasize residents’ privacy and choice. Residents typically have private locking rooms and bathrooms. Personal care services are available on a 24-hour a day basis.
B
C
care/case management
Offers a single point of entry to the aging services network. Care/case managers assess clients’ needs, create service plans, and coordinate and monitor services; they may operate privately or may be employed by social service agencies or public programs. Typically case managers are nurses or social workers. (In Illinois this is also referred to as Care Coordination.)
Care Coordination
care plan
(also called service plan or treatment plan)
Written document which outlines the types and frequency of the care services that a consumer receives. It may include treatment goals for the consumer for a specified time period. These plans can be medical or social.
caregiver
Person who provides unpaid support and assistance with various activities to a family member, friend or neighbor. May provide emotional or financial support, as well as hands-on help with different tasks. Caregiving may also be done from a long distance and may be hired from an outside agency. (For paid caregiver support see home care.)
Comprehensivve Care Coordination (CCC)
The comprehensive assessment that every older Illinois citizen may receive whether or not they are eligible for the Community Care Program.
Centers for Medicare and Medicaid Services
This federal organization oversees the Medicare and Medicaid programs.
chore services
Help with chores such as home repairs, yard work, and heavy housecleaning.
chronic illness
Long-term or permanent illness (e.g. diabetes, arthritis) which often results in some type of disability and which may require a person to seek help with various activities.
comprehensive assessment
An organized process for gathering information to determine diagnosis and the types of services and/or medical care needed and to develop recommendations for services. Depending on the reason for assessment, it may include: a medical examination and questions about physical, emotional and mental health, family support system, living situation, and the types of assistance that someone may need. May be conducted at home, in the hospital, in an assessment center or clinic, or in a long-term care facility.
congregate housing
Individual apartments in which residents may receive some services, such as a daily meal with other tenets. (Other services may be included as well.) Buildings usually have some common area such as a dining room and a lounge as well as additional safety measures such as emergency call buttons. May be rent-subsidized (known as Section 8 housing).
conservatorship
A legal arrangement granted by the court in which a person chooses an individual to make personal decisions on hi/her behalf. The person must be mentally competent, but physically unable to manage his/her own affairs. Consult an attorney for more details.
co-insurance
see co-payment
Continuing Care Retirement Community (CCRC)
(also called life care community)
Communities, which offer multiple levels of care (independent living, assisted living, skilled nursing care) housed in different areas of the same community or campus and which give residents the opportunity to remain in the same community if their needs change. Provide residential services (meals, housekeeping, laundry), social and recreational services, personal care, and nursing care. Require payment of a monthly fee and a possible large lump-sum entrance fee. (Licensed as nursing home/residential care facilities or as homes for the aging).
co-payment
(also called co-insurance)
The specified portion (dollar amount or percentage) that Medicare, health insurance, or a service program may require a person to pay toward his or her medical bills or services.
county home
see nursing home
custodial care
Care that does not require specialized training or services.
D
deductible
The initial share of a medical or long-term care expense that consumers must pay before their insurance or the program will cover the expense.
dementia
Term, which describes a group of diseases (including Alzheimer’s Disease), which are characterized by memory loss and other declines in mental functioning.
durable medical equipment
(also called home medical equipment)
Equipment such as hospital beds, wheelchairs, and prosthetics used at home. May be covered by Medicaid and in part by Medicare or private insurance.
durable medical power of attorney
see durable power of attorney for health care
durable power of attorney
A document, which names a person (called an “attorney-in-fact”) who will act as someone’s agent and who will make decisions on their behalf, if they are incapacitated. The power of the attorney-in-fact can be restricted to specific areas (such as health care) or can cover broad decision-making responsibilities. Consult an attorney for more details.
durable power of attorney for health care
(also called durable medical power of attorney or health care proxy)
Document in which someone names another person who will make medical decisions for them in the event that they are not able to make them for themselves. Consult an attorney for more details.
E
Eldercare Locator
Information and referral services sponsored by the Administration on Aging. Call (toll-free) 1-800-677-1116 Monday through Friday from 9 a.m. to 8 p.m. E.S.T. to obtain information about services in your community. Also available online (www.eldercare.gov).
emergency response systems
(also called lifelines or personal emergency response systems)
A call button – usually worn by the older individual – which can be pushed to get help from family, friends, or emergency assistance in case of emergency. Can be purchased or rented.
energy assistance programs
Home energy assistance program (HEAP) federal program that offers consumers credit or vouchers to help pay for winter utility bills. Check with your local Area Agency on Aging for more details.
escort services
estate recovery
States are required by law to “recover” funds from certain deceased Medicaid recipients’ estates up to the amount spent by the state for all Medicaid services (e.g. nursing facility, home and community-based services, hospital, and prescription costs).
F
fee-for-service
The way traditional Medicare and health insurance work. Medical providers bill for whatever service they provide. Medicare and/or traditional insurance pay their share, the patient pays the balance through co-payments and deductibles.
for profit
Organization or company in which profits are distributed to shareholders or private owners.
Friendly Visitor/Senior Companions
Programs in which volunteers regularly visit homebound or institutionalized elders to provide socialization, run errands, and generally “check in” with them.
G
geriatric care manager
Health care professionals (usually social workers or nurses) who have aging-related expertise and are familiar with the services available to assist with care. Fees for these services range from $30 to $150 per hour to conduct assessments, arrange for services and monitor the provisions of those services. Their services can meet a one-time need. Or provide ongoing assistance.
geriatric assessment center
Organization that uses a variety of health care professionals such as physicians, nurses, social workers, dietitians, physical and occupational therapists, and others to conduct comprehensive assessments and to develop recommendations for care. Usually have a geriatrician on staff, and is often affiliated with a hospital or a university medical school. Has access to a wide variety of health and social services.
geriatrician
Physician who is certified in the care of older people.
Grandparents/Relatives Raising children
Part of the Family Caregiver Support Program which provides services for individuals age 55+ who are raising children related to them because the parents are unable or unwilling to do so.
group home
see board and care home
guardianship
Legal arrangement in which the court appoints a surrogate decision-maker to act on someone-s behalf because they are declared incompetent. May include guardianship of the person, estate (finances), or both. The guardian may or may not know this person, depending on the situation at the time of the appointment.
H
Health Care Financing Administration (HFCA)
Former name of the federal organization that oversees the Medicare and Medicaid programs. Now known as the Center for Medicare and Medicaid Services.
health care proxy
see durable power of attorney for health care
health maintenance organization (HMO)
Managed care organization that offers a range of health services to its members for a set rate, but which requires its members to use health care professionals who are part of its network of providers. (see also Medicare HMOs).
home care or home care services
Long-term or short-term care services received in a home. For example: homemaker, personal care, home-delivered meals, chore services, errands, shopping, med reminders, bathing assistance, ambulation assistance or ERS.
home and community based services (HCBS)
see home care
home health care
Includes a wide range of health-related services such as assistance with medications, wound care, intravenous (IV) therapy, and help with basic needs such as bathing, dressing, mobility, etc., which are delivered in a person’s home.
home durable equipment
home sharing/shared housing programs
Usually involve unrelated individuals sharing a home and the chores and expenses included in-home ownership. Those sharing the home typically have their own rooms, but share common areas (such as the kitchen). The home may be owned by the people living there or by a nonprofit organization.
homebound
One of the requirements to qualify for Medicare home health care. Means that someone is generally unable to leave the house, and if they do leave home, it is only for a short time (e.g. for a medical appointment) and requires much effort.
homemaker services
Help with meal preparation, shopping, light housekeeping, errand services, and laundry.
hospice
Services for the terminally ill provided in the home, a hospital, or a long-term care facility. Includes home health services, volunteer support, grief counseling, and pain management.
I
Illinois Department on Aging
Coordinates services for older adults in Illinois and is funded through the federal Older Americans Act via the Area Agencies on Aging. They are also funded by State General Revenue Funds such as case coordination units, comprehensive care coordination and the community care program services.
Illinois Department of Children an Family services (DCFS)
Regulates and protects the well being of Children in the state of Illinois.
Illinois Department of Health Care and Family Services (formerly Public Aid)
The Illinois state agency dedicated to improving the lives of Illinois' families through healthcare coverage, child support enforcement and energy assistance. (This agency assists with Medicaid, food stamps, etc)
Illinois Department of Job & Family Services (IDJFS)
State agency that oversees programs that provide health care, employment and economic assistance, child support, and services to families and children.
Illinois Department of Public Health
State agency whose responsibilities include inspecting and licensing all long-term care facilities, Home Health Care agencies and home care agencies within the state of Illinois. state agency that oversees aging services programs within the state of Illinois.
independent living facility
Rental units in which services are not included as part of rent, although services may be available on site and may be purchased by residents for an additional fee.
instrumental activities of daily living (IADLs)
Household/independent living tasks, which include using the telephone, taking medications, money management, housework, meal preparation, laundry, and grocery shopping.
irrevocable burial account
When determining eligibility for Medicaid, the state allows consumers to set aside money in a trust or with a funeral director for burial expenses as part of a pre-paid burial plan. Consult your county department of human services or an attorney for more information.
J
K
L
level of care (LOC)
Amount of assistance required by consumers which may determine their eligibility for programs and services. Levels include: protective, intermediate, and skilled.
levy-funded program
Home care service programs for older adults that are funded by special property tax levies. Services and fees vary by program. Contact your local Area Agency on Agency to find out if such a program exists in your county.
life care community
see continuing care retirement community
lifelines
see emergency response systems
limited guardianship
A legal arrangement whereby the court appoints a surrogate decision-maker, but limits his/her authority to specific decisions or limits the length of time the guardianship is to be in place.
living trust
A trust that is set up while someone (called the grantor trustor) is still alive. Assets are transferred to the trust, and the grantor names a “trustee” who controls the assets in the trust and “beneficiaries” who will inherit the trust after the grantor has died. May be revocable (meaning that the grantor may change the terms of the trust or take back assets) or irrevocable (meaning that the trust may not be touched by the grantor). May also be considered when determining the grantor’s eligibility for Medicaid.
living will
A document, which states a person’s preferences for future medical decisions including the withholding or withdrawing of life-sustaining treatments such as artificial nutrition and hydration or the use of equipment such as ventilators and respirators. (See also advance directive.)
long-term care (LTC)
Range of medical and/or social services designed to help people who have disabilities or chronic care needs. Services may be short or long-term and may be provided in a person’s home, in the community, or in residential facilities (e.g. nursing homes or assisted living facilities).
long-term care insurance
Insurance policies, which pay for long term, care services (such as nursing home and home care) that Medicare and Medigap policies do not cover. Policies vary in terms of what they will cover, and may be expensive. Coverage may be denied based on health status or age.
long-term care ombudsman
see ombudsman
M
managed care
Method of organizing and financing health care services which emphasizes cost-effectiveness and coordination of care. Managed care organizations (including HMOs, PPOs, and PSOs) receive a fixed amount of money per month (called a capitation), no matter how much care a member needs during that month.
Meals-on-Wheels
see nutrition services/home-delivered meals
Medicaid
Federal and state-funded program of medical assistance to low-income individuals of all ages. There are income eligibility requirements for Medicaid. Check with your local Administrative Agency or county department of human services for more information.
Medicare
Federal health insurance program for persons age 65 and over (and certain disabled persons under age 65). Consists of 3 parts: Part A (hospital insurance) and Part B (optional medical insurance which covers physicians’ services and outpatient care in part and which requires beneficiaries to pay a monthly premium). Pare D (prescription drug Assistance)
Medicare+Choice
Option under Medicare, which gives consumers a choice of plans including managed care and fee-for-service plans. Options consist of traditional fee-for-service, HMOs, HMOs with POS, PPOs, PSOs, private fee-for-service, religious/fraternal benefit society plans, and medical savings accounts. Current Medicare beneficiaries are not required to change plans unless they so desire.
Medicare HMOS
Under Medicare HMOs (health maintenance organizations), members pay their regular monthly premiums to Medicare, and Medicare pays the HMO a fixed sum of money each month to provide Medicare benefits (e.g. hospitalization, doctor’s visits and more). Medicare HMOs may provide extra benefits over and above regular Medicare benefits (such as prescription drug coverage, eyeglasses, and more). Members do not pay Medicare deductibles and co-payments; however, the HMO may require them to pay an additional monthly premium and co-payments for some services. If members use providers outside the HMO’s network, they pay the entire bill themselves unless the plan has a point of service option.
Medicare HMOs with Point of Service (POS)
Operates similarly to a regular Medicare HMO except that the plan covers part of the expense if members use providers from outside the network.
Medicare Select (also called MedSelect)
A type of supplemental insurance plan (Medigap/Medisup) that combines managed care with a standard Medigap plan. Plans may require members to use the doctors and hospitals within its network, but premiums are likely to be lower than regular Medigap/Medisup plans.
Medigap
Insurance supplement to Medicare that is designed to fill in the “gaps” left by Medicare (such as co-payments). May pay for some limited long-term care expenses, depending on the benefits package purchased.
MedSelect
see Medicare Select
mental health services
Variety of services provided to people of all ages, including counseling, psychotherapy, psychiatric services, crisis intervention, and support groups. Issues addressed include depression, grief, anxiety, stress, as well as severe mental illnesses.
N
nonprofit/not-for-profit
An organization that reinvests all profits back into that organization
nursing home
Facilities licensed by the state to offer residents personal care as well as skilled nursing care on a 24 hour a day basis. Provide nursing care, personal care, room and board, supervision, medication, therapies and rehabilitation. Rooms are often shared, and communal dining is common. (Licensed as nursing homes, county homes, or nursing homes/residential care facilities).
nutrition services
Include the following: home delivered meals (also called Meals-on-Wheels) – hot, nutritious meals delivered to homebound older people on weekdays. Can accommodate special diets. congregate meals – hot, nutritious lunches served to older adults in group settings such as churches or synagogues, senior centers, schools, etc. Donations are requested, although not required.
O
occupational therapy
Designed to help patients improve their independence with activities of daily living through rehabilitation, exercises, and the use of assistive devices. May be covered in part by Medicare.
Older Americans Act
Federal legislation enacted in 1965 that provides a wide variety of services for the health and wellbeing of older adults in the united States. It provides Federal funding for aging services such as an employment program for seniors, information and referral, nutrition programs, respite for family caregivers, senior centers and much more. It created the infrastructure of Federal, state and local agencies that plan and coordinate aging services programs. (See also Title III services).
ombudsman
Trained professional or volunteer who advocates for the rights of older people receiving long-term care services (both facility-based care and home-care) and who investigates their problems with or concerns about their care.
P
personal care (also called custodial care)
Assistance with activities of daily living as well as with self administration of medications and preparing special diets.
physical therapy
Designed to restore/improve movement and strength in people whose mobility has been impaired by injury or disease. May include exercise, massage, water therapy, and assistive devices. May be covered in part by Medicare.
Planning and Service Areas (PSAs)
Multi-county regions of the state whose aging services are coordinated by Area Agencies on Aging.
point of service (POS)
A health maintenance organization (HMO) with this option will cover part of the expense if a member decides to use a provider outside the plan’s network.
pre-admission review
Required of all people living independently in the community who wish to enter a nursing home. Ensures that community and home-based long-term care options are presented to all older people who are able to take advantage of them.
pre-admission screen
For those requesting admission to a Medicaid-certified nursing facility must receive approval from their PASSPORT Administrative Agency before they may be admitted. This approval (the Pre-admission screen) is a federal requirement to ensure that nursing home residents who need mental health services or specialized services for the mentally retarded or developmentally disabled are identified at admission.
preferred provider organization (PPO)
Managed care organization that operates in a similar manner to a HMO or Medicare HMO except that this type of plan has a larger provider network and does not require members to receive approval from their primary care physician before seeing a specialist. It is also possible to use doctors outside the network, although there may be a higher co-payment.
private fee-for-service
see Medicare+Choice
provider
Individual or organization that provides health care or long-term care services (e.g. doctors, hospital, physical therapists, home health aides, and much more).
provider sponsored organization (PSO)
Managed care organization that is similar to a HMO or Medicare HMO except that the organization is owned by the providers in that plan and these providers share the financial risk assumed by the organization.
Q
Qualified Medicare Beneficiary (QMB)
Individual enrolled in a Medicaid program, which pays for Medicare consumer cost-share expenses (deductibles, co-payments, and Part B premiums) for low-income elders and persons with disabilities who qualify for Medicare Part A. There are income eligibility requirements for this program.
Qualifying Individual (QI)
Individual enrolled in a Medicaid program, which pays for all or part of Medicare Part B monthly premiums for low-income elders and persons with disabilities who qualify for Medicare Part A. There are income eligibility requirements for this program.
R
rehabilitation services
Services designed to improve/restore a person’s functioning; includes physical therapy, occupational therapy, and/or speech therapy. May be provided at home or in long-term care facilities. May be covered in part by Medicare.
residential care
see assisted living
Residential State Supplement (RSS)
State-funded program which gives cash assistance to older persons and to blind and disabled persons of all ages who are Supplemental Security Income (S.S.I.) recipients and who do not medically qualify for nursing home placement, but who live in other approved group living settings such as board and care homes and adult foster homes. There is an income eligibility requirement for receiving RSS.
respite care
Services which allow caregivers to take a temporary break from caregiving responsibilities. They may include In-home caregivers, adult day services or temporary overnight stays in assisted living or other long term care facility.
rest home
see assisted living
S
senior center
Provides a variety of onsite programs for older adults including recreation, socialization, congregate meals, and some health services. Usually a good source of information about area programs and services.
Senior Health Insurance Information Program (SHIIP)
Program which provides free information and advice about health insurance, including Medicare, Medicaid, Medigap, long-term care and other health insurance. Check the phone book for the SHIIP center in your area.
service plan
see care plan
skilled care
“Higher level” of care (such as injections, catheterizations, and dressing changes) provided by trained medical professionals, including nurses, doctors, and physical therapists.
skilled nursing facility (SNF)
Facility that is certified by Medicare to provide 24-hour nursing care and rehabilitation services in addition to other medical services. (See also nursing home).
Social Services Block Grant services
special care units
Long-term care facility units with services specifically for persons with Alzheimer’s Disease, dementia, head injuries, or other disorders.
Specified Low Income Medicare Beneficiary (SLMB)
Individual enrolled in a Medicaid program which pays for Medicare Part B monthly premiums for low-income elders and persons with disabilities who qualify for Medicare Part A. There are income eligibility requirements for this program. Contact your local PASSPORT Administrative Agency or county human services for more information.
speech therapy
Designed to help restore speech through exercises. May be covered by Medicare.
spend-down
Medicaid financial eligibility requirements are strict, and may require beneficiaries to spend down/use up assets or income until they reach the eligibility level.
spousal impoverishment
Federal regulations preserve some income and assets for the spouse of a nursing home resident whose stay is covered by Medicaid. Contact your local county department of human services for more information.
subacute care (also called transitional care)
Type of short-term care provided by many long-term care facilities and hospitals which may include rehabilitation services, specialized care for certain conditions (such as stroke and diabetes) and/or post-surgical care and other services associated with the transition between the hospital and home. Residents on these units often have been hospitalized recently and typically have more complicated medical needs. The goal of subacute care is to discharge residents to their homes or to a lower level of care.
Supportive Living
In the state of Illinois, a new option called supportive living is also available. Supportive living is much like assisted living. Supportive living communities are designed for seniors who are no longer able to live on their own safely, but do not require the high level of care provided in a nursing home. The difference between assisted living and supportive living in the state of Illinois is that, by providing services as outlined by the state, supportive living communities are able to offer a financial assistance program to their residents.
support groups
Groups of people who share a common bond (e.g. caregivers) who come together on a regular basis to share problems and experiences. May be sponsored by social service agencies, senior centers, religious organizations, as well as organizations such as the Alzheimer’s Association.
T
telephone reassurance
Program in which volunteers or paid staff call homebound elders on a regular basis to provide contact, support, and companionship.
Title III services
Services provided to individuals age 6o and older which are funded under Title III of the Older Americans Act. Include: congregate and home-delivered meals, supportive services (e.g. transportation, information and referral, legal assistance, and more), in-home services (e.g. homemaker services, personal care, chore services, and more), and health promotion/disease prevention services (e.g. health screenings, exercise programs, and more). Contact your local area agency on aging to see what services may be available in your area. (See also Older Americans Act)
Title XX services (also called Social Services Block Grant services)
Grants given to states under the Social Security Act, which fund limited amounts of social services for people of all ages (including some in-home services, abuse prevention services, and more). Contact your local Area Agency on Agency or county department of human services to find out what services may be available in your area.
transitional care
see subacute care
transportation services (also called escort services)
Provides transportation for older adults to services and appointments. May use bus, taxi, volunteer drivers, or van services that can accommodate wheelchairs and persons with other special needs.
treatment plan
see care plan
U
V
Veterans Affairs (V.A.)
Offers acute and long-term care benefits (nursing home care and home care) benefits to veterans of the United States Armed Forces, and in some cases, their families. Services are provided by V.A. medical centers around the country. Contact your local or state V.A. for more information.
W
X
Y
Z