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Glossary of Senior Care Terms

Activities of Daily Living (ADLs): Routine activities that an individual performs daily, such as eating, bathing, dressing, toileting, walking, and continence.

Adult Day Care/Center: Provides companionship, social activities, and assistance with daily tasks/health-related services to adults in a non-residential setting.

Advance Directive: A document that declares an individual’s wishes regarding their medical treatment in the event they become unable to communicate directly. Often referred to as a “living will”.

Area Agency on Aging (AAA): Local agencies created under the Older Americans Act (OAA) to assist individuals ages 60+ to live independently in their own home. They provide supportive social services for the seniors, as well as caregiver support for the families and community. The Kent County AAA is Area Agency on Aging West Michigan.

Assisted Living (AL): A housing system created for seniors who need routine daily assistance but do not require the high level of care from a nursing home. They offer life enrichment programs, prepared meals, and housekeeping services, in addition to medical care. There are two types of licensed Assisted Living communities- Adult Foster Care, and Home for the Aged.

Adult Foster Care (AFC): Accommodates 6-20 people, for ages 18+

Home for the Aged (HFA): Accommodates 21+ people, for ages 60+

Certified Nurse Assistant (CNA): Assists with a patients’ needs under the supervision of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). Often referred to as an “aide”.

Continuing Care Retirement Community (CCRC): A community that offers independent living, assisted living, and nursing home care, therefore allowing an individual to potentially remain in the same community for the remainder of his/her life as he/she moves through the continuum of care. Usually requires an entrance fee, also known as a “buy in”, as well as a monthly rent. There are 3 types of contracts with CCRCs: Types A, B, and C. Continuing care falls under Types B and C. See Life Care Contracts below for Type A.

Life Care Contracts: A Type A contract is considered a life care contract. Some CCRC communities offer this contract, where individuals living in the CCRC would be able to remain in the community should they become financially unable to pay for services. Their monthly fees would be subsidized by the community. Call Crossroads for assistance in navigating between these options.

Durable Medical Equipment (DME): Equipment (such as walkers, wheelchairs, etc.) needed to enhance quality of life and is typically included in most insurances, including Medicare in specific instances.

Durable Power of Attorney (DPOA): Also known as POA. A legal document stating the person who will dictate your wishes should you become unable to communicate them on your own, either in full or limited circumstances, such as medical care or finances only. The individual stating their wishes is called the ‘principal’, and the individual authorized to make the decisions on the principal’s behalf is called the ‘agent’.

Elimination Period: This refers to the time period between the onset of an individual’s injury and the date that they can begin collecting benefits from an insurer. The individual is eligible for benefits during this time, however no benefits will be paid until the elimination period is complete. These vary dramatically between policies; it may apply to the entire benefit, specific benefits, or not even have one at all.

Entrance Assessment: (Health and financial) The tool used to determine a senior’s level of care and service needs, as well as financial viability, prior to being accepted into a senior living community.

Home Care/Private Duty Home Care: A type of home care where caregivers assist with tasks such as personal care, homemaking/companionship, meal preparation, medication reminders, and transportation. Most private duty home care companies also have training for caregivers on disease-specific illnesses, such as Alzheimer’s, ALS, etc.) This care is performed by CNAs, LPNs, and RNs depending on the service. Most insurances (with the exception of long term care insurance), including Medicare, do NOT cover these services.

Home Health Care: Services that are administered in your home by licensed, trained professionals with the goal of treating an illness or injury. This type of care is prescribed by a doctor, and can include visits from aides, nurses, doctors, and therapists such as PT, OT, speech, etc. (depending on what your doctor has ordered) and is typically short-term. Most insurances and Medicare cover these services. This does NOT include meal preparation, companionship visits, housekeeping, etc. See Home Care/Private Duty Home Care for more information about those services.

Hospice Care: Team of medical professionals that provide care focused on pain management as well as emotional support, for individuals facing a terminal diagnosis. Ordered by a doctor, this care typically comes to the patient’s home or occurs at an inpatient hospice facility, with a goal of improving quality of life rather than curing the complex/terminal disease or stopping its progression. An individual must be considered
terminal, or within six months of death, to receive hospice benefits from their insurance and Medicare.

Hoyer Lift: Type of patient lift equipment that can be either manual or electric, which can move an individual from a sitting to standing position or vice versa, or transfer them to another area, such as from bed to chair. In licensed Skilled Nursing Facilities, this equipment requires two staff members to operate. The machine has a sling that is positioned underneath the patient, and the arms of the lift attach to the
swing thereby allowing the patient to be mobile or change positions.

Independent Living (IL): Type of living community designed for seniors, usually 55+, where the individual does not require routine daily assistance with medical/personal care. These communities focus on life enrichment programs, offering many activities for the residents, and encourage them to engage socially with their fellow residents. Monthly rent includes meals, housekeeping, room/board, and most activities.
Many IL communities now offer home care services on site, that you can purchase to provide additional assistance (medical or personal care) when needed.

Licensed Practical Nurse (LPN): A nurse who is licensed by the state, and has completed a practical nursing program. They can be under the supervision of a Registered Nurse (RN) or doctor.

Long Term Care Insurance: Type of insurance an individual can purchase that provides at least 24 months of coverage for individuals age 65+ that can be used in nursing homes, assisted livings, home health care/private duty, and other long-term care services such as adult day centers. Coverage varies between policies.

Medicaid: Federally funded and state administered insurance program for individuals with income and asset restrictions. In the state of MI, Medicaid does not pay for independent living, assisted living, or private duty home care.

Medicare: Also known as “traditional Medicare” or “original Medicare”. Federally administered insurance program for: individuals age 65+, individuals under age 65 with certain disabilities, or individuals with End-Stage Renal Disease. It has 3 parts: Part A, B, and D. Part A is hospital insurance that covers inpatient hospital care, and individuals typically do not pay a monthly premium for this coverage. Part B typically has a monthly premium for this coverage that covers doctor services and outpatient care. Part D is exclusively prescription drug benefits and is provided by private insurance companies. Individuals select their own plan and pay the monthly premium. Call Crossroads today for more specific qualification criteria.

Medicare Advantage: Also known as “Part C” or “MA Plans”. Type of insurance plan offered by private insurances that essentially replaces an individual’s traditional Medicare Parts A and B plans. The individual’s coverage is determined by the chosen private plan, and benefits/out-of-pocket costs can vary dramatically between plans. This coverage is NOT the same as a Medigap policy.

Medigap: Also known as “Medicare Supplemental Insurance”. Insurance that supplements Medicare costs not covered by traditional Parts A and B. It is provided by private health insurance companies with a monthly premium.

Memory Care: Assisted Living or Skilled Nursing Facilities that offer added care options specifically for individuals with memory disorders, such as specially trained staff, programs/activities designed for the memory impaired, and generally higher staffing ratios. Secured memory care communities have keypads and/or alarms to alert staff if a resident were to attempt to leave the building.

Observation Status: The termed used for the status of an individual held in the hospital while the doctor decides if he or she requires more care, but the person is not admitted inpatient. If you are under observation status at the hospital, it is important to know you are not technically admitted – even though the doctors may keep you overnight. This is critical for health insurance, especially Medicare, since you will
be billed for outpatient services, as opposed to being “inpatient” status which is covered by Medicare Part A. See also “Medicare”.

Occupational Therapy (OT): Therapy administered by a licensed, occupational therapist that assists individuals with strengthening their fine motor skills and activities of daily living.

Palliative Care: A type of care performed by a team of medical professionals that focuses on comfort-seeking measures at any time during the course of a disease, whether chronic or terminal. The treatment goals include relieving pain and improving quality of life, but not intended to cure the disease itself. This care most often occurs in the setting where the patient first receives treatment – as opposed to at home like
in hospice care.

Physical Therapy (PT): Therapy administered by a licensed, physical therapist that assists individuals with strengthening their large motor skills and restoring their strength.

Registered Nurse (RN): A nurse who is licensed by the state, and has graduated from a school of nursing program.

Respite Care: Services available to temporarily relieve caregivers of their caregiving tasks. Available at home through home care services, or at various Assisted Living/Skilled Nursing Facilities.

Senior Move Managers: Individuals who assist adults with downsizing and moving to a new residence.

 

Skilled Nursing Facility (SNF): Also known as Long Term Care Facility. Nursing home that has been certified by Medicare. They are state-licensed facilities offering short-term rehab and long-term care, for individuals with advanced conditions where symptoms and/or treatments cannot be controlled at home or in an assisted living community, or when an individual needs consistent, around the clock, supervised care.
Medicare/Insurance companies regulate the benefits, including the length of stay, and can vary depending on many conditions. Call Crossroads for more assistance.

Spend Down: Also known as excess income. The process of spending money on medical bills and various MEDICAID-APPROVED  xpenditures to qualify for Medicaid eligibility. Not all expenses are approved by Medicaid, and spending money outside of these regulations could be considered a divestment and would result in a penalty to the applicant. Call Crossroads today for more information.

Toileting: Termed referring to assisting an individual in using the bathroom. Can also refer to incontinence care.

Trust: Legal definition for an agreement where property/assets is administered by a separate party (trustor), and controlled by a designated individual (trustee), in order to benefit an individual (beneficiary).

Trustee: Individual named in the trust to manage the benefits for the trust’s beneficiary.

Trustor: Individual/business/third party who creates the trust.

Two-Person Assist: Term of mobility classification, where two staff members are required to transfer an individual (for example, from bed to chair, or to use the restroom). Typically most skilled nursing facilities utilize equipment to help this process such as a Hoyer Lift, and law requires that a minimum of two staff members are needed to operate such equipment.

Veteran’s Aid and Attendance (VA benefits): Monetary benefits available to eligible veterans and their survivors who require any of the following: the assistance of another, homebound care, or nursing home care due some incapacity. Contact Crossroads today for assistance with applying for this benefit.

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