Eldercare Glossary


Association for the Advancement of Retired Persons. An association of people to promote the welfare of senior citizens. More information at www.aarp.org.

Activities of Daily Living (ADL)

An individual's daily habits such as bathing, dressing and eating. ADLs are often used as an assessment tool to determine an individual's ability to function at home, or in a less restricted environment of care.

Acute Care

A pattern of health care in which a patient is treated for an acute (immediate and severe) episode of illness, for the subsequent treatment of injuries related to an accident or other trauma, or during recovery from surgery.

Administration on Aging (AoA)

The principal federal agency responsible for administering the provisions of the Older Americans Act. It advocates at the national level for the needs, concerns and interests of elder persons throughout the nation.

Adult Day Health Care

Day care that provides medical, rehabilitative and social services through an individualized plan of care to persons 18 years of age or older with functional limitations caused by physical, cognitive or mental impairment.

Adult Day Programs

Also known as Adult Day Care, these community-based programs provide individualized day care in a protective setting to persons 18 years of age or older who need personal care services, supervision or assistance with ADLs.

Advance Directive

A document, such as a health care proxy or living will which allows an individual to convey his or her wishes about end-of-life care ahead of time. In Massachusetts, only the Health Care Proxy is legally binding on medical providers.

Alzheimer's Day Care Resource Centers

Individualized day care for people with moderate to late stage Alzheimer's disease or related dementias.

Alzheimer's Disease

A progressive, degenerative form of dementia that causes severe intellectual and subsequent physical deterioration.


A system under Medicare in which out-of-pocket costs depend on whether your doctor or supplier of healthcare equipment and supplies (such as wheelchairs, oxygen, braces and ostomy supplies) agrees to accept the Medicare approved payment amount. When doctors and suppliers agree to accept the Medicare approved amount, they accept assignment.

Assisted Living

Broad range of residential care services, but does not include nursing services. Normally lower in cost than nursing homes.

Assisted Living Facility

In California, this is referred to as a licensed Residential Care Facility or Residential Care Facility for the Elderly.

Attendant Care Services

Forms of assistance which help a person with a disability meet his or her essential needs at home or at work, such as bathing, toileting, dressing, cooking, eating, communicating, traveling to and from work and similar personal needs.


The person designated to receive benefits from an insurance policy or health plan.

Benefit Eligibility Triggers

Criteria used by insurance companies to determine when the beneficiary is eligible to receive benefits.

Care Management or Care Coordination Services

A service in which a professional, typically a nurse or social worker, may assess service needs and/or arrange, plan, monitor or coordinate long-term care services.


One who provides daily care that enables a frail or physically challenged person to live at home despite illness or disability.

CARF Accredited

A rehabilitation facility that has been chosen to be reviewed by the Commission on the Accreditation of Rehabilitation Facilities (CARF), a private accreditation agency, and has been found to be in compliance with CARF quality standards.


Civilian Health and Medical Program of the Veteran's Administration; a cost-sharing health plan for dependents of qualified disabled veterans.


Community Health Accreditation Program, the leader in improving the quality of care in the home health industry.

Cognitive Impairment

A deficiency in a person's short or long-term memory, including orientation as to person, place and time; deductive or abstract reasoning; or judgment as it relates to the person's safety awareness.


People provided by home health agencies who regularly visit frail elders providing socialization, medical escort, errand service, light meal preparation, as well as respite or temporary relief to family caregivers.


Legal process in which a probate court appoints one or more persons to handle the financial affairs of a person the court determines to be incompetent or otherwise unable to handle her/his own finances.

Council on Aging (COA)

A municipally-appointed volunteer agency that provides services to elders, families and caregivers. While each COA is unique to its community, most councils offer information and referral, transportation, outreach, meals (congregate and home delivered), health screening and fitness and recreation programs.

Custodial Care (also called Personal Care)

Care to help individuals perform activities of daily living, as well as some other basic activities.

Daily Benefit

A specified dollar amount that is the maximum amount paid per day for services covered by the policy.


Deterioration of intellectual faculties, usually due to a disorder of the brain.

Disease Management

Integrated treatment plans for patients with chronic or recurring conditions so that each encounter is not viewed as a distinct event but as part of an overall care process.

DNR/DNI Order (Do Not Resuscitate/Intubate Order, also known as a "Comfort Care Order")

Instructions in the medical record of an individual who has decided that they not wish cardiopulmonary resuscitation. A DNR informs medical personnel, including EMTs and paramedics, to provide care and transport in the community without artificial means to maintain heart function and breathing.

Durable Power of Attorney

A document that grants a person(s) the legal powers to perform on behalf of the Grantor certain specified acts and functions, related to real estate, banking and financial transactions, personal and family maintenance, and government benefits, among others. This power is effective immediately and continues to be effective even if the Grantor becomes disabled or incompetent.

Elimination Period

A specified amount of time during which an individual must pay for covered services before the insurance company will begin to make payments (also referred to as a Deductible Period or Benefit Waiting Period).

Enrollment Period

A certain period of time when you can join a Medicare health plan, if it is open and accepting new Medicare members. If a health plan chooses to be open, it must allow all eligible people with Medicare to join. There are four periods during which you can enroll in Medicare Part A: Initial Enrollment Period (IEP), which starts three months before you are 65 and seven months afterwards; General Enrollment Period (GEP), which is the first three months of each year; Special Enrollment Period (SEP), for people who did not sign up when they were 65; and Transfer Enrollment Period (TEP), for those who only have Part B and enrolled in a Medicare managed care plan.

Family Medical Leave Act (FMLA)

A federal law that provides caregivers up to 12 weeks of job-protected leave to care for a seriously ill parent, child or spouse (also covers leave for one's own serious illness, a birth or an adoption). There is no wage replacement available with this leave.

Geriatric Care Manager

A professional case manager, usually a licensed social worker, who assesses an elder's ability to live independently in a home environment, develops an appropriate care plan for services and equipment, and organizes needed home health services. This person may monitor and augment services on an on-going basis, or trouble shoot as particular problems arise.


A health care professional who specializes in elder care, with a degree in nursing, psychology, sociology or other social-related professions. An applied gerontologist works directly with elders, evaluating and assisting individuals, families and groups. A research gerontologist is a scientist who conducts research on the biological, psychological and sociological phenomena associated with old age and aging.

Guaranteed Renewable

A term meaning that a company cannot cancel your policy or change any of the benefits, unless you fail to pay the premiums. A company may raise premiums for all policyholders within a particular group, but not for an individual member of a group.

Health Insurance Portability and Accountability Act (HIPAA)

Federal health insurance legislation passed in 1996 that allows, under specified conditions, long-term care insurance policies to be qualified for certain tax benefits.

Healthcare Provider

Healthcare professional or facility or group of healthcare professionals or facilities that provide health care services to patients.

Home Health

Care in the home which usually includes the following: home health care, personal care, homemaker services, hospice services and respite care.

Home Health Aide

Also known as homemaker home health aides or home attendants, these workers are employed by families with an elderly and/or disabled family member to assist the family in caregiving, helping the patient remain in the home.

Home Health Care

Full range of medical and other health-related services such as physical therapy, nursing, counseling and social services that are delivered in the home of a patient, by a provider.

Homemaker Services

Programs that provide in-home workers to do light housekeeping (including laundry and meal preparation), shopping and errands. Homemakers may also assist with self-administered medications and with personal care tasks such as grooming, bathing and dressing. Assistance with chores or activities that are necessary for an individual to be able to remain in their residence.


Facility or program providing care for the terminally ill.

Independent Living Units

Housing units that include some basic services such as meals and housekeeping, usually for a fee. These units may exist in a Continuous Care Retirement Community (CCRC) that also has assisted living units and a skilled nursing facility.

Inflation Protection

An insurance policy option that provides increases in benefit levels to help cover expected inflationary increases in the cost of long-term care services.

Infusion Therapy

The intravenous (IV) administration of medications and nutrition, including fluid replacements, chemotherapy and antibiotics.

Intermediate Care Facility (ICF)

A nursing home which provides health-related services to individuals who do not require the degree of care or treatment given in a hospital or skilled nursing facility, but who (because of their mental or physical condition) require care and services which are greater than custodial care and can only be provided in an institutional setting.

Joint Commission, The

An independent non-profit group that accredits healthcare organizations and monitors quality of care provided.

Life Insurance Settlements (also called Viatical Life Insurance Settlements)

A method to receive funds for life policy benefits before death or the term of the policy. The advantage is to receive cash for current needs, such as home health expenses. The disadvantage is that you will not receive the full face value of the policy. When you pass, the viatical company is the beneficiary of the policy. Many families are more interested in their loved one obtaining the best quality of life for the time they have left, rather than using the funds for themselves after the loved one is gone.

Living Will

A set of instructions documenting a person's wishes about medical care intended to sustain life. It is used if a patient becomes terminally ill, incapacitated, or unable to communicate or make decisions.

Long-Term Care Insurance

Insurance designed to pay for some or all of the costs of long-term care.

Long-Term Care Ombudsman

A state-certified advocate serving residents in nursing homes and Residential Care Facilities for the Elderly.

Meals on Wheels (MOW)

A service that provides home-delivered meals to elderly and disabled citizens without regard to income. It is funded through a combination of federal funds through Title IIIC of the Older Americans Act and state funds.

Medicaid (Medi-Cal in California)

A joint federal and state program that provides hospital expense and medical expense coverage to those with low-income (or very high medical bills relative to income and assets) and certain aged and disabled individuals.

Medical Underwriting

A method insurers use to evaluate an individual's personal health and potential claim risk when determining whether to issue a policy, and sometimes how much to charge as a premium.


A federal government program established under Title XVIII of the Social Security Act of 1965 to provide hospital expense and medical expense insurance to elderly and disabled persons. Benefits for nursing home and home health services are limited. More information at www.medicare.gov.

Medicare Part A

Hospital insurance for those 65 and older, primarily provides coverage for in-patient hospital care, skilled nursing home, home health, and hospice care.

Medicare Part B

Medical insurance for those 65 and older, provides limited coverage for out-patient physician services, ambulance use, durable medical equipment and home health care services.

Medicare HMO

A Health Maintenance Organization for individuals 65 years and older covered by Medicare.


A type of health insurance elders can purchase to supplement their health benefits under Medicare and bridge the gap between what Medicare pays and what clinical care and prescription drugs actually cost.

National Alliance for Caregiving

Non-profit coalition dedicated to providing support to family caregivers and the professionals who help them and to increasing public awareness of issues facing family caregivers. More information at www.caregiving.org.

NORC (Naturally Occurring Retirement Communities)

An initiative for connecting elders to community-based eldercare services while remaining in their own homes and staying connected to neighbors and community institutions. A NORC connects elders to supportive services and to each other, often using computer technology as a key tool.

Nursing Home

A term used to cover a wide range of institutions providing 24/7 personal care and skilled nursing care, also called skilled nursing facilities, intermediate care facilities and custodial care facilities. Not all nursing homes are Medicare-approved/certified facilities.

Occupational therapy

A form of therapy that helps people improve basic motor functions and reasoning, and their ability to perform tasks in their daily living and working environments.

Older Americans Act

The Older Americans Act (OAA) of 1965 calls for a range of programs that offer services and opportunities for older Americans, especially those at risk of losing their independence. The Older Americans Act focuses on improving the lives of older people in areas of income, housing, health, employment, retirement and community services.

Older Californians Act

Sets forth the state's commitment to its older population and other populations served by the programs administered by the California Department of Aging.

Palliative Care

Whole array of services that eases the transition from life to death. It includes management of pain and physical symptoms, but goes well beyond the physical. Palliative care also includes care and sympathy for emotional suffering, loss and bereavement. It helps the patient, and those who love and care for the patient, deal with the ambiguities of serious illness.


A type of transportation for people whose physical condition restricts their use of regular public transit systems. Services are provided by lift-equipped vans and shuttles that can be scheduled as needed for pick-ups and drop-offs. This is also known as "demand responsive transportation."

Pastoral Care

Assists patients, families and friends as they call on the supportive dynamics of their spiritual beliefs and traditions to help them in the healing process.

Personal Emergency Response Systems (PERS)

A medical communications alerting system that allows an elder experiencing a medical emergency at home to access medical service via an electronic transmitter to a central monitoring station.

PDA Waiver

A program that is set up to allow money that is traditionally used for nursing home care to be used for care for individuals who want to remain at home.

Period of Care

A period of time during which you need and receive continuous care that is covered by your long-term care policy.

Personal Care (see Custodial Care)

Pre-existing condition illnesses or disability for which you were treated or diagnosed prior to applying for a life, health or long-term care insurance policy.


A specified sum of money paid to an insurance company for a policy that guarantees the payment of specified benefits. This payment may be a single sum or periodic payments.


A legal proceeding defined by state law in which the court determines the validity of a decedent's will and the correctness with which the provisions of the will are carried out.


Services and therapies needed by people who have sustained severe injury, often due to trauma, a stroke, an infection, a tumor, surgery or a progressive disease.

Residential Care

Facilities for the Elderly (RCFE) Commonly referred to as assisted living facilities, they provide non-medical care and supervision for persons who need assistance with activities of daily living.

Respite Care

Short term, temporary care provided to people with disabilities in order that their families can take a break from the daily routine of caregiving. Respite services may sometimes involve overnight care for an extended period of time.

Reverse Mortgage

Provides tax-free funds based on the equity in a home, paid as a fixed payment, monthly payments, a line of credit, or a combination of these. No payments are made by the owners, and they can never be forced to leave their home. The lender recovers assets when the home is sold. Any equity balance remains in the homeowners' estate.

Section 8 Housing

An affordable housing assistance program offered by the federal government, either as rental vouchers which can sometimes be used for assisted living housing or as a "project-based Section 8" which pertains to a specific building.

Skilled Nursing Facility (SNF)

A nursing home providing services for residents whose general condition tends to be unstable, and requires close observation and care given by professional staff over a 24-hour period. Some skilled care is financed by Medicare; however, the majority must be covered by private funds or Medicaid.

Social Security Disability Income (SSDI or SSI, Supplemental Security Income)

A monetary benefit paid through Social Security to persons under age 65 with disabilities. SSI-G provides funds for eligible residents to pay for certified assisted living. It can be combined with GAFC (Group Adult Foster Care) subsidy for those financially and clinically eligible.

Speech Therapy

A therapy that treats speech impairment from stroke, dementia, Parkinson's disease or multiple sclerosis; cognitive and memory problems with speaking and listening, voice disorders, speech disorders, and swallowing disorders (dysphasia.)


A process of spending excess assets to meet Medi-Cal (Medicaid) eligibility requirements.

Tax-Qualified Long-Term Care Insurance Policy

A policy that conforms to certain standards in federal law and offers certain federal tax advantages.

Third-Party Liability

A party other than a beneficiary who is responsible for payment of part or all of a specific Medicare claim. Medicare supplemental insurance (Medigap) coverage is one example.

Veterans Aid and Attendance Benefit

Pays for in-home personal assistance to qualifying American veterans and their spouses or widows. They must have served at least 90 days during a period of war, and must meet other requirements. More information at www.usawarvet.com.

Viatical Life Insurance Settlements (see Life Insurance Settlements)

Waiver of Premium

A provision in an insurance policy that allows the policyholder to stop paying premiums once benefits begin being paid by the policy. The point at which the waiver begins and ends differs from policy to policy.

Wander Locator

Tracking equipment used for wander prevention and location for those who are wander-prone (Alzheimer's.)