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This glossary is available to give you general information about words and terms associated with Texas aging, disability or long-term care.

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 Healthcare Organizations).

Activities of Daily Living (ADLs) - Basic personal activities which include bathing, eating, dressing, mobility, transferring from bed to chair, and using the toilet. ADLs are used to measure how dependent a person may be on requiring assistance in performing any or all of these activities.

Admissions Coordinator/Director - Coordinates the admissions procedures for incoming residents.

Adult Day Care - Community-based group programs designed to meet the needs of functionally and/or cognitively impaired adults. Adult day centers provide a caring, home-like setting for individuals who, for their own safety and well-being, can no longer be left at home alone. Adult day centers offer protected settings which are normally open five days a week during business hours and include a mixture of health, social and support services. Specialized programs for individuals with Alzheimer's disease or related disorders also exist.

Adult Day Health Care - A category of adult day care which provides comprehensive, professional support in a protected environment including on-site nurses, physical therapists, social workers, and/or other professionals for adults who are experiencing a decrease in physical, mental, and social functioning and require tailored medical and/or psychiatric supervision. Such centers normally offer a wide range of therapeutic and rehabilitative activities as well as social activities, meals, and transportation.

Advanced Directives - These are a way for an individual to accept or refuse medical care. They can protect your rights even if you become mentally or physically unable to choose or communicate your wishes. Living Wills and Durable Power of Attorney for Health Care are two examples of Advanced Directives.

Aging in Place - A concept which 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 aging process of aging. If your loved one has lived in the same residence for many years but has developed frailties which might require institutionalization, you should consider whether the residence can be modified to compensate for some of these problems. If you are successful the elder may be able to remain "in place" for several more years.

Alzheimer's Care Facilities - Referring to the specialty care of older adults with advanced dementia and Alzheimer's Disease.

Alzheimer's Disease A progressive neurological disease that affects brain functions, including short-term memory loss, inability to reason, and the deterioration of language and the ability to care for oneself. An estimated 3% of people between the ages of 65 and 74 have Alzheimer's, rising to about half those age 85 and over.

Area Agency on Aging (AAA) - A local (city or county) agency, funded under the federal Older Americans Act, that plans and coordinates various social and health service programs for persons 60 years of age or more. The network of AAA offices consists of more than 600 approved agencies.

Assisted Living Facilities (ALF) - Provide shelter and care but do not offer medical or skilled nursing services. Private or semi-private rooms, meals, housekeeping, protective oversight, and some degree of personal care are available.

Assistive Devices - This term refers to a range of products and technology designed to help elders or people with disabilities lead more independent lives. Examples include special telephones for people with hearing impairments, walking aids, elevated toilet seats, communication devices, etc.

Caregiver - A person who provides 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 long distance.

Care/Case Management - Offers a single point of entry to the aging services network. Care/case management 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.

Community-Based Services - Services designed to help older people remain independent and in their own homes; can include senior centers, transportation, delivered meals or congregate meals site, visiting nurses or home health aides, adult day care, and homemaker services.

Continuum of Care - The entire spectrum of specialized health, rehabilitative, and residential services available to the frail and chronically ill. The services focus on the social, residential, rehabilitative and supportive needs of individuals as well as needs that are essentially medical in nature.

CVA - Refers to a cerebrovascular accident or stroke in which an area of the brain is damaged due to a sudden interruption of blood supply.

Dementia - The medical term for a group of symptoms that describes a loss of intellectual ability, including loss of mental processes (e.g., vocabulary, abstract thinking, judgment, memory loss, physical coordination) that interfere with daily activities. The symptoms can be brought on by degenerative diseases (e.g., Alzheimer's, Huntington's and Parkinson's diseases), vascular diseases or stroke, metabolic disorders (thyroid, liver kidney dysfunction or certain vitamin deficiencies), AIDS, drugs and alcohol, or psychiatric disorders. Some dementing disorders may respond to treatments, others do not.

Discharge Planner - A nurse or social worker who assists patients and families in transitioning from the hospital to another setting. Services may include assistance in locating home care services, rehabilitation, or nursing home care.

Durable Medical Equipment (DME) (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 General Power of Attorney - A delegation of power to another to make legal or financial decisions.

Durable Power of Attorney for Health Care - A delegation of power to another to make medical decisions. It should be used as a companion document with a living will.

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Eldercare Locator (800-677-1116) - A nationwide directory assistance service designed to help older persons and caregivers locate local support resources for aging Americans. Eldercare Locator is a public service of the Administration on Aging, U.S. Department of Health and Human Services and is administered by the National Association of Area Agencies on Aging and the National Association of State Units on Aging.

Elder Law - The specialty within law that focuses on the legal and financial needs of the elderly, including estate planning (wills, trusts, etc.), Medicare and Medicaid eligibility and advocacy, and issues of competence.

Emergency Response Systems - Allows for 24 hour monitoring and response to medical or other emergencies.

Home Care - Provides a range of supportive services in the home from intensive medical support to assistance with activities of daily living to housekeeping. This type of care can include nurses, social workers, occupational therapists, physical therapists, and other rehabilitation services. This support allows many elders and people with disabilities to remain in their own homes.

Home Health Aide - A person who, under the supervision of a home health or social service agency, assists elderly, ill or disabled person with household chores, bathing, personal care, and other daily living needs. Social service agency personnel are sometimes called personal care aides.

Homemaker Services - In-home help with meal preparation, shopping, light housekeeping, money management, personal hygiene and grooming, and laundry.

Home Health Aide - Provides personal care: including bathing, dressing and grooming, and some household services.

Hospice Care - Provided to those with a terminal illness, and can include medical, counseling, and social services.

Independent Living - Multi-unit senior housing development with supportive services such as meals, housekeeping, social activities, and transportation. Independent Living typically encourages socialization by provision of meals in a central dining area and scheduled social programs. Unless an Assisted Living program is available on site, congregate housing does not provide any health-care services or assistance with ADLs, and is not licensed. May also be known as Independent Living or Retirement Housing/Home.

In-Home Services - This term refers to such services as home health aide, family respite services, visiting and telephone reassurance and chore maintenance which enable older persons to remain in their homes for as long as possible. They offer an alternative to premature institutionalization.

Intermediate Care - Occasional nursing and rehabilitative care ordered by a doctor and performed or supervised by skilled medical personnel.

Intermediate Care Facility (ICF) - A nursing home, recognized under the Medicaid program, which provides health-related care and services to individuals who do not require acute or skilled nursing care, but who, because of their mental or physical condition, require care and services above the level of room and board available only through facility placement. Specific requirements for ICF's vary by state. Institutions for care of the mentally retarded or people with related conditions (ICF/MR) are also included. The distinction between "health-related care and services" and "room and board" is important since ICF's are subject to different regulations and coverage requirements than institutions which do not provide health-related care and services.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) - The Joint Commission evaluates and accredits nearly 19,000 health care organizations and programs in the United States. An independent, not-for-profit organization, the Joint Commission is the nation’s predominant standards-setting and accrediting body in health care. Since 1951, the Joint Commission has developed state-of-the-art, professionally based standards and evaluated the compliance of health care organizations against these benchmarks.

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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 possibly a microwave or stove.

Licensed Practical Nurse (LPN) - 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 - Similar to CCRC, but differs in that a Life Care Community provides all levels of care on site, including acute care and physician's visits. No change is made in the monthly fee, regardless of the level of medical care required by the resident.

Long-Term Care (LTC) - A wide range of medical and non-medical services ranging from custodial help with activities of daily living (ADL's) to occasional nursing care to skilled nursing services provided to people who are physically or mentally unable to provide independent care for themselves. Usually used to describe care for the elderly although younger disabled persons also utilize long-term care services. Care may be needed while recovering from an accident or illness, during an extended period of disability, or simply as a result of the normal aging process. Home Healthcare, adult day care, respite care and nursing home stays fall into the category of long-term care.

Long-Term Care Facilities - Institutions that provide nursing care to people who are unable to care for themselves and who may have health problems ranging from minimal to serious. These facilities are often used for short-term rehabilitation after hospitalization.

Long-Term Care (LTC) Insurance - Insurance that covers expenses incurred when the insured receives specified services associated with extended care in a variety of settings including the individual's home, nursing homes and community-based facilities such as assisted living facilities and adult day care centers.

Medicaid / Medical Assistance - A federal and state government program in which the states provide health care for low-income people.

Medicaid (Title XIX) - Federal and state funded program of medical assistance to low-income individuals of all ages. There are income eligibility requirements for Medicaid.

Medicare (Title XVIII) - Federal health insurance program for persons age 65 and over (and certain disabled persons under age 65). Consists of 2 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).

Medication Management - A formalized procedure, with a written set of rules, for the management of self-administered medicine in an assisted living setting. A typical program will include management of the timing and dosage for residents, and may include coordination with a resident's personal physician. The resident must take the medication him or herself. For instance, the facility can remind the resident that she needs to give herself the medicine injection, but the facility cannot perform the actual injection itself.

Medicare - The primary health insurance program for people aged 65 and older and those with certain disabilities. Medicare coverage provides for acute hospital care, physician services, brief stays in skilled nursing facilities, and short-term skilled home care related to a medical problem. Medicare coverage is determined by the nature of services required by the patient, not the specific diagnosis. Coverage is restricted to medical care, and does not include prescription drugs or custodial care at home or in nursing homes.

Medicaid - A joint federal-state program which covers health services for low-income individuals and families. Coverage and eligibility requirements vary from state to state. Medicaid is the primary payer of nursing home care. In addition, many states offer some level of home and community-based long-term care services for eligible individuals. Such additional services are at the option of the state and are not mandated by Federal law.

Medigap Insurance - A private insurance policy designed to supplement the coverage of the Medicare program. Medigap policies are typically designed to minimize Medicare copayments and deductibles for covered services and generally do not offer expanded coverage such as long term care services or prescription drugs.

Mental Health Services - A listing of professionals, including psychiatrists, psychologists, counselors and social workers, who evaluate and treat mental illness and promote mental health.

Multipurpose Senior Center - A multipurpose senior center is a community or neighborhood facility established for the organization and provision of a broad spectrum of supportive services, including health, social, nutritional, and educational services, and the provision of facilities for recreational activities for older individuals.

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Non-Medical Home Care - A non-medical agency provides home companion caregivers who can assist with most non-medical personal needs, such as meal preparation, light housekeeping and laundry chores, running errands, sitter services, bill paying, and cmpanionship on either a a live-in or hourly basis.

Nursing Home - Facility licensed by the state to offer residents personal care as well as skilled nursing care on a 24 hour a day basis. Provides nursing care, personal care, room and board, supervision, medication, therapies and rehabilitation. Rooms are often shared, and communal dining is common.

Nursing Home Care - Full-time care delivered in a facility designed for recovery from a hospital, treatment, or assistance with common daily activities.

Ombudsmen - An advocate for nursing home residents. The ombudsman is ready to help if you need information on the nursing homes in your state. The ombudsman also works to resolve problems between nursing homes and residents or their families. Complaints about nursing homes are confidential unless the ombudsman has permission to use the resident's name. (800) 252-2412.

Parkinson's Disease Glossary of Terms (Double click on link for complete list)

Personal Emergency Response System - An electronic device that enables the user to contact help in case of a fall or other medical emergency. A number of private companies offer PERS systems which link the user with designated contact persons and local emergency services on a 24-hour basis.

Respite Care - Temporary or intermittent care for individuals with disabilities, illnesses, dementia or other health concerns to give relief to caregivers from the demands of ongoing care. Respite care can be provided at home, in the community (e.g., adult day care centers or special respite programs) or overnight in a facility.

Retirement Communities - Referring to larger complexes with self-contained living units for older independent adults.

Residential Care Facilities (Personal Care Homes) - Referring to smaller-sized complexes catering to both independent older adults and those requiring some level of health services care.

Rehabilitation & Physical Therapists - Professionals who improve mobility, relieve pain, and prevent or limit permanent disabilities.

Remodeling for Accessibility - Architects and designers who understand the specialty requirements of remodeling for the geriatric population.

SALT (Seniors and Law Enforcement Together) - The SALT Council decides what services or programs the TRIAD will offer, recruits volunteers and oversees the results.

Senior Agencies Services - This category includes community, city, state, and federal agencies catering to the needs of seniors.

Senior Apartment - Age-restricted building with self-contained living units for older adults who are able to care for themselves and live independently. Usually no additional services such as meals or transportation are provided.

Senior Center - Provides a variety of on-site 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 Social Services - Referring to social clubs, senior centers, and providers offering any number of activities and services outside the medical and housing arena.

Skilled Nursing Facility (SNF) - A facility licensed by the individual state, and one that may be certified by Medicare, providing care that requires the highest level of medical skills with continuous, 24-hour attention from a registered or licensed practical nurse, under a physician's orders and/or supervision. May also provide Intermediate or Custodial Care and makes care available from other medical practitioners and for emergency services.

Social Worker - In the long term care setting, social workers assesses a resident's psychosocial progress and helps the resident to maintain a healthy outlook on life. A social worker provides counseling to residents and families, and are important during a resident's initial period of adjustment to the long term care setting.

Spend-Down - Medicaid financial eligibility requirments 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.

State Health Insurance Assistance Programs - Provides free help home services, Medicaid eligibility requirements, private Long-Term Care Insurance, with questions on long-term care costs. If you are confused about Medicare coverage of nursing or have health insurance questions, contact the State Health Insurance Assistance Program at (800) 252-9240.

State Survey Agencies - Conduct annual surveys (like inspections) of every Medicare or Medicaid certified nursing home in your state, and cite homes for deficient practices. Survey agencies enforce Federal guidelines on nursing homes and have the power to sanction homes. If you have a complaint about the quality of life or quality of care inside a nursing home, contact your State's Survey Agency at (800) 228-1570.

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.

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