activities of daily living (adls) Routine activities including eating, dressing, grooming, bathing, toileting, sleeping, bed mobility, transferring, and ambulating.
adult day care A group setting that provides care and supervision to older or disabled adults and offers a structured program of activities and meals. Hours of operation are usually weekdays from 8:00 a.m.–6:00 p.m. Some may offer weekend or extended hours and some offer transportation to and from the client’s home.
advanced directive A legal document that provides information in advance about the expressed wishes for medical treatment and intervention, health care, end-of-life issues, and appoints a spokesperson to make health-care decisions in the event that the author is unable to make these decisions. A living will, durable power of attorney for health care, and a health-care proxy are all examples of advance directives.
Alzheimer’s disease First discovered in 1906 by German physician Dr. Alois Alzheimer, Alzheimer’s disease is a progressive presenile dementia that can begin in the forties or fifties. It affects the part of the brain that controls language, memory, and thought. As it progresses, these processes can be lost. There is no known cause or cure.
ambulation The action of walking.
assisted living A group residence for adults in which the adults live independently in separate apartments or dwellings but share services such as meals, laundry, housekeeping, limited transportation and group activities, and can pay for additional assistance with bathing, dressing, grooming, ambulation, and medication supervision. There is staff available twenty-four hours in case of urgent need. No skilled care is provided.
board-and-care home A shared residential setting for seniors or the disabled that provides twenty-four-hour supervision and assisted living. Often these are large single-family homes in which each resident has his own bedroom or may share a bedroom. A staff is available twenty-four hours to provide assistance with ADLs. Congregate meals are provided.
burnout A condition that results from chronic stress caused by a job or other set of responsibilities. Caregivers can burn out from the stress of care-giving responsibilities. It is a state of physical and emotional exhaustion, and can include physical illness.
care manager A care manager or case manager is a professional social worker or registered nurse trained to assist in evaluating, coordinating, and managing the care of seniors or others in need of health-care or assisted-living issues. Geriatric care or case managers specialize in managing care for seniors.
caregiver A person who assumes responsibility for and provides care to another person.
commode A bedside commode is a chair with a seat that lifts up to reveal a toilet seat with a detachable bucket underneath. It is placed at or near the bedside for toileting when the patient can’t get to the bathroom. The bucket can be removed and the urine or feces dumped into the toilet for disposal. With the bucket removed, the commode can also be placed over a toilet to provide a raised toilet seat for those who need a higher seat, such as after hip surgery.
competency The ability to understand information, make informed decisions, and legally act on your own behalf.
custodial care Custodial care is not skilled and therefore not medically necessary. It involves assisting with ADLs and supervision to prevent personal harm or injury. Custodial care is not covered by insurance, Medicare, or Medicaid.
decubitus A pressure sore also known as a bedsore, which is a breakdown of the skin caused by friction or pressure from sitting or lying in one position and diminishing the blood flow to the area. Areas of the body where the skin is thin or over bony spots are more prone to breakdown.
dementia An irreversible progressive decline in mental function characterized by deficits in memory, impaired judgment or reasoning, and loss of cognitive abilities such as social or intellectual processes.
durable medical equipment (DME) Used for assisting or treating an illness, injury, or condition, and maintaining safety. Examples of DME include a hospital bed, walker, cane, commode, bath bench, suction machines, colostomy supplies, catheter supplies, and wound care supplies.
durable power of attorney (DPOA) A legal document that appoints another person to manage your affairs in the event you are unable or unavailable to do so. The specific responsibilities are outlined in the document and the power is limited to those responsibilities. To appoint a DPOA for health care, the specific responsibilities would be to make health-care decisions for you if you are unable to do so, based on your written wishes. Unless otherwise specified, the only decisions covered by this would be for health care.
gait The pattern or manner of walking. An unsteady gait may be due to pain or decreased strength and can be seen as a limp or staggering.
homebound Being confined to the home, rarely able to leave, and then only with great difficulty and usually for medical appointments. The reason for being homebound can be physical or mental. This can also be a temporary situation such as during the recovery from surgery or major illness or injury. However, just because a person no longer drives does not necessarily mean she is homebound. A person must be homebound to meet criteria to receive home-health care.
incontinence The loss of self-control over the bladder or bowel and having involuntary discharge of urine or feces.
JCAHO An acronym for the Joint Commission on Accreditation of Health Care Organizations. Hospitals, home-health agencies, and DME companies often seek accreditation from JCAHO to ensure they meet quality-care standards.
levels of care The stages or degrees of care provided by residential facilities such as independent and assisted-living services.
living will A legal document and one form of advance directive in which instructions and wishes regarding medical care and treatment are specified in advance so they can be carried out in the event the person is not able to communicate or make decisions. Some states limit how specific the instructions can be.
long-term-care facility A facility that provides skilled and custodial care to seniors or others who are unable to care for themselves due to disabilities, illness, injury, age, and health conditions.
long-term-care insurance A private insurance policy designed to provide benefits to cover some of the costs of custodial care in such settings as nursing homes, adult day cares, at-home care, and assisted-living facilities.
medically necessary A term used to designate the fact that prescribed medical care and services, medications, supplies, DME, X-rays, and laboratory tests are essential to the diagnosis and treatment of an illness, disease, or injury.
Medicare certified If a facility, practitioner or provider, or healthcare agency is Medicare certified, it meets the federal regulations and is approved to provide care and be reimbursed under Medicare for services rendered.
ombudsman Someone who investigates complaints and helps mediate disagreements and grievances between patients and facilities or providers. They play an active role in overseeing the quality of patient care in skilled nursing facilities and nursing homes.
personal care Includes assistance with ADLs such as bathing, grooming, dressing, toileting, and eating.
primary care practitioner (PCP) The PCP can be a physician, D.O. (osteopath), or ND (naturopath) who oversees and coordinates the care of patients with other health-care providers such as physicians, hospitals, and home-health agencies. The NP (nurse practitioner) or PA (physician assistant) working with a physician can also act as a PCP to coordinate care.
respite care Care that is provided by another in relief of the primary caregiver in order to provide the caregiver a break for such purposes as to replenish herself or to meet other obligations.
skilled care Medically necessary care provided by a nurse, therapist (physical, occupational, or speech), or other licensed health-care provider. The care requires the skills and education of that provider.