Glossary of Terms

Accreditation
This certification means that a retirement community or service provider has met the standards set by a governing body or organization (not a government agency or regulatory group). The provider must be evaluated comprehensively to meet predetermined standards of quality. Accrediting organizations for the retirement 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 (ADL)
Bathing, toileting, grooming, getting dressed and eating, as well as other activities involving personal care.

Acute Care
Short-term treatment for patients who need hospitalization for a brief but severe illness or injury. Care is generally provided in an emergency department, ambulatory care clinic or other short-term hospital unit. The goal is to stabilize the patient’s health and discharge them as soon as is medically appropriate.

Administrator
This licensed professional manages the day-to-day operation of a care facility, i.e., a nursing home or Assisted Living facility.

Advance Medical Directives
This term describes three legal documents, giving decision-making powers to a surrogate, should a person become unable to make legal or medical treatment decisions independently, due to mental or physical disability.

• A Living Will specifies the type of medical treatment desired, should the individual become incapacitated by an incurable, irreversible condition. It can cover such areas as pain relief, antibiotics, hydration, feeding, CPR (cardiopulmonary resuscitation) and the use of life-support equipment.
• A Health Care Proxy designates another person to make health care decisions if the patient becomes incapable of making his or her wishes known. The health care proxy has the same rights to request or refuse treatment that the individual would have if capable of making and communicating decisions.
• Durable Power of Attorney gives permission for others to execute legal documents if an individual is stricken by an incapacitating medical condition. The person given Durable Power of Attorney can make bank transactions, sign Social Security checks, apply for disability, or simply write checks to pay the utility bills.

Alzheimer's Disease
This degenerative age-related disease impairs cognitive ability. Symptoms may include forgetfulness, wandering and inability to recognize others. The disease is caused by neuron dysfunction and death in brain regions responsible for cognitive functions. Alzheimer’s is believed to be caused by both genetic and environmental factors.

Alzheimer's or Dementia Care Facility
See “Special Care Unit.”

Ambulatory
The ability to walk around, not bedridden.

Assisted Living Facilities (ALF)
Senior residential communities offer state-licensed programs, including meals, laundry, housekeeping, medication reminders, assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs).

Certified Nursing Assistant (CNA)
See “Nurse Assistant.”

Charge Nurse
This RN or LPN supervises a unit within a nursing facility. The charge nurse schedules and supervises nursing staff and provides care to residents.

Chronic Illness or Condition
An ongoing illness, requiring lifelong treatment, such as asthma, diabetes, and sometimes depression.

Continuing Care Retirement Community (CCRC)
These residential communities provide a continuum of housing accommodations and services for seniors, including Independent Living, congregate housing, Assisted Living, and Skilled Nursing care.

Continuum of Care
This term describes the full spectrum of care provided by Continuing Care Retirement Communities. It may include Independent Living, Assisted Living, Nursing Care, Home Health, Home Care, and Home and Community-Based Services.

Cognitive Impairment
The inability to perform mental functions, the result of accident or illness. Cognitive impairment is one key measurement of Alzheimer’s, dementia and other memory-loss conditions.

Community Based Services
A formal network of agencies and organizations offering diverse services to help keep individuals in their homes and in the community. Though usually not covered by insurance, community-based services are often available on a needs basis, at low or no cost.

Dementia
A progressive neurological, cognitive, or medical disorder affecting memory, judgment, and cognitive abilities.

Developmental Disability (DD)
A condition characterized by chronic physical and mental disabilities. DDs include cerebral palsy, retardation, thyroid problems, seizures, and quadriplegia.

Director of Nursing (DON)
A DON supervises all nursing staff in a nursing home, formulates nursing policies and monitors the quality of care delivered, as well as compliance with Federal and state nursing-care regulations.

Home Health Care
A licensed provider offers medical and nursing services in a person’s home.

Hospice Care
These services provide care and comfort to those with a terminal illness and their families. Hospice care may include medical, counseling, and social services. Most hospice care is given in the patient’s home, while specialized hospices and some hospitals also provide hospice care.

Independent Living
These multi-unit senior housing developments usually provide supportive services, such as meals, housekeeping, social activities, and transportation. Independent Living is offered as part of Congregate Housing, Supportive Housing, and Retirement Communities.

Instrumental Activities of Daily Living (IADLs)
These everyday tasks include preparing meals, shopping, managing money, managing medication, and housekeeping.

Kitchenette
A kitchenette usually includes a sink, cabinets, a mini-refrigerator, and possibly a microwave. A full kitchen would 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 and provide a range of health care services, such as medication management and changing of dressings. The LPN designation requires one year of post-high school education and passing a state licensing exam.

Long-Term Care
Services provided to persons of any age with chronic health impairments.

Medicaid
This medical/financial health insurance assistance program, jointly funded by Federal and State government, provides benefits to people with limited financial resources, the disabled, and the elderly. To qualify, individuals must meet income eligibility criteria. Medicaid accounts for about 52 percent of the nation's care costs. It pays for almost 70 percent of residents in nursing homes. The person must have exhausted nearly all assets and be in a nursing facility that participates in this program.

Medicare
This national medical insurance program is administered by the Social Security Administration for individuals age 65 and over and certain disabled people, regardless of income. It pays for hospital and nursing facility care (Part A) and physician services, therapies, and home health care (Part B).

Medical Director
The medical director has overall responsibility for formulating and implementing all policies related to medical care. The medical director also coordinates with an individual's personal physician to ensure that the facility delivers the prescribed care. The medical director may sometimes be a resident's primary physician.

Memory Care
Memory care refers to the treatment and supervision of people with memory impairment, including Alzheimer’s, Parkinson’s and other forms of dementia. The level of care depends upon the degree of memory loss, from mild to severe. In the most advanced cases, patients may need to reside in secure areas with 24 assistance.

Non-Ambulatory
Unable to walk around; usually bedridden or hospitalized.

Not-for-Profit
Facilities owned and/or operated by all-volunteer government or community-based boards of trustees. Board members donate their time and talents to ensure that a not-for-profit organization's approach to care responds to local needs. Not-for-profit homes and services use any surplus income to improve services for their clients or residents. Many not-for-profit organizations are often associated with religious denominations and fraternal groups. Not-for-profits may also interact with Congress and Federal agencies to further causes that serve seniors.

Nurse Assistant
A Nurse Assistant provides the most personal care to residents, including bathing, dressing, and toileting. In nursing facilities that participate in Medicare and Medicaid, Nurse Assistants must be trained, tested, and certified to provide care. They work under the supervision of a Registered Nurse or Licensed Practical Nurse.

Occupational Therapy
This process helps people relearn the activities of daily living, administered by a licensed therapist.

Physical Therapy
Individualized programs of exercise to improve physical mobility, often administered following a stroke, fall, or accident. Physical therapists plan and administer prescribed treatment programs to help patients restore their abilities and strength.

Plan of Care
Nurses develop a plan of care by assessing objective and subjective data to support a patient’s diagnosis, establishing goals for the patient’s nursing care, and stating the expected outcomes. Then the nursing interventions are determined—the services required to meet the stated goals. Interventions are modified or added as needed, during the progress of the patient’s treatment. The Plan of Care sets a specific review date to determine if goals have been achieved.

Registered Nurse (RN)
This graduate trained nurse must pass a state board examination and be licensed by a state agency to practice nursing. The RN evaluates resident needs, develops and monitors care plans in conjunction with physicians, and executes highly technical, Skilled Nursing treatments. The degree requires a minimum of two years of college as well as passing the state exams.

Rehabilitation
Therapeutic care for those requiring intensive physical, occupational, or speech therapy.

Respite Care
Assisted Living facilities or nursing homes can offer temporary relief for caregivers, ranging from several hours to days. This service may also be provided in the home.

Special Care Units
Alzheimer Special Care Units (SCUs) are secure facilities for patients with Alzheimer’s and other forms of dementia, often within nursing homes and retirement communities. SCUs help staff control common problems with dementia patients, such as wandering, while providing long-term care. Many states have enacted regulations governing the policies, staffing levels and other standards for SCU operations.

Wellness
Retirement communities usually offer a Wellness Philosophy, with programs combining physical fitness with mental, emotional, social and spiritual development to enrich the whole person.