Glossary of Terminology
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(A)
Accelerated Death Benefit - A feature of a life insurance policy that allows you to use some of the policy's death benefit prior to death.
Activities of Daily Living (ADLs) - Describes daily activities such as dressing, bathing, eating, toileting, transferring out of a bed or chair, and walking. Inability to perform one or more ADLs is often used as eligibility criteria for long term care services.
Administration on Aging (AOA) - A division of the U.S. Department of Health and Human Services which oversees programs and services for older adults. A major role is coordination of programs under the Older Americans Act through state-level departments on aging and a nationwide network of local level Area Agencies on Aging (AAAs). The AOA is an advocate for program and policy development for services that help vulnerable older persons remain in their own homes by providing supportive services and other programs.
Adult Day Care - Community-based group programs designed to meet the needs of functionally and/or cognitively impaired adults. Adult day care 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 care 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 specialized category of adult day care which provides comprehensive, professional support in a protected environment. Adult day health care includes 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.
Adult Protective Services - A community-based investigative service that looks into cases of suspected elder abuse, neglect or endangerment.
Alzheimer's Association - A volunteer organization that sponsors education programs and offers supportive services to individuals with Alzheimer's disease and their families. Chapter offices are located throughout the U.S.
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; that percentage raises to about half of those aged 85 and over. Currently, Alzheimer's disease is incurable.
Area Agency on Aging (AAA) - Created by the Federal Older Americans Act; AAAs represent a network of over 600 program sites. They function as a focal point for aging concerns at the community level. Services include information and referral, nutrition, employment, in-home services, counseling, legal services, and day health care with an emphasis on ease of access.
Assisted Living Facilities (ALF) - A residential apartment complex which caters to older adults by providing built-in care services and 24-hour on-call assistance. ALFs maximize independence, but do not provide skilled nursing care. Most ALFs do not accept public financing and rely on private pay from residents or their families.
Assistive Equipment - This term refers to a range of in home products and technology designed to help elders or those with disabilities lead more independent lives. Examples include special telephones for people with hearing impairments, walking aids, elevated toilet seats, communication devices, etc.
(B)
Beneficiary - The individual or organization that is entitled to the benefits or proceeds of a will, trust or insurance policy.
Benefit Period - The number of years of coverage on your insurance policy. Many policies will offer between three and five years and some will offer lifetime benefits. Lifetime benefits will cost roughly 30% more than a five year plan.
Benefit Triggers – A term used by insurance companies to decide when to pay benefits.
Board and Care Home - A small to medium-sized group residence that offers residents a private or shared room, meals, and includes some assistance with activities of daily living, but not skilled nursing. Also known as Adult Foster Homes.
(C)
Caregiver - Individuals (typically female family members or friends) who provide unpaid assistance to see that the physical, psychological, and/or social needs of another person are met.
Care Management Services – Services rendered by a professional, typically a nurse or social worker, who assists in planning, arranging, monitoring, or coordinating long term care services.
Care Manager - A professional who coordinates appropriate social and medical services for elders or persons with a disability and their families. Sometimes referred to as a "case manager or “case worker”."
Care Provider - All health care professionals (e.g., doctor, nurse or home care worker) or institutions (hospital, clinic, or nursing home) that provide health care or related social services.
Cash Surrender Value - The amount of money you may be entitled to receive from the insurance company when you cancel a life insurance or annuity policy. The amount of cash value will be determined as stated in the policy.
Catheter - A device used to control urinary incontinence using a receptacle bag.
Chronic Care - Ongoing provision for medical, social, psychological, and spiritual care that enable persons with serious and persistent conditions to optimize their functional independence and well-being.
Chronic Condition - A disease or condition that lasts over a long period of time or constantly repeats its course and typically cannot be cured. Chronic conditions are often associated with disability.
Codicil - a supplement to a will, containing an addition, explanation, modification, etc., made in writing and attached to the original document.
Cognitive Impairment - A deficiency in a person's memory, orientation as to person, place and time, ability to reason and judgment. Typically related to an illness or injury (e.g., Alzheimer's disease, stroke or traumatic brain injury).
Coinsurance - The amount you are required to pay for medical services after your deductible. It is usually a percentage of billed charges. For example, if the insurance company pays 70 percent of the claim, your coinsurance is 30 percent.
Community Based Services - Services designed to help elders and functionally impaired people stay independent and remain in their own homes (e.g., adult day care, senior centers, and day respite programs).
Companionship Services – People who visit isolated and homebound elders for conversation, reading, and light errands. May also be termed "friendly visitor" services.
Continuing Care Retirement Community - Usually refers to an upscale residential community that provides a continuum of care - from private apartments to assisted living to skilled nursing care - all in one location. The primary advantage of this model is that an individual or couple does not need to relocate if health care needs change over time.
Copayment - A charge your health plan requires you to pay for a specific medical service. For example, you may pay $25 for an office visit or $10 for a prescription and your health plan pays the remainder of the medical charges.
Cueing - Directing or supervising the actions of people with cognitive impairment (e.g., showing the person how to eat, giving visual or verbal reminders for dressing or toileting).
Custodial Care - Assistance with the activities of daily living and related non-medical care. Medicare prohibits reimbursement for custodial care services in-home or in a nursing home.
(D)
Daily Benefit - The amount of insurance benefit in dollars a person purchases for long term care expenses.
Deductible - The amount of money you must pay, to cover your annual medical care expenses before your insurance starts paying.
Dementia - The medical term for symptoms that describe a loss of intellectual ability, including a loss of mental processes (e.g., vocabulary, abstract thinking, judgment, memory loss, and 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.
Depression - A reversible psychiatric disorder characterized by an inability to concentrate, difficulty sleeping, feelings of hopelessness, fatigue, the “blues”, shame and guilt.
Designated Beneficiary Plan - This plan allows your beneficiaries to avoid probate by naming them and specifying what percentage of your estate will be left to each of them.
Diabetes - a disorder in which the body cannot properly convert foods into the energy needed for daily activities. Diabetes tends to be genetic but factors other than heredity are responsible as well. There are two main types of diabetes. Type I, or insulin-dependent, is the more severe for of the disease. Type II, or adult onset, is the more common form and accounts for more than 85% of all cases. Diabetes cannot be cured, but it can be controlled. Control requires carefully regulating one's diet, regular exercise, and, if necessary, insulin.
Discharge Planner - A nurse or social worker who helps patients and their families in transitioning from a hospital to another setting. Services may include assistance in locating home care services, rehabilitation, or nursing home care.
(E)
Elder Abuse -. Most often defined as an action taken by someone who is trusted by an elder that causes harm. It can manifest in a variety of ways, including physical abuse, sexual abuse, emotional abuse, financial abuse, neglect, abandonment, and self-neglect.
Elimination Period - A type of insurance policy deductible. It is the length of time the individual must pay for covered services before the insurance company will begin to make payments. The longer the elimination period in a policy, the lower the premium.
Exclusions - Defined conditions or circumstances for which an insurance policy will not provide benefits.
(F)
Fee-for-Service - A payment system where a provider is paid for each service rendered rather than paid a pre-negotiated amount for each patient.
Friendly Visitor - Community-based services that offer home visits by non-skilled people for home-bound elders or people with disabilities.
(G)
Geriatric Assessment Team - A team of health care professionals, usually led by a geriatrician, that provide coordinated diagnostic services to older adults.
Geriatric Care Manager - A social worker or nurse with experience in geriatric care, who performs an individual assessment, establishes a care plan and oversees an elder's care.
Geriatrician - A physician who specializes in the care of the elderly.
Guaranteed Renewable - When a company cannot change the coverage of a policy or refuse to renew the coverage for other than nonpayment of premiums.
(H)
Health Insurance Portability and Accountability Act (HIPAA) - Federal health insurance legislation passed in 1996 that allows, under specific conditions, long term care insurance policies to be qualified for certain tax benefits.
Health Maintenance Organization (HMO) - A health plan in which you pay a monthly premium and the HMO covers your cost of care to see doctors within a predefined network. You must choose a primary care physician who coordinates all of your care and refers to any specialists you might need. As an HMO participant, you will usually bear the cost of medical services which do not participate in your plan's network.
Home Care - Provides a range of services in the home from medical support to assistance with daily activities 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 Aids – People who provide care to older adults or those with disabilities at home. Training or certification may vary for home health aides, but typical services include assistance with activities of daily living, managing medications and household tasks.
Homemaker Services - Services which do not include hands-on care. May include shopping, laundry, light cleaning, meal preparation, and transportation assistance. Also referred to as home chore services.
Homeshare - A cost-effective living arrangement in which a group of elders share a house or apartment. Sometimes this includes a person who functions as a light caregiver and who may also make some of the meals.
Hospice Care - Services and care at home (or in a health facility) for terminally ill individuals and their families. Hospice care offers counseling, and pain and discomfort management. People cannot enter Hospice care until their projected final 6 months of life.
(I)
Incontinence - The body’s lack of ability to control urination or bowel movements or both.
Independent Practice Association - A group of physicians who contract with a health maintenance organization to provide services for their members.
Independent Living Centers - Community-based centers for disabled individuals of all types. Centers across the U.S. offer information about benefits and local resources, support, and advocacy with the goal of maximizing the ability of disabled persons to live independently.
Independent Provider - A home health care worker who is hired privately, outside of a home care agency.
Instrumental Activities of Daily Living (IADLs) - A measure of independent functioning sometimes used at assessment. IADLs include the ability to shop, prepare meals, manage money, and perform housekeeping duties.
(L)
Lapse - When a renewal premium is not paid; sometimes terminating the policy.
Lifetime Maximum - Maximum amount of benefits available to a policy holder during his/her life. All benefits are subject to this maximum, unless stated as unlimited.
Long Term Care (LTC) - Long term care includes health and social services, rehabilitative, therapeutic, skilled nursing, and other supportive, palliative care or supervision provided over an extended period of time. These services can be performed at home, in the community, in residential care facilities, and in nursing homes.
Long Term Care Ombudsman Programs - Federally-funded services charged with investigating and resolving complaints made by or on behalf of residents of nursing homes, board and care homes, and other residential care facilities. The program promotes policies and practices meant to improve the quality of life, health, safety, and rights of these residents.
(M)
Meals on Wheels - A independent program of home-delivery of free hot lunches. Usually operates Monday through Friday.
Medicare - The primary health insurance program for those aged 65 and older and the disabled. Medicare coverage provides for acute hospital care, physician services, brief stays in nursing facilities, and short-term 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 plan which covers health services for low-income individuals and families. Coverage and eligibility varies from state to state. Medicaid is the primary payer of nursing home care. 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 policy meant to supplement the coverage of the Medicare program. Medigap policies are typically designed to minimize Medicare copayments and deductibles for services and usually do not offer expanded coverage such as long term care services or prescription drugs.
Medi-Cal – Medicaid program for California.
Medicare Supplemental Insurance - Private insurance policies meant to supplement Medicare. (See Medigap Insurance above)
(N)
National Institute on Aging (NIA) - NIA is the principal biomedical research agency of the United States Government focusing on health and aging. The NIA encourages healthy aging by conducting and supporting biomedical, social, and behavioral research and education.
Noncancellable Policies – An insurance policy that cannot be cancelled and whose rates cannot be changed by the insurance company; such as the guaranteed renewable policy.
Nonforfeiture Benefits – An insurance policy that returns a part of the premiums to you if you cancel your policy or let it lapse.
Nursing Home - A common term for a Skilled Nursing Facility (SNF).
Nutrition or Congregate Meal Programs - Nutritional programs that provide lunches for older adults on weekdays in central locations such as senior centers, community centers, or schools.
(O)
Occupational Therapist - A rehabilitation professional that assists individuals to compensate for functional limitations as a result of an injury, illness or disability by learning skills needed to perform the activities of daily living and optimize independence.
Older Americans Act (OAA) - Legislation that established the federal Administration on Aging, which funds certain aging-related services administered by state-level departments and which helped create a nationwide network of community-based support services for older adults. The OAA established the Area Agencies on Aging and has provisions covering senior nutrition, housing, in-home care and other services. The OAA must go through Congressional budget reauthorization to ensure funding for new and existing programs.
Out-of-Pocket Maximum - The maximum amount of money that will be required per year for deductibles and coinsurance in addition to regular premiums.
(P)
Paratransit Services – Provides transportation (e.g., wheel chair accessible van or mini-bus) for seniors and/or people with disabilities. Services may include transportation to senior centers, medical care, shopping malls, or specific appointments.
Personal Emergency Response System (PERS) - An electronic device that enables the user to contact help in the case of a medical emergency. Many private companies offer PERS systems that link the user with designated contact persons and local emergency services on a 24-hour basis.
Physical Therapist - A rehabilitation professional who uses various therapies to help individuals maximize mobility, and restore strength and body movement following an illness, or injury (e.g., stroke, fall, back injury, etc).
Point-of-Service Plan (POS) - A managed care plan incorporating aspects of health maintenance organizations (HMOs) and preferred provider organizations (PPOs). POS offers the option to go to a network provider and pay a flat fee, or to an out-of-network provider and pay a deductible and/or a coinsurance charge.
Pre-Existing Condition - An illness or disability of which you were aware within a certain time period (typically 6-12 months) before applying for a new insurance policy. A pre-existing condition clause would prohibit coverage of the particular condition during the designated time period.
Preferred Provider Organization (PPO) - A group of health care providers that have agreed to offer medical services to a health plan's members at specific costs. PPO members make their own decisions about their health care instead of going through a primary care physician.
Premium - The amount paid monthly or quarterly, in exchange for health insurance coverage.
Primary Care Physician - Under an HMO or point-of-service plan, the primary care physician is the first contact for health care. The primary care physician is often used to make referrals to health care specialists, as necessary.
Primary Caregiver - Usually a spouse or adult child who takes on the main or day-to-day responsibility of caring for the physical, psychological, and/or social needs of another person.
Provider – Any qualified health care worker (e.g., doctor, nurse or home care worker) or institution (hospital, clinic, or nursing home) that provides health care or related social services.
(R)
Rescind - When an insurance company cancels a policy.
Residential Care Facility - A common term for a group home, specialized apartment complex or other institution where individuals live and receive care services. The term is used to refer to a range of residential care options including assisted living facilities, board and care homes and skilled nursing facilities.
Respite Care - Temporary or occasional care for individuals with disabilities, illnesses, dementia or other health concerns to provide 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.
Rider – An addition to an insurance policy that may change the provisions of the policy.
(S)
Senior Center - Community-based programs that offer a variety of services, including social activities, nutrition, educational and recreational opportunities for older adults.
Skilled Nursing Facility (SNF) - A residential care facility offering a protected, therapeutic environment for individuals who require rehabilitative care or who can no longer live independently because of chronic physical or mental condition. SNFs must be licensed by the state and are subject to certain state and federal regulations.
Social Adult Day Care - A dividion of adult day care which focuses on socialization and therapeutic recreation. There is typically no health monitoring or nursing oversight.
Speech Therapist - Specialists who provide therapy to overcome speech and communication problems, such as speech difficulties following a stroke. Speech therapists may also provide assistance for managing swallowing problems.
State Health Insurance Assistance Program - Federal program that trains volunteers to provide counseling on the insurance needs of senior citizens.
Sub-Acute Care - A level of maintenance where there is no urgent or life-threatening condition which requires medical treatment. Hospitals typically do not provide sub-acute care on an ongoing basis. Sub-acute care may include long-term ventilator care or other procedures needed on a routine basis either at home or by trained staff at a skilled nursing facility.
Substantial Assistance - A situation where hands-on, stand-by help is required to perform activities of daily living.
Substantial Supervision - The presence of a person guiding and watching over another who has a cognitive impairment.
Support Group - A group of people with a common experience (e.g., a disease, disorder, caregiving, etc.) where one can share one's concerns and receive information and support from other group members. Groups may or may not be facilitated by an expert. Many support groups are now available on-line via the Internet.
(T)
Tax-Qualified Long Term Care Insurance Policy - A policy that conforms to certain standards and offers certain tax advantages.
Telephone Reassurance - Friendly calls made by agencies or volunteers that offer reassurance, contact, and socialization to an elderly person at a predetermined time each day.
Term Life Insurance – Provides coverage for a person for one or more years. It pays a death benefit only if you die during that term. It generally does not build a cash value.
Third Party Notice - An option that lets you name someone who the insurance company would notify if your coverage is about to end due to non-payment of premium. This can be a relative, friend, or professional such as a lawyer or accountant, for example.
Thirty-Day Free Look - The right to return the policy within 30 days after purchase, if you do not want it for any reason, and the right to receive a refund for the premium paid.
TTY - A modified phone system for the hearing-impaired. The user can type messages to another person and read responses on a small screen. Also commonly referred to as "TDD" (telecommunication device). A "read only" conversation can exist between two people who each use TTY equipment. Otherwise, a non-hearing impaired caller can use a relay service where a special operator acts as a go-between to translate the speaker's words into text and text print into voice communication.
(U)
Underwriting - The process of examining, accepting, or rejecting insurance risks, and classifying those selected, in order to charge the proper amount.
Universal Life Insurance - A flexible policy that allows you to vary your premium payments and adjust the face amount of your coverage.
(W)
Waiver of Premium - A provision in an insurance policy that relieves the policy holder of paying the premiums while receiving benefits.
Whole Life Insurance – A policy that builds monetary value and covers a person for as long as he or she lives if premiums continue to be paid.
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Helpful Links |
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Housing Options |
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| There are a wealth of housing options out there for your elderly loved one, including Independent Living Communities, Assisted Living, Nursing Homes and Personal Care Homes. Be sure to educate yourself on each of these options and evaluate the various differences. For example, are there nurses on-site to provide medication management? Do they offer mobility assistance? Is there housekeeping and laundry service? These are all factors above and beyond price that will help you find the perfect home for your loved one. |
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| You've Taken the First Step |
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| Now that you've found National Care Providers you've taken the first step to locating the perfect eldercare options for your loved one. Please call us if we can be any assistance along the journey. We are here to serve! |
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