Following is a glossary of terms which may be helpful in your search for the right type of senior care.


A sudden and severe condition

Activities of Daily Living (ADL)

Physical functions that an individual performs each day, including bathing, dressing, eating, toileting, walking or wheeling, and transferring into and out of bed.

Administration on Aging

An agency of the U.S. Department of Health and Human Services. AOA is an advocate agency for older persons and their concerns at the federal level. AOA works closely with its nationwide network of State and Area Agencies on Aging (AAA).

Advanced Directives

A written statement of an individual’s preferences and directions regarding health care. Advanced Directives protect a person’s rights even if he or she becomes mentally or physically unable to choose or communicate his or her wishes.


Determination of a resident’s care needs, based upon a formal, structured evaluation of the resident’s physical and psychological condition and ability to perform activities of daily living.

Certified Nursing Assistant (CNA)

The CNA provides personal care to residents or patients, such as bathing, dressing, changing linens, transporting and other essential activities. CNAs are trained, tested, and certified and work under the supervision of an RN or LVN.

Centers for Medicare and Medicaid Services (CMS)

Formerly the U.S. Health Care Financing Administration, CMS is an element of the Dept. of Health and Human Services, which finances and administers the Medicare and Medicaid programs. Among other responsibilities, CMS establishes standards for the operation of nursing facilities that receive funds under the Medicare or Medicaid programs.

Continuing Care Retirement Communities (CCRC)

Housing communities that provide different levels of care based on the needs of their residents – from independent living apartment to skilled nursing in an affiliated nursing facility. Residents move from one setting to another based on their needs, but continue to remain a part of their CCRC’s community. Typically CCRCs require a significant payment prior to admission, then charge monthly fees above that.

Durable Power of Attorney (DPAHC)

A legal document in which a competent person gives another person (called an attorney-in-fact) the power to make health care decisions for him or her if unable to make those decisions. A DPA can include guidelines for the attorney-in-fact to follow in making decisions on behalf of the incompetent person.

Dual Eligibles

Someone who is qualified for both Medicaid and Medicare.

Health Care Directive

A written legal document which allows a person to appoint another person (agent) to make health care decisions should he or she be unable to make or communicate decisions.

Health Care Power of Attorney

The appointment of a health care agent to make decisions when the principal becomes unable to make or communicate decisions.


Hospice/palliative care is provided to enhance the life of the dying person. Often provided in the home by health professionals, today there are many nursing facilities and acute care settings that also offer hospice services. Hospice care, typically offered in the last six months of life, emphasizes comfort measures and counseling to provide social, spiritual, and physical support to the dying patient and his or her family.

Hospice Care

The provision of short-term inpatient services for pain control and management of symptoms related to terminal illness.

Living Will

A legal document in which a competent person directs in advance that artificial life-prolonging treatment not be used if he or she has or develops a terminal or irreversible condition and becomes incompetent to make health care decisions.

Long Term Care (LTC)

The broad spectrum of medical and support services provided to persons who have lost some or all capacity to function on their own due to a chronic illness or condition, and who are expected to need such services over a prolonged period of time. Long term care can consist of care in the home by family members who are assisted with voluntary or employed help, adult day health care, or care in assisted living or skilled nursing facilities.


The federally supported, state operated public assistance program that pays for health care services to people with a low income, including the elderly or disabled persons who qualify. Medicaid pays for long term nursing facility care, some limited home health services, and may pay for some assisted living services, depending upon the state.


The federal program providing primarily skilled medical care and medical insurance for people aged 65 and older, some disabled persons and those with end-stage renal disease.

Medicare Part A

Hospital insurance that helps pay for inpatient hospital care, limited skilled nursing care, hospice care, and some home health care. Most people get Medicare Part A automatically when they turn 65.

Medicare Part B

Medical insurance that helps pay for doctor’s services, inpatient hospital care, and some medical services that Part A does not cover (like some home health care). Part B helps pay for these covered services and supplies when they are medically necessary. A monthly premium must be paid to receive Part B.

Nurse, Licensed Vocational (LVN)

A graduate of a state-approved nursing education program, who has passed a state examination and been licensed to provide nursing and personal care under the supervision of a registered nurse or physician. An LVN administers medications and treatments and acts as a charge nurse in nursing facilities.

Nurse, Registered (RN)

Nurses who have graduated from a formal program of nursing education (two-year associate degree, three-year hospital diploma, or four-year baccalaureate) and passed a state-administered exam. RNs have completed more formal training than licensed practical nurses and have a wide scope of responsibility including all aspects of nursing care.

Occupational Therapy

Services provided to those individuals who are unable to cope with the tasks of everyday living and who are threatened or impaired by physical illness or injury, psychosocial disability, or development deficits. Occupational therapists work in hospitals, rehabilitation agencies, long-term care facilities, and other health-care organizations.


The ombudsman program is a public/government/community-supported program that advocates for the rights of all residents in 24-hour long-term care facilities. Volunteers visit local facilities weekly, monitor conditions of care, and try to resolve problems involving meals, finances, medication, therapy, placements and communication with staff.

Private Pay Patients

Patients who pay for their own care or whose care is paid for by their family or another private third party, such as an insurance company. The term is used to distinguish patients from those whose care is paid for by governmental programs (Medicaid, Medicare, and Veterans Administration).

Physical Therapy

Services provided by specially trained and licensed physical therapists in order to relieve pain, restore maximum function, and prevent disability or injury.

Power of Attorney

A legal document allowing one person to act in a legal manner on another’s behalf pursuant to financial or real-estate transactions.

Pre-Admission Screening

An assessment of a person’s functional, social, medical, and nursing needs, to determine if the person should be admitted to nursing facility or other community-based services available to eligible Medicaid recipients.

Resident Care Plan

A written plan of care for nursing facility residents developed by an interdisciplinary team which specifies measurable objectives and timetables for services to be provided to meet a resident’s medical, nursing, mental and psychosocial needs.

Respite Care

Scheduled short-term nursing facility care provided on a temporary basis to an individual who needs this level of care but who is normally cared for in the community. The goal of scheduled short-term care is to provide relief for the caregivers while providing nursing facility care for the individual. Short-term stay beds used for respite care must be distinct from general nursing facility beds.

Skilled Nursing Care

Nursing and rehabilitative care that can be performed only by, or under the supervision of, licensed and skilled medical personnel.

Skilled Nursing Facility (SNF)

Provides 24-hour nursing care for chronically-ill or short-term rehabilitative residents of all ages.

Speech Therapy

This type of service helps individuals overcome communication conditions such as aphasia, swallowing difficulties and voice disorders. Medicare may cover some of the costs of speech therapy after client meets certain requirements.

Sources: U.S. Dept. of Health & Human Services; American Health Care Association; Center for Medicare & Medicaid Services;, 2007.

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