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GlossaryThe Key Terms of Aging Network Accessibility - Use and design of a space that allows the greatest amount of use by a person with a disability (Examples: Easy reach appliance, turning spaces that would allow a wheelchair to maneuver easily.) ADA- Americans with Disabilities Act - This act guarantees access and reasonable accommodation for persons with mental or physical disabilities. It's "predecessor," called "Sec. 504," is still applicable, as well. ADL- Activities of Daily Living - Some of the ADL are fairly standardized, universally accepted everyday tasks, such as bathing, dressing, grooming, eating, taking medications, and other personal care activities. The ability to perform such tasks in turn is indicative of a person's ability to manage independently or conversely the inability to perform indicates a need for assistance. For example, a person who cannot get out of a chair without assistance may need a specific intervention, such as physical therapy, or he/she may need 24-hour oversight in case of emergency, depending upon many other factors. Activities of Daily Living can be measured objectively, thereby providing valuable guidance when decisions about care and living arrangements must be made. Further, the need for assistance with Activities of Daily Living (ADL) or the inability to perform ADL is used to determine eligibility for many government programs such as Medicaid reimbursed long-term care services. Also see ‘IADL. Adaptability - Use and design of space that addresses the problems of individual differences over a period of time. Allows the space to be easily changed as needed (Examples: Widening an existing doorway, adding a stair lift to a staircase). Adaptive Equipment (also ‘Assistive Devices’, ‘Assistive Technology’, ‘Independent Living Aids’) - Any service or tool that helps older or disabled adults perform the activities they have always done but must now do differently. Such technology may be something as simple as a walker to make moving around easier or an amplification device to make sounds easier to hear (for talking on the telephone or watching television, for instance). ADHC- Adult Day Health Care, also known as ‘Adult Day Care Services’- Structured community-based programs that provide social and recreational activities, meals, and social work services for frail older people and adults with disabilities who might otherwise require institutional placement or in-home care to remain in their communities. Through a structured and comprehensive program, adult day care centers offer a variety of health, social and related support services in a supervised, protective setting during the day-time, commonly open during business hours on weekdays. Some programs also run during the evenings and on weekends. Adult Care Home (also ‘Residential Care Facility’, ‘Community-Based Care Facility’) - Designed for individuals who have difficulty living alone but do not need daily nursing care. Services offered may include housekeeping services, meals, help with daily activities, transportation to appointments, help with medication, and social and recreational activities. Advance Directives - These legal documents are ways of making your preferences known in advance, in case you become unable to speak for yourself at a future time. They include Living Wills, Durable Powers of Attorney for Health Care and Durable Financial Powers of Attorney. All are best tailored to your needs if executed with the assistance of an attorney, but standard forms are also available. See below for definitions of each. Affordable Housing (also ‘Public Housing’ and ‘Subsidized Housing’) - The Department of Housing and Urban Development (HUD's) affordable housing program was established to provide decent and safe rental housing for eligible low-income families, the elderly, and persons with disabilities. Eligibility is determined by the following criteria: (1) annual gross income; (2) whether a person qualifies as elderly, a person with a disability, or as a family; and (3) U.S. citizenship or eligible immigration status. Income limits vary from area to area. All affordable housing communities comply with federal fair housing regulations, accepting income-qualified residents without regard to race, color, religion, sex, disability, familial status, or national origin. Also see ‘Department of Housing and Urban Development’. ADRC - Aging and Disability Resource Center - Serve as a community resource for individuals of all income levels and a range of populations - older adults, younger persons with disabilities, family caregivers, as well as persons planning for future long-term care needs. ADRC programs offer information, assistance and access to long-term care services and support. To find out if there is an ADRC in your area, go to your state profile. Alzheimer's Disease - A progressive dementia, meaning the loss of memory and/or cognitive (thinking, reasoning) abilities, caused by specific changes in the brain, that gets worse over time. Only a small percentage of people with Alzheimer's Disease have inherited it, usually those with a history of the illness in their immediate family who had an early age onset of symptoms. ALFs- Assisted Living Facilities (also ‘Personal Care Homes’)- Residential facilities, generally an apartment, either single or shared, for older adults who are unable to perform the activities of daily living. These activities include assistance with toileting, bathing, dressing, medication management, meals and housekeeping and other activities of daily living, but do not require nursing care on a regular basis. These facilities are licensed by the state and would not be covered by Medicare or Medicaid. Also see ‘ADL’, ‘IADL’, ‘Skilled Nursing Care’. Assistive Devices - See ‘Adaptive Equipment’. Assistive Technology: See ‘Adaptive Equipment’. Board and Care Home (also ‘Group Home’) - Residential private homes that are designed to provide housing, meals, housekeeping, personal care services, and support to frail or disabled residents. In many states, Board and Care Homes are licensed or certified and must meet criteria for facility safety, types of services provided, and the number and type of residents they can care for. Board and Care Homes are often owned and managed by an individual or family that is involved in the every day operation of the home. CCRC- Continuing Care Retirement Communities - Usually large housing complexes provide a continuum of care, including residential living, assisted living, and skilled nursing care, all at one site. CCRCs provide the security of a coordinated system of services designed to address the comfort, health, wellness, and developing needs of adults as they grow older. Caregiver - The term widely used for someone caring for another person. Any relative, partner, friend or neighbor who has a significant personal relationship with and provides a broad range of assistance for an older person or an adult with a chronic or disabling condition is considered a caregiver. These individuals may be the sole caregiver or one of several that live with or separately from the person receiving care. Caregiver Assessment - A systematic process of gathering information that describes a caregiving situation and identifies the particular problems, needs, resources and strengths of the family caregiver. It approaches issues from the caregiver's perspective and culture, focuses on what assistance the caregiver may need and the outcomes the family member wants for support, and seeks to maintain the caregiver's own health and well-being. Care Coordination Services (also ‘Care Management’, ‘Case Management’)- Programs that develop care plans for the evaluation, treatment or care of individuals who, because of age, illness, disability or other difficulties, are unable to arrange for services on their own behalf. Care management programs assess an individual’s needs; coordinate the delivery of services; ensure that services are obtained in accordance with the care plan; and follow up and monitor progress to ensure that services are benefiting the client. Professionals, usually nurses or social workers, help family members and older adults remain independent. Care managers assess, arrange and monitor long-term care supports. Case Management- See ‘Care Coordination Service’. Care Management - See ‘Care Coordination Service’. Care Recipient - An adult with a chronic illness or disabling condition or an older person who needs ongoing assistance with everyday tasks to function on a daily basis. The person needing assistance may also require primary and acute medical care or rehabilitation services (occupational, speech and physical therapies. Chore Service - Includes heavy cleaning, light housekeeping, laundry, minor repair, yard work, limited personal care, grocery shopping, meal preparation, and shopping assistance. Such services assist individuals who are unable to perform day-to-day household duties. Clinical Research (also ‘Clinical Trial’) - A clinical trial is a research study with human volunteers intended to answer specific medical questions. Intervention trials determine whether experimental treatments or new ways of using known therapies are safe and effective under controlled environments. Observational trials address health issues in large groups of people or populations in natural settings. Cognitive Disorder (also ‘Cognitive Impairment’) - Impairment with mental abilities, such as judgment, memory, learning, comprehension and reasoning, or a loss of ability to process thoughts. CCSP - Community Care Services Program, also known as ‘Community Care’ -Community Care Services Program is the name used in Georgia for a Medicaid-funded program which can provide services for a person frail enough to meet guidelines for nursing home care, but who chooses to live in the community. To be eligible, strict income, asset and care need requirements must be met. Services are not first-come, first-served and for many a cost-share (payment out of pocket) may be required, even if all other eligibility criteria are met. Community-based Care or Services - See above. It is also common to hear people who work with older adults talk about "community" services. This is a generic term meaning services that come to a person's residence or are available to that person still living at home, as opposed to a service delivered in an institutional facility, such as a nursing home. You may even see the term "community spouse" used to refer to the husband or wife of a person who lives in a nursing home, if that other spouse is still living in the "community." Community-Based Care Facility - See ‘Adult Care Home’. Companion Services (also ‘Friendly Visitors’, ‘Telephone Reassurance’) - These programs, which have different titles in different communities, provide regular personal or telephone contact for older persons who are homebound or live alone. Volunteers often provide the service. Besides developing friendships, the programs ensure that someone will have contact with the older person to identify their needs and notify those who can help. Congregate Meals - Refers to a service in which older individuals receive free or low cost meals in a group setting. Besides promoting better health through improved nutrition, these types of meal programs provide daily activities and socialization for participants. Conservatorship - The process in which an individual is appointed by a court of law to manage a person's financial, health care, and/or other personal affairs because the person is not able to or is not competent to manage his/her own affairs. Becoming a guardian or conservator requires a court order. Consumer Directed Care (also ‘Consumer directed option’, ‘Consumer directed program’) - An approach to the delivery of services which allows the consumers (care receivers and their families) to make choices about the services they receive. Depending on the program, consumers are able to assess their own needs, choose which services to receive, hire the workers of their own choice, often including family members. Cash & Counseling is one type of consumer-directed program, available in some states. Convalescent Hospitals (also ‘Long-Term Care Facilities’, ‘Nursing Homes’ ‘Rest Homes’, ‘Skilled Nursing Facilities’) - Facilities for individuals who need skilled nursing care without being in a hospital. They provide medical services and 24-hour nursing care, help with daily activities, recreation, and rehabilitative care. Custodial Care (also ‘Personal Care’) - Non-skilled service or care, such as help with bathing, dressing, eating, getting in and out of bed or chairs, moving around and using the bathroom. Personal care can also include preparing special diets and giving medications. Dementia - Is a generic term which refers to an abnormal loss of memory, confusion, ability to think or reason or recognize people and words, inability to problem-solve, the inability to complete multi-step activities such as preparing a meal or balancing a checkbook, and, sometimes, personality changes or unusual behavior. We sometimes use it like a diagnosis, but it may be more helpful to think of dementia as a symptom. It may be temporary and thus be reversible, i.e. caused by depression or medication reactions. Irreversible dementia, a permanent condition such Alzheimer's disease, may get steadily worse. Dementia, or "cognitive impairment," may be caused by a wide variety of injuries or illnesses, some much more serious than others. Also see ‘Alzheimer’s Disease’, ‘Cognitive Impairment’. DMA- Department of Medical Assistance - Department of Medical Assistance administers Medicaid programs, including CCSP or Community Care and other Medicaid waiver programs. Each state has its own DMA. DPAHC- Durable Power of Attorney for Health Care - Any "power of attorney" allows you to delegate authority to make specific decisions on your behalf to the person you name (your "agent") in the document. Legally, if you are in a coma or otherwise incapacitated, you are not capable of "delegating." Therefore, an ordinary power of attorney is void once you are incapacitated. DFPA - Durable Financial Power of Attorney - Same as above, but covers your money, assets and property. The two instruments, if you execute both, need to work together. For example, make provisions so that the medical care you want can be reimbursed. This does not replace the need for a will. All powers of attorney expire when you do. Elder Law (also ‘Elder Law Attorney’) - It is an emerging legal specialty. Any attorney may be well-versed in the areas of law of particular interest to older adults, but increasing numbers are emphasizing this as their primary practice. The attorney handles general estate planning issues and counsels clients about planning for the management of assets and health care with alternative decision-making documents - to prepare for the possibility of becoming incapacitated. The attorney may also assist the client in planning for possible long-term care needs, including nursing home care. In fact, the Older Americans Act mandates that part of its funding be used to insure access to legal aid to older Americans who may need serves they cannot afford due to limited income. Emergency Response Systems - Programs that provide electronic equipment that connects frail elderly individuals or people who have disabilities with participating hospitals, paramedics, designated family members or other sources of emergency assistance. Estate Recovery/Medicaid - Federal law dictates that each state place into effect an estate recovery program which provides for recovery of medical assistance to a Medicaid recipient. Recovery programs generally focus on receipt of expenses associated with long-term care services of the chronically ill. Family Caregiver - Any relative, partner, friend or neighbor who has a significant personal relationship with and provides a broad range of assistance for an older person or an adult with a chronic or disabling condition. These individuals may be the sole caregiver or one of several that live with or separately from the person receiving care. Also see ‘Caregiver’. FCSP- Family Caregiver Support Program - It offers support services to family caregivers of persons age 60 and older, or adults of any age with dementia, and to grandparents and other relatives who are 55 or older who are caring for children (under age 18) or adults with developmental disabilities (age 19-59). Services include information to caregivers about available support services; assistance to caregivers in gaining access to supportive services; individual counseling, support groups and caregiver training; respite care; and supplemental services (e.g., emergency response systems, home modifications). To access your local FCSP, contact your AAA through the Eldercare Locator at: www.eldercare.gov or (800) 677-1116. Friendly Visitors - See ‘Companion Services’. Georgia Cares -Is designed to educate older adults about low cost prescription programs; health insurance; managed care; long-term care insurance and Medicare savings programs. Geriatric Assessment - Programs that evaluate the medical or psychosocial functioning of an elderly person arrive at a diagnosis and identify possible treatment. Geriatric Care Manager - Individuals who have specific training enabling them to help create and manage a plan of care that meets the needs of an older adult and to explain the resources and options that are available to individual clients and their family members on a fee-for-service basis. Group Home - See ‘Board and Care Home’. Guardian - The person appointed by a court, usually a probate court under a modern protective services statute, to perform the court-ordered tasks of caring for an incapacitated adult's financial affairs and/or personal needs. Guardianship - The process in which an individual is appointed by a court of law to manage a person's financial, health care, and/or other personal affairs because the person is not able to or is not competent to manage his/her own affairs. Becoming a guardian or conservator requires a court order. HCBS - Home and Community-Based Services - A variety of supportive services delivered in community or home settings. These services are designed to help older persons and adults with disabilities remain living at home. Examples of HCBS include personal care with bathing, chore assistance, adult day services, transportation to medical appointments, and home-delivered meals. Home Health Care - Health care and supportive services, including medication assistance, nursing services and physical therapy, provided in the home, usually by a licensed home health aide or nurse, to help homebound sick or disabled persons continue living at home as independently as possible. There are two types of home care: In-Home Care - Companionship, household chores, cooking, and assistance with everyday activities provided in the home, usually by an unlicensed worker, and the second type is skilled nursing care by a Licensed Certified Nursing Assistant (CNA), Licensed Practical Nurse (LPN) or Registered Nurse (RN) with the ability to administer medication and other medical services that would not require a physician’s care. Medicare, Medicaid and some private insurance policies pay for limited Home Health Care with certain restrictions (also see ‘Personal Attendant Services’). Home Health Agencies - Companies that provide short-term skilled nursing or rehabilitative services to homebound persons. Medicare, Medicaid, Veteran's Administration or private insurance may cover these services. Home Modification - Adaptation and/or renovation to the living environment intended to increase ease of use, safety, security and independence. There are some local, state, Federal and volunteer programs that provide special grants, loans and other assistance for home remodeling, repair and modification. Examples of home modification include grab bars, bath seats, transfer benches, and hand rails and ramps for stairways. Hospice and Palliative Care - Care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than cure (called palliative care that relieves discomfort but does not improve the patient's condition or cure the disease). The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home -- in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to provide support for the patient's emotional, social, and spiritual needs as well as medical symptoms as part of treating the whole person. Hospice care is typically paid for by Medicare and is not usually considered long-term care. HUD - Housing and Urban Development - The U.S. Department of Housing and Urban Development funds public and subsidized housing, including senior high-rises, as well as "Sec. 8" vouchers for apartments, mortgage programs and demonstration projects. In-home Care - See ‘Home Health Care’. Independent Living Aid - See ‘Adaptive Equipment’. ILCs - Independent Living Centers - Typically non-residential, consumer-controlled, community-based organizations providing services and advocacy by and for persons with all types of disabilities. ILCs provide an array of independent living services including peer counseling, employment readiness and independent living skills training. I&A- Information & Assistance - A service that includes the identification of and referral to public services and resources. For example, I&A programs for older adults might include information about housing, meals and adult day service programs. I&A may be provided via the Internet, in-person, through resource guides or over the phone. I & R - Information & Referral - Programs whose primary purpose is to maintain up-to-date information about human services in the community and to link people who need assistance with appropriate service providers. IADL- Instrumental Activities of Daily Living - Tasks such as preparing meals, managing money, shopping for groceries or personal items, performing light or heavy housework, and using a telephone. Also see ‘ADL’. Intermediate Care Nursing Homes - Facilities that admit residents on medical referral and maintain services and facilities for institutional and intermediate care. Intermediate care is providing food, including special diets, shelter, laundry and personal care services such as help with dressing, getting in and out of bed, bathing, and feeding, medications and similar assistance, such services being under the supervision of a nurse. A facility must obtain a permit. Language Pathologist (also Speech Language Pathologist) - Tests, diagnoses and treats people with speech and swallowing problems. Living Will - Georgia does have living will legislation. A living will can instruct physicians as to your wishes, should you be terminally ill. LTC - Long Term Care - A set of health, personal care and social services designed to help people who have disabilities or chronic care needs, including dementia. LTC services may be provided in the person's home, in the community, in assisted living facilities or in residential facilities. Long Term Care Facilities - See ‘Convalescent Hospitals’. Long Term Care Ombudsman - Ombudsman functions at the state and local level and work cooperatively with nursing homes and board and care facilities to improve the quality of life for residents. In Atlanta, the Ombudsman provides advocacy services to nursing home and assisted living residents in the 10 county metropolitan area. It functions at the state and local level and work cooperatively with nursing homes and board and care facilities to improve the quality of life for residents. They serve as patients' rights advocates, investigating and negotiating resolutions to concerns voiced by residents in matters of resident services, safety and care. Long-Term Care Insurance - This type of private insurance policy is designed to cover a range of long-term care expenses (specified in the policy) in a facility or at home. Meals on Wheels (also known as Home Delivered Meals) - Home delivered meals are hot and nutritious meals delivered to homebound persons who are unable to prepare their own meals and have no outside assistance. Medicaid - A government health insurance program administered by states for people with low incomes. Medicaid pays for health care services including physician visits and hospital stays, as well as in-home care or nursing home care, if the individual's income and assets are within certain limits and they meet other eligibility requirements. Medicare - A government health insurance program for people 65 and older, some people under age 65 with disabilities and people with End-Stage Renal disease. Being a Federal program for hospital and medical care, Medicare is tied to Social Security eligibility. Medicare does NOT pay for extended nursing home stays. It has three parts: Medicare Part A covers hospital costs, as well as limited skilled nursing, home health and hospice care, generally without a monthly premium. Part B covers medical costs, such as doctor's visits and outpatient care, to those who pay a monthly premium. Part D includes limited prescription drug coverage, through private insurance companies, for those who choose to pay a monthly premium. Medicaid Waiver - Programs that allow states to provide services in the home or community, reimbursable by Medicaid, to individuals at risk of institutionalization or who are receiving institutional care and need help in returning to the community. Medigap - A term coined for privately purchased health insurance that fills in the "gaps" in Medicare coverage. You may purchase this coverage or it may be purchased by your employer or former employer. Mental Health - Programs that provide preventive, diagnostic and treatment services in a variety of community and hospital-based settings to help people to achieve maintain and enhance a state of emotional well-being, personal empowerment and the skills to cope with everyday demands. Nursing Homes - A residential facility for persons with chronic illness or disability and require 24 hour nursing assistance. Also called a ‘convalescent home’ and ‘long-term care facility’, Nursing Homes are defined by the Georgia Department of Human Resources as facility that provides basic and skilled nursing care that includes room and board, rehabilitation, and a full range of other therapies, treatments, and programs which may not primarily include care and treatment of mental diseases. People who live in nursing homes are referred to as residents. Nursing Homes are classified as the following: SNF (skilled nursing facility) – a certified nursing facility with a Medicare provider agreement. NF (nursing facility) – Medicaid nursing facility. SNF/NF Dual Cert – certified nursing facility for both Medicaid and Medicare. SNF/NF Distinct Part – the certified nursing facility is a distinct part of a rehabilitation center, hospital or another SNF or NF. Licensed Only – licensed by Georgia but has no Medicare or Medicaid certification OT- Occupational Therapist - Helps patients change their activities or environment so they can eat, dress and bathe. OT may also train family caregivers to assist the patient. Personal Care - See ‘Custodial Care’. Personal Care Homes (also ‘Assisted Living Facility’) - Any dwelling that provides or arranges for the provision of housing, food services and one or more personal services for one or more adults who are not related to the owner or administrator by blood or marriage. Personal services include but are not limited to individual assistance with and supervision of self administered medications and daily living activities such as eating, bathing, grooming, dressing and toiletry. A home must obtain a permit, and the Department of Human resources may register personal care homes that care for two or three residents. See ‘Assisted Living Facilities’. Also see ‘ADL’, ‘IADL’, ‘Skilled Nursing Care’. Personal Support Services - Provides light housekeeping and basic personal care in the consumer's home. PT - Physical Therapist - Treats physical disabilities and works with patients to improve general fitness. A PT may also teach patients how to use a walker, artificial limb or wheelchair. PoA - Power of Attorney - It is a legal document that gives someone else the authority to make financial, legal or health care decisions and transactions on one's behalf. The power can be specific to a certain task or broad to cover many duties. The power can be given to start immediately or upon mental incapacity. To be valid the document must be signed by the person before he/she becomes disabled. Prescription Programs - Programs that help individuals obtain prescription medications at reduced or no cost. Eligibility is usually based on need or income. Residential Care Facility - See ‘Adult Care Home’. Respite - It is the provision of short-term, temporary relief to those who are caring for family members who might otherwise require permanent placement in a facility outside the home. Respite care may include in-home assistance, a short-term nursing home stay or adult day care and can vary from a few hours to several weeks. Rest Homes - See ‘Convalescent Hospitals’. Reverse mortgage - A special type of loan used by older Americans to convert the equity in their homes into cash. It is often used by older adults that are house rich but cash poor. Instead of making monthly payments to a lender, as with a regular first mortgage or home equity loan, a lender makes payments to you. Senior Centers – Function as meal sites, screening clinics, recreational centers, social service agency branch offices, mental health counseling clinics, older worker employment agencies, volunteer coordinating centers, and community meeting halls for older adults.These centers provide services to older adults such as home delivered meals, hot noon meals, recreation, transportation, intake for employment programs, outreach, trip, education and other services to assist older adults to remain independent in their own homes. The centers in the 10-county metropolitan area in Atlanta range from centers where there may be an activity room to large multi-purpose centers with fitness and computer centers. Skilled Nursing Care - The term refers to a level of care which must be furnished by or under direct supervision of licensed nursing personnel and under the general direction of a physician in order to assure the safety of the patient and achieve the medically desired result. Examples of skilled nursing care are: intravenous injections, tube feeding, kidney dialysis, colostomy care, the use of medical gases, observation and monitoring of a patient's unstable condition, and changing sterile dressings. Skilled Nursing Homes - See ‘Convalescent Hospitals’. Skilled Nursing Level of Care - Level of care, usually required around the clock, that is provided by, or under the supervision of, a Registered Nurse or licensed Practical Nurse. It is provided only when prescribed by a doctor and usually on an inpatient basis at a hospital or skilled nursing facility. Skilled nursing care may include the administration of medications, tube feeding, and the changing of wound dressings. In order to qualify for many public programs, care receivers must have a doctor declare that they require a skilled nursing level of care. SOURCE - Enrollees must have Medicaid and Supplemental Security Income and be 65 or older with a chronic health problem or under 65 and disabled. Support Groups - Autonomous groups of individuals who share a common problem or concern and who meet together on a voluntary basis for mutual support. Members of mutual support groups share their experiences, strengths and hopes and rely on one another for assistance in the group setting. Professionals or peers may facilitate groups. Supportive Services - Programs that decrease the personal and social isolation of elderly or disabled individuals. Speech language Pathologist - See ‘Language Pathologist’. Telephone Reassurance - See ‘Companion Services’ Universal Design - Design of products and spaces to make them usable by all people to the greatest extent possible (targets as much of the population as possible) Visitability - Provides for a minimum level of access that will allow a person using a wheelchair basic access to the ground floor of a home. (Examples: Step-less entry, 32” clear doorways, first floor bed and bath with enough space for two to simultaneously use space).
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