Activities of Daily Living (ADLs)
The basic everyday functions that people normally accomplish independently to care for themselves. Activities of daily living include eating, bathing, dressing, grooming, moving about and using the bathroom. The ability to perform ADLs can be used as a very practical measure of a person’s ability or disability.
Advance Directives
A legal term that refers to the written instructions people create ahead of time to specify their medical treatment preferences or the actions they wish to be taken for their care if they should become unable to make decisions for themselves due to illness or incapacity. Some advance directives name a surrogate decision maker (someone to act on the person’s behalf). Advance directives generally fall into three categories: living will, durable power of attorney and health care proxy.
Assisted Living Facility (ALF)
A residence that provides supervision or assistance with activities of daily living (ADLs), coordination of services by outside health care providers, and monitoring of residents’ activities to help ensure their health, safety, and well-being, while allowing them to live as independently as possible. Assistance may include the administration or supervision of medication, or personal care services provided by trained staff.
Care Manager
A health and human services professional whose job is to create, coordinate, monitor and periodically review the care plan for an individual after completing a needs assessment. The care plan may include transportation to regular doctors’ visits, home health care, home health aides to assist with activities of daily living (ADLs), and other necessary services. The care manager arranges for and coordinates these services by accessing appropriate resources and providers near the individual who needs care. The care manager typically acts as an advocate, a point of contact and a liaison with the family of the person receiving care. Most professional care managers have a background in social work, nursing, psychology, geriatrics, long-term care or other fields related to aging or to people with special needs. See a video, “What a Professional Care Manager Can Do for You,” produced by the National Association of Professional Geriatric Care Managers.
Care Plan
A written plan of services developed by a care manger, in consultation with a client or client’s representative, to guide health care professionals involved with the client’s care. The care plan is based on a needs assessment of the client and includes goals; the types of services; the quantity, frequency and duration of services; start dates; and other considerations.
Certified Nursing Assistant (CNA)
A person who has successfully completed a training program or course with a curriculum prescribed by the State Board of Nursing. A CNA can assist clients with certain physical activities of daily living (ADLs) within the defined scope of care.
Concierge (or social work assistant)
A person who assists a client with things like grocery shopping, bill paying and other instrumental activities of daily living (IADLs), to help the client maintain independence and quality of life.
Continuing Care Retirement Community (CCRC)
A community that offers a range of housing situations or levels, including independent living, assisted living and nursing home care. As residents age or their capacities change, they may move into a different living arrangement within the community.
Disability Benefits
Social Security benefits paid to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. Federal law requires a very strict definition of disability. In general, to qualify for disability benefits, a person must meet two different earnings tests: 1) A “recent work” test based on the person’s age at the time he became disabled; and 2) a “duration of work” test to show that the person worked long enough under Social Security.
Social Security pays benefits through two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Durable Power of Attorney
A type of advance directive that legally designates certain powers to others in the case of an incapacitating medical condition. The durable power of attorney allows another person or persons to make bank transactions, sign Social Security checks, apply for disability, or simply write checks to pay household bills while an individual is medically unable.
Elder Care Attorney
A lawyer who specializes in or is skilled in the laws that affect elderly or aging adults, such as estate planning and administration, including tax questions; Medicare, Medicaid, disability and other long-term-care issues; and legal guardianship, commitment matters and related concerns.
Elder Law
A term coined to cover an area of legal practice that places emphasis on issues that affect the aging population.
Geriatric Care Manager
A care manager who specializes in issues of aging and care for older adults. Typically, a geriatric care manager evaluates the person’s situation; assesses his needs; makes recommendations; arranges for appropriate social, home care, and health services; and keeps family members informed of all arrangements. Geriatric care managers who are members of the National Association of Professional Geriatric Care Managers (NAPGCM) commit to a specific code of ethics and standard of practice.
To learn more, watch this short video, “What a Professional Care Manager Can Do for You,” developed by the NAPGCM.
Geriatrics
A branch of medicine that deals with the problems and diseases of the elderly or aging population.
Health Care Proxy
A type of advance directive that legally designates another person to make health care decisions for an individual should that individual no longer be able to make (and communicate) decisions. The health care proxy has, in essence, the same rights to request or refuse treatment as the individual he represents.
Home Health Aide
A person who assists ill, elderly or disabled people in the home, carrying out personal care and housekeeping tasks. Home health aides who have completed an HHA training program with certification are preferred.
Independent Living
A residential situation for elderly or senior adults who are able to live on their own and care for themselves. This arrangement may or may not provide hospitality or supportive services.
Instrumental Activities of Daily Living (IADLs)
The six key tasks that help measure a person’s ability to live independently in the community: performing light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone and managing money.
Legal Guardianship
The designation of a person or persons to be responsible for the food, health care, housing and other life necessities of an individual who is deemed fully or partially incapable of providing these things for himself.
Living Will
A type of advance directive that specifies the kind of medical treatment desired in the event that a person can no longer make decisions for himself. A living will can be very general or very specific. Living wills typically include language requesting that life-sustaining measures be withheld (or continued) in the event of a terminal illness or irreversible condition. A more specific living will might include an individual’s wishes regarding services such as analgesia (pain relief), antibiotics, hydration (administering fluids), feeding, resuscitation and the use of life-support equipment.
Medicaid
A health insurance program jointly funded by the federal and state governments, and managed by the states, that provides care for individuals and families who cannot pay for their own medical expenses. Among the groups served by Medicaid are certain qualifying U.S. citizens and resident aliens: primarily low-income adults and their children, and people with specified disabilities. Poverty alone does not necessarily qualify an individual for Medicaid. Also called medical assistance (MA), Medicaid should not be confused with Medicare.
Medical Assistance (MA)
See Medicaid.
Medicare
A health insurance program funded and administered by the federal government that primarily serves people aged 65 and over. People of any age with certain disabilities or kidney failure may also qualify for coverage. Citizenship or certain residency requirements must be met. Recipients must be eligible for Social Security benefits with at least 10 years of payments contributed into the system through payroll deductions from their earned wages. Medicare and Medicaid are not the same.
Needs Assessment
A formal process undertaken to evaluate the health and social care needs of a client.
Nursing Home (or skilled nursing facility)
A care facility where people who require continual nursing or have significant deficiencies in performing activities of daily living stay on a short- or long-term basis. Residents include elderly adults as well as younger people with physical or mental disabilities. Eligible adults aged 18 or older can stay in a nursing home to receive physical, occupational and other rehabilitative therapies following an accident, illness or operation. Also known as a skilled nursing facility, nursing homes are sometimes referred to as convalescent homes or rest homes.
Psychosocial
Involving aspects of both social and psychological behavior. The term broadly refers to a person’s mental health in relationship to (or his interaction with) other individuals, his community and society in general.
Residential Treatment Center (RTC)
A live-in facility that provides therapy for substance abuse, mental illness or behavioral conditions. A residential treatment facility or the treatment undergone there is commonly referred to as rehab.
Skilled Nursing Facility (SNF)
See nursing home.
Social Security Disability Insurance (SSDI)
A federal insurance program that provides assistance to people with disabilities. SSDI is funded by an individual’s payroll taxes. To qualify for benefits, the individual must have a physical or mental condition that prevents him from working for at least 12 months or that will result in death. Eligible candidates must also be younger than 65 and have worked for at least five out of the last 10 years.
Social Work Assistant
See concierge.
Special Needs Trust
A trust created to ensure that an individual who is mentally or physically disabled or ill can benefit from the use of property or funds that are intended to be held for his use. In addition to personal planning reasons (e.g., the beneficiary lacks the mental capacity to handle financial affairs), there may be other fiscal advantages to this kind of arrangement. This type of trust may help the beneficiary avoid losing access to essential government benefits. See definition of “trust” below.
Supplemental Security Income (SSI)
A needs-based federal income assistance program funded by general tax revenues that provides assistance to people with disabilities. Eligibility requires a physical or mental condition that prevents the individual from working for at least 12 months or that will result in death. Candidates also must be younger than 65 and have worked for at least five out of the last 10 years. People who receive SSI are usually eligible to receive monthly food stamps and Medicaid, which helps pay for doctors’ visits and hospital bills. The amount of SSI an individual can receive depends on where the person lives, what he owns and the monthly income he collects. SSI benefits are more limited than SSDI benefits.
Trust
An arrangement in which financial assets (e.g., money, real estate or other property) are administered by one person or organization, such as a bank or trust company (referred to as the trustee), for the benefit of another. The person entitled to benefit from the trust arrangement is known as the beneficiary.
Trust Officer
A person who manages assets that were placed in a trust (see above) with a bank or trust company for other people or organizations. These assets might include pension funds, school endowments, money from the settlement of a lawsuit, real estate, or other or property or funds. Sometimes trust officers act as executors of estates upon a person’s death. They also may work as accountants, lawyers or investment managers.