Glossary of Terms

Accreditation- a “stamp of approval” such as by JCAHO, signifying that a provider, facility, residential care center or other health care entity has met the industry standards for quality of care and services developed for its particular setting. Some healthcare entities voluntarily seek accreditation whereas others (e.g. organizations that receive payment for services from Medicare or Medical Assistance) are required to be accredited as a condition of reimbursement for services.

Activities of Daily Living (ADLs) - basic tasks essential for day-to-day functioning, such as bathing, dressing, grooming, eating, and getting in and out of a bed or chair. See also IADLs.

Adaptive Devices - a variety of items that can provide the assistance needed to stay at home; may include wheelchairs, walkers, touch-sensitive light switches, phone amplifiers, stair lifts, chairs with lifts and even computers.

Adult Day Services (ADC or ADS) sites offer a structured, supervised setting and services to meet the needs of functionally impaired adults, and are licensed by the Penna. Dept. of Aging. Services may include social activities, personal care, assistance with eating or using the toilet, assistance with taking medications, and sometimes, therapies. Adult Day Centers usually operate during normal business hours, five days a week. Some Centers offer services in the evenings and on weekends. Adult Day Services may be subsidized or privately paid.

Advance Directives - a written document used to express a person’s wishes regarding what care s/he would like to receive or not receive if s/he becomes unable to express them.

Alzheimer’s Unit or Alzheimer’s Care - a unit or program for individuals with Alzheimer’s disease or other cognitive impairments. Such programs usually feature specially designed and secure environments, structured activity programs and greater staff-to-resident ratios.

Area Agency on Aging (AAA) – the local agent of the Pennsylvania Department of Aging which plans and coordinates services for older adults in designated geographic areas. Pennsylvania has 52 AAAs covering its 67 counties.

Assessment - a process used to gather information about an individual to determine his or her needs and/or eligibility for services. Information collected may include health status, ability to perform activities of daily living, mental status, financial status etc

Assisted Living Facilities provide assistance with activities of daily living, 24-hour supervision, and medications management. Assisted Living Facilities are licensed by the PA Department of Public Welfare.

Caregiver Assistance - a range of services that may provide physical, emotional and/or financial relief to the primary caregiver of an older adult.

Care / Case Management - the process through which consumer needs are met in the most appropriate, least restrictive setting. This process focuses on consumer need; mutually developing a care plan addressing needs; explaining options for service delivery; ongoing monitoring of services; periodically reassessing the situation; adjusting the care plan as needed; and notification to providers of changes in service provision.

Centers for Medicare and Medicaid Services (CMS) – federal agency in charge of implementing the law by developing policies and procedures. CMS also pays claims and contracts with commercial insurance companies to process claims for acute care, long term care, home care, hospice care and medical equipment. See Medicare and Medical Assistance.

Congregate Meals - nutritious meals and snacks generally served to groups or participants at Senior Centers.

Continuing Care Retirement Communities - retirement communities that provide a wide spectrum of care from independent living arrangements to skilled nursing facilities. Residents move between levels of care as their needs change. Some CCRCs require a lifetime contract and guarantee care at all levels from independent to skill nursing. Others charge a monthly fee.

Counseling - services that are provided to assist individuals in adjusting to changes or difficult/stressful situations, and to learn effective ways for dealing with them.

County Assistance Office (CAO)- the offices in each county that provides information on food stamps, medical assistance and general assistance under the PA Department of Public Welfare (DPW).

Custodial Care - Help and supervision with daily living activities - dressing, eating, personal hygiene, and similar functions.

Dementia - a term used to describe a group of brain disorders that disrupt and impair cognitive functions (thinking, memory, judgment, personality, mood, and social functioning). Alzheimer's disease is the most common cause of dementia.

Elder Abuse - any situation in which an older adult experiences physical or emotional harm from another individual. Also, see Protective Services.

Elder Law Attorney - An attorney who specializes in laws that deal with the rights and issues of the health, finances, and well-being of the elderly and the power of other individuals and the government to control them.

Estate - The term used to represent all of an individual or couple's personal assets. Estate planning is a plan for what will happen to an individual or couple's assets and liabilities after death

Estate Recovery - the Department of Public Welfare (DPW) is required to recover the cost paid for persons 55+ who received Medical Assistance benefits for hospital or nursing home care or prescription drugs and have since died. For more information call 1-800-528-3708

Executor - The person named in a will to carry out the distribution of an estate.

Geriatric Assessment - An evaluation of an older person's physical, psychological, and social condition by a professional team of specialists who make recommendations to the older person, family, and primary care doctor.

Geriatric Care Manager - professionals specifically trained to provide case management services to older individuals. See care management.

Geriatrician – a physician (MD or DO) who has completed special courses in the assessment and care of older adults. Many have also passed a special examination and are certified in this area.

Guardianship - The process in which an individual is appointed by the court to manage a person's financial and/or personal affairs because the court has found that person to be unable to (incapacitated) manage his/her own affairs.

Home and Community Based Services - services provided in your home or at a location in your community to assist individuals to function as independently as possible.

Home Delivered Meals - nutritious meals and snacks delivered to your home when you are unable to prepare meals and have no one else to do so. Home Delivered Meals may be subsidized or privately paid.

Home Health Care - Nursing and other health care services that are physician ordered and performed in the home by someone with special training including registered nurses, licensed practical nurses, therapists and home health aides. Home Health Agencies licensed by the PA Department of Health provide and coordinate these services. Services may be paid by insurance, private pay, or subsidy may be available.

Home Modifications - installation of bathroom equipment, safety bars, ramps, widening doorways for wheelchair access, and other changes to a home to allow as much as independence as possible.

Home Support Services - assistance with shopping, laundry and general household chores. May be privately paid or subsidy may be available.

Hospice Care- medical, psychological, and spiritual support to individuals who are terminally ill, as well as support for their family. The care is primarily based in the home and emphasizes pain control, symptom management, and emotional support rather than life-sustaining measures. Hospice services are also available at inpatient hospice facilities and in skilled nursing facilities.

Incontinence - The involuntary loss of urine or feces. Common among older adults and mistakenly believed to be a normal part of aging..

Independent living facilities – apartment units designed to promote independence, which may provide common space and activities, and offer special services for a fee.

Informed Consent – term frequently used to indicate that the person approves a suggested course of action and that the advantages, disadvantages, risks and benefits have been explained and are understood.

Instrumental Activities of Daily Living (IADLs) – activities other than personal needed on a daily basis; includes meal preparation, shopping, laundry, housework and home maintenance, using telephone and transportation, managing money. Also see ADLs.

Quality Insights of Pennsylvania (QIO) - a quality improvement organization designed to protect Medicare beneficiaries receiving care in Pennsylvania. Call QIO if you are denied services or are dissatisfied with the quality of care you received. Formerly known as KePRO

Licensure - official permission by a governmental entity, such as the state, to practice a particular profession or provide a particular service. Licensing ensures a minimum level of health and safety standards are met, which are intended to protect the public. Entities that must hold a license are defined in statute, and standards that must be met are usually outlined in regulations.

Living Trust - A revocable living trust allows transfer of ownership of property to a separate entity called a trust which is managed according to the rules established in the trust document for the benefit of the beneficiaries named in the trust. Irrevocable living trusts are similar to revocable living trusts, except that they cannot be revoked (that is, changed or ended). In addition to having the same benefits as a revocable trust, an irrevocable trust also may provide savings on the estate taxes, and may prevent the loss of government benefits for a loved one. Living Trusts can be a source of great misinformation and misrepresentation by unscrupulous businesses and salespeople. Caution should be exercises before committing to a Living Trust and ONLY AFTER consultation with a qualified independent attorney, or call to the AAA or Consumer Protection Office.

Living Will -see Advanced Directives

Long Term Care - a wide range of assistance and services designed to meet medical, personal and social needs in a variety of settings or locations to enable a person live as independently as possible.

Long Term Care Insurance - insurance designed to provide coverage 12+ months for functionally or medically necessary diagnostic, preventive, therapeutic, rehabilitative, or maintenance level services provided in a setting other than an acute care unit of a hospital.

Medical Assistance (also called Medicaid) - health insurance program financed by the federal and state governments for eligible low-income people that can pay for all or part of the cost of certain medical care and services, Medicare deductibles and copayments, and nursing home care if the individual's income and assets are within certain limits.

Medicare - the national health insurance program for eligible people 65 and older and some disabled individuals. Part A covers hospital costs. Part B covers doctor bills and other medical costs. Patients must pay deductibles and copayments, and make up any expenses not covered by Medicare. Medicare generally does not cover long term health care services.

Medigap – refers to any supplemental insurance designed to complement Medicare's benefits by filling in some of the gaps of Medicare coverage. Medigap insurance policies are non-group policies that may pay for Medicare deductibles, prescription drugs, or other services not currently covered by Medicare.

Mental Health Services – community-based services to diagnose and treat mental health needs which may be long-standing or develop later in life. Services may be obtained privately or paid by insurance and provided through psychiatrists, counseling agencies, and behavioral healthcare organizations in the community.

Nurse Practitioner – a registered nurse who specializes in a particular area of care and has obtained a master’s degree in that specialty. Most have passed an examination in their specialty area and are certified. They may practice independently or with a physician.

Nursing Facility (Nursing Home or skilled nursing facillity) – provides physician-ordered inpatient medical services and supervised nursing care on a 24-hour basis for persons who do not require acute care hospitalization, and whose needs can only be met in this setting. Nursing facilities are licensed by the PA Department of Health and are usually but not always certified by Medicare or Medical Assistance. They may be free-standing or a special unit of a hospital or retirement center.

Nursing Services - hands-on medical care, health supervision, observation and monitoring provided by registered, licensed nurses as ordered by a physician.

Ombudsman - a person who is available at Area Agencies on Aging to investigate and resolve complaints and advocate for and protect the rights of older persons receiving long-term care services.

PACE, PACENet - Pharmaceutical Assistance Contract for the Elderly assists eligible Pennsylvanians with payment of prescription medicines through a copayment program. Eligibility: previous calendar year's income less than $14,500 for a single person or $17,700 for a married couple. PACENet extends eligibility to single persons with previous year’s income between $14,500 and $23,500 and married couples between $17,700 and $31,500

Patient Bill of Rights - list of policies and procedures to ensure that patients receiving health care services will be treated with dignity and participate fully in decisions relevant to their health care.

Pennsylvania Department of Aging (PDA) - State department that administers programs benefiting older adults and seeks to enhance the quality of life of older Pennsylvanians. PDA oversees Area Agencies on Aging.

Personal Care - assistance with bathing, dressing, eating, walking, and using the toilet. May be privately paid or subsidy may be available.

Personal Care Homes - premises where four or more un-related adults who do not require nursing care may reside and receive food, shelter, personal care, financial management, and supervision. They are licensed by the PA Department of Public Welfare.

Personal Emergency Response System (PERS) - Equipment that monitors the safety of individuals in their homes through signals electronically transmitted to an emergency-monitoring center. More commonly understood as the “Help, I’ve fallen and can’t get up” device.

Power of attorney (POA) - In Pennsylvania, any person of capacity, 18 or older can make a POA to designate another person to act on his/her behalf. The POA can be limited to certain specific responsibilities or it can cover large general areas of decision-making regarding one’s financial affairs. It is best to work with an attorney to make it as precise but flexible as needed.
Durable POA - a power of attorney that is enforceable even if the principal becomes disabled or incapacitated. Durable medical POA - a legal document which names a person who will make health care decisions for the principal if that individual becomes incompacitated or unable to express wishes for himself or herself.

Protective Services – a unit of the Area Agency on Aging which accepts reports of physical, sexual or emotional abuse, neglect by caretaker, self-neglect, exploitation and abandonment, 24-hours, 365 days a year. and provides assistance for those aged 60 and older who have functional limitations and are at imminent risk of danger to his/her person or property.

Respite - temporary assistance to give a caregiver a break from caregiving. This can be a temporary overnight stay in a Respite Center, an Adult Day Service Center, or someone to stay in the home for a few hours or longer.

Reverse Mortgage - enables elderly homeowners to convert the equity in their homes to monthly income or a line of credit.

Senior Centers - community centers which provide services such as social activities, congregate meals, health screenings, educational programs, exercise programs to PA senior citizens. Bucks County has one senior center in each school district.

Shared housing - A program available in some communities that matches individuals for the purpose of living together in one house. One of the individuals may be the owner of the house.

Shared Ride Program - provides reduced fare transportation to eligible residents who are 65 and over utilizing shared rides (through the BCT transportation system in Bucks County.)

Skilled care - A type of health care given when a medical condition necessitates skilled nursing or rehabilitation staff to manage, observe, and evaluate care.
Subsidized Housing - rental assistance available from the Federal Government to low income elderly people and families. Income eligibility is 50% of median income for county residence.

Telecommunication Device Distribution Program - known as LiberTTY, this program distributes TTY devices (also known as TDD - Telecommunications Device for the Deaf) which enables both hearing and speech impaired individuals to connect any phone utilizing a local Message Relay Center. This program has eligibility requirements.

Therapies - a range of care including but not limited to physical therapy, speech therapy or occupational therapy to assist in regaining or improving the ability to walk, talk or take care of personal needs. Usually paid by insurance.

Will – a legal document that sets forth a person’s wished for disposing of assets after death.

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