Glossary of Terms

AREA AGENCIES ON AGING (AAA)

Also called the Department of Aging and Adult Services (DAAS) in San Francisco

ALZHEIMER'S DISEASE (AD)

Alzheimer's disease is a degenerative disorder that strikes brain neurons, causing memory loss and impairing the patient's ability to communicate, pay attention and make judgments. As it progresses, the disease also affects the ability to perform simple everyday tasks on one's own, such as bathing, dressing and eating. The disease was named for German neurologist Alois Alzheimer, who, in 1907, first described the brain lesions that mark the condition. Some 4 million Americans are estimated to suffer from Alzheimer's disease, most of them over age 65.

ADULT DAY CARE

Centers which provide a supervised social environment for clients with medical, physical, cognitive, or emotional disabilities which require monitoring or treatment. These programs also provide respite for family and caregivers.

ADULT DAY HEALTH CENTER (ADHC)

Day Care Centers that are usually state licensed to provide supportive health services as well as a supervised social environment. The license usually stipulates staffing that includes a registered nurse (RN), a social worker, a physical therapist (PT), an occupational therapist (OT), a speech therapist (ST) as well as the recreational and support staff of any day center. Most centers provide transportation and a hot lunch. The program is not meant to provide rehabilitation but rather to help participants maintain as much capacity as possible.

ACTIVITIES OF DAILY LIVING (ADL)

Those everyday personal care tasks that are required for people to live on their own such as: the ability to feed oneself, go to the toilet, take a bath or get out of bed. See also Instrumental Activities of Daily Living (IADL).

ADVANCE DIRECTIVES

Written statements, prepared in advance of a serious illness, in which an individual can state his/her preferences when a treatment decision is necessary.

AGEISM

Prejudice or negative stereotypes about people based on chronological age.

AMERICAN DISABILITIES ACT

Federal statutes involving required accommodation for people with physical disabilities. These often involve access to public buildings, businesses, and transportation.

AOA - Administration on Aging

Federal Agency responsible for policy and implementation of Aging programs, particularly the Older Americans' Act (OAA).

APS - Adult Protective Services

The official agent usually housed within a county administered agency that is mandated by state law to receive, investigate, and respond to complaints of neglect and abuse of an elderly (65 or over) or dependent person.

ASA - American Society on Aging

A national professional organization.

ASSISTED LIVING

Housing for an elderly or disabled person that provides room, meals, and varying levels of assisted care. This care could include assistance with personal needs, monitoring medication, laundry, housekeeping, recreational opportunities, transportation to medical appointments, and other supports. In the State of California Assisted Living is usually officially licensed under the title Residential Care Facilities for the Elderly (RCFE). Many facilities that title themselves Assisted Living are retirement communities that offer separate apartments and are licensed in whole or in part as RCFEs. (see Residential Care Home)

BEREAVEMENT COUNSELING

Psychotherapy or supportive counseling that is designed to help people come to terms with the loss of significant others in their lives.

BOARD & CARE

see Residential Care Home and Assisted Living.

CARE MANAGEMENT

see Case Management

CASE MANAGEMENT

The practice of having a single expert, often a social worker, psychologist, counselor, or a nurse, who works with the client, family and other professionals involved with a case to plan and coordinate some or all of the health and social services needed by the client. Some case management programs are public funded. Other services are through private practitioners that charge a fee-for-service rate. CDA - California Department of Aging - governance at the state level, responsible for monitoring programs of the county area agencies on aging.

CHRONIC ILLNESS

A sickness or disability that persists for a long period of time, whether or not it causes death. Top 10 Chronic Conditions for people 65+: Arthritis, Hypertension, Hearing Impairment, Heart Disease, Stroke, Cataracts, Orthopedic Deformations, Chronic Sinusitis, Diabetes, Visual Impairment, Varicose Veins.

CASE MANAGER (CM)

See Case Management.

COLA - Cost of Living Adjustment

CONGREGANT MEAL SITE

Locations that are easily accessible in a number of neighborhoods where older adults (62 and over) can obtain a low cost hot meal. Often these sites are located at Multi-purpose Senior Centers.

CONSERVATORSHIP

The court process in California in which a special agent (often a family member) is appointed to make decisions concerning a person who no longer has capacity. There are two primary types of conservatorship. These are Conservatorship of Person and Conservatorship of Estate.

CONTINUING CARE FACILITIES

These are retirement communities that provide a wide range of supports for an older adult. The supports range from independent living, assisted living, and skilled nursing care. In most cases an older individual or couple enters the facility as a completely independent person, and then they obtain higher levels of care as needed. Most often these types of communities agree to provide housing and support for the resident up through skilled nursing care. Various plans exist for these facilities that offer a range of meal options, housing options, activities, and personal care.

CONVALESCENT HOME

see skilled nursing facility

DAAS - DEPARTMENT OF AGING AND ADULT SERVICES

The name of the Area Agency on Aging in San Francisco.

DEMENTIA

A condition marked by an incapacitating decline of intellectual abilities, including memory and the ability to think.

DHHS - US DEPARTMENT OF HEALTH AND HUMAN SERVICES

DHS - DEPARTMENT OF HEALTH SERVICES

San Francisco Health Department, offering clinics, flu shots, and more. Diagnosis Related Groups (DRGs) - Distinct categories of diseases that are the basis for Medicare's financial reimbursement to hospitals.

DURABLE POWER OF ATTORNEY

A legal document giving another person authority to make financial and legal decisions if the principal becomes physically or mentally incompetent.

ELDER ABUSE

Any physical abuse, sexual abuse, abandonment, isolation, neglect, financial abuse of an older (65 or over) or dependent person.

ELDER LAW

Field of law that deals with the complexities of legal issues that concern the elderly. These can include estate planning, benefits problems, conservatorship, and a range of other issues.

ESTATE PLANNING

Process that includes planning for the present and future use of assets.

FRIENDLY VISITORS

Individuals, usually volunteers, that visit homebound older adults to provide support and socialization.

GERIATRICS

The medical specialty treating the diseases and problems of old age.

GERIATRICIAN

A physician who specializes in the practice of geriatrics.

GERONTOLOGY

Scientific study of the process and problems of aging.

GERONTOLOGIST

A specialist in gerontology

GSA - Gerontological Society of America

A national professional organization.

HCFA - Health Care Financing Administration

Federal agency that funds Medicare.

HEALTH CARE AGENT

A person who accepts the power to make health care decisions for someone else.

HEALTH CARE PROXY

A delegation of authority to a health care agent.

HICAP - Health Insurance Counseling and Advocacy Program

Provides counseling on health insurance issues and options.

HMO - HEALTH MAINTENANCE ORGANIZATION

A health care payment and delivery system involving networks of doctors and healthcare institutions. It offers consumers a comprehensive range of benefits at one annual fee (often with co- payments or deductibles that vary from service to service) but they can see only providers in the network. Physicians and other health professionals often are on salary or contract with the HMO to provide services. Patients are assigned to a primary care doctor or nurse as a "gatekeeper" who decides what health services are needed and when.

HOME HEALTH AIDE

Provides personal care and help with monitoring medications, exercises and other assistance for a disabled elderly person.

HOSPICE

Facility or program designed to provide a centralized program of palliative and supportive services to dying persons and their families in the form of physical, psychological, social and spiritual care.

HOUSING MODIFICATION FOR THE DISABLED

Assessing the need for and installing physical supports like grab rails, bathroom modifications, access ramps and other equipment to help a disabled individual remain safely in their home.

IADL - Instrumental Activities of Daily Living

Those everyday tasks required for home management e.g., shopping, cooking, housekeeping, laundry, transportation, and financial management.

IHSS - In Home Supportive Services

The program in each county in California that is usually associated with a Department of Social Services that provides home attendant care (assistance with ADLs and IADLs) for elderly or dependant adults who can qualify for the State Medi-Cal program.

INDEPENDENT LIVING

see retirement community

INFORMATION & REFERRAL (I&R)

A service offered in most community that provides information about services that are available to older or dependent adults and consultation about how to access and use these services.

LIFELINE

A telephone alert system that enables elderly persons who live alone to receive help in a medical emergency.

LIVING WILL

A general written statement specifying or limiting medical treatment. It is an official legal document, but different states have different requirements about witnesses and other rules under which a living will is acceptable.

LONG TERM CARE (LTC)

Medical and social services needed on a continuing basis by an older or dependent adult who can no longer manage as an independent person. These services differ from rehabilitative services which are short term and aimed at helping a patient regain a formal level of independent capacity. Long term care services can include ongoing in-home care, or services through an adult day care center. For people who can no longer live at home long term care can mean residence in a Residential Care Home, Assisted Living Facility or Skilled Nursing Facility.

LONG TERM CARE INSURANCE

Insurance designed to defray the cost of on-going long term care.

LVN - LICENSED VOCATIONAL NURSE

(In California)

MANAGED CARE

A term that applies to the integration of health care delivery and financing. Managed care plans, such as an HMO, manage or control what is spent on health care by closely monitoring how doctors and other medical professionals treat patients. Such organizations try to limit referrals to costly specialists and require preauthorization for hospital care and services to keep costs down.

MEDI-CAL

The California Medicaid program. A federally aided, state operated and administrated program that provides medical benefits for certain low-income persons in need of health and medical care. Medi-Cal also provides long term care services. Subject to broad federal guidelines, California determines the benefits covered, program eligibility, rates of payment for providers, and methods of administrating the program.

MEDICATION REMINDERS

Support for a person who suffers from memory loss that helps them remember to take medication at the proper time. These reminders may be provided by a home attendant or through a service that calls the person at home.

MEDICARE

A Federal health insurance program available to older Americans and to many adults with disabilities. In most cases a person becomes eligible at age 65 or if they have a disability. Medicare is divided into several parts. Part A covers inpatient hospital, rehabilitation in a skilled nursing facility, rehabilitative home health, and hospice services. Part B covers most reasonable and necessary medical services including outpatient physician's services, mental health care, durable medical equipment and other services.

NEUROPSYCHOLOGICAL TESTING

Professional evaluation performed by a clinical psychologist to evaluate cognition, orientation, judgment, and legal capacity. Often the testing is provided to determine if symptoms displayed by the patient are due to an organic dementia like Alzheimer's disease or if they stem from other causes like depression, a mental illness, or medication.

NIA - NATIONAL INSTITUTE ON AGING

A Federal Agency responsible for funding clinical, basic science, social and behavioral science research in aging.

NIH - NATIONAL INSTITUTES OF HEALTH

(Federal Agency)

NURSE PRACTITIONER (NP)

A professional nurse (RN) who has special training to be a primary provider of health care.

OLDER AMERICANS ACT (OAA)

Federal law that authorizes and funds direct service such as senior centers, nutrition programs, information and referral services

OBRA

Omnibus Budget Reconciliation Act (Federal Law 1985)

OCCUPATIONAL THERAPY (OT)

Use of a vocational or vocational tasks as a form of therapy.

PACE - Program of All-inclusive Care for the Elderly

A model for managed health care programming which was developed by On Lok that provides community based care to seniors living in their own homes.

PALLIATIVE CARE

Care usually provided by a hospice service for a patient with a terminal condition. The care is not provided to cure the patient but to manage pain and to make the patient as comfortable as possible. Often palliative care is paired with supportive counseling for the patient and their family members.

POINT OF SERVICE (POS)

A provision that would allow patients in certain managed care plans which limit choice of doctors and hospitals to seek treatment outside the plans. Patients who use this option would pay more.

PHYSICAL THERAPIST (PT)

A person professionally trained in the practice of physical therapy.

RESIDENTIAL CARE FACILITY

see Assisted Living

REGISTERED NURSE (RN)

A professional nurse who has had medical training at a university and has passed state licensing requirements to practice.

RECREATION THERAPY (RT)

A professional therapeutic process which utilizes recreation services for purposive intervention in some physical emotional, and/or social behavior to bring about a desired change in that behavior and to promote the growth and development of the individual.

RESPITE SERVICES

Supports for a family member or other caregiver who is assisting someone with a serious medical condition or dementia. Respite is designed to help the family member get a break from their caregiving responsibilities. Respite care may entail the patient entering a facility for a short stay or it may be services provided by an in home attendant or day care program.

RSVP

Retired Senior Volunteers Program

SENIOR CENTERS

These programs are sometimes called Multi-purpose Senior Centers. They provide older adults who are not home bound the opportunity for social interaction in a centralized location via a variety of activities and programs.

SKILLED NURSING FACILITY (SNF)

A state licensed medical facility that provides services for rehabilitation or for long term care. Often they are called nursing homes or convalescent hospitals.

SOCIAL DAY CARE

These day care programs are designed for an adult who is physically disabled, or suffers from memory loss that provides recreation, support, usually a hot meal and transportation. They also provide respite for the participant's caregiver or other family members. See also Adult Day Care and Adult Day health Care.

SPEECH THERAPIST

A specially trained professional person who specializes in helping a person regain speech after suffering from a stroke or other debilitating condition. A speech therapist also has training to provide care for a patient who has difficulty in swallowing.

SPENDING DOWN

Spending or disposing of assets so that they are reduced to a level that qualifies one for Medicaid (in California: Medi-Cal).

SSI - Supplemental Security Income

A monthly cash grant provided to eligible individuals who have particularly low income and assets.

SUPPORT GROUP

A group, usually of family members or caregivers with responsibilities for a disabled relative, that meets for mutual support, and to discuss practical means of addressing their relative's needs. Often these groups are lead by a professional facilitator that is knowledgeable about the issues discussed by the group and is aware of a range of supportive services.

SUPPORTIVE SERVICES

A range of supports including home attendant care, home health care, adult day care, case management, counseling, legal assistance, meals programs, transportation, and other designed to help an older or disabled adult maintain their highest level of functioning and remain safely in the home.

TAR - Treatment Authorization Request

TELEPHONE SUPPORT

Services provided by an agency or volunteers over the phone to help an individual maintain their highest level of functioning at home. The support could include supportive counseling, suicide prevention, medication reminders, and daily check-ins.

TITLE XVIII

Medicare / Social Security Act

TITLE XIX

Medicaid / Social Security Act

TRANSPORTATION SERVICES

Programs offered in many communities to help elderly and disabled people go to medical appointments, shopping, and recreation. Often these programs are a para-transit type service that is offered for individuals who can not use regular fixed route transport (city busses). Some para-transit programs require that the user obtain certification under the American Disabilities Act as needing this type of assistance. Some specific housing communities and day care services include transportation as past of the range of options offered by their particular program.

TRUSTEE

Legal term referring to a holder of property on behalf of a beneficiary. The trustee may be a person or company, whether or not they are a prospective beneficiary.