Article Posted: 04/30/2008
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Glossary of terms related to ElderCare
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A

Access Services - Services and activities aimed to enhance and facilitate the awareness of and participation in programs available to elders. Examples are information and referral, outreach, and transportation.

Activities of Daily Living (ADLs) - These activities include assistance with eating, feeding, transferring, dressing, bathing, walking, and toileting. Assessment of ADLs is often used as a basis for assessing functional status.

Administration on Aging (AoA) - The Administration on Aging (AoA), an agency in the U.S. Department of Health and Human Services is the official Federal agency dedicated to policy development, planning and the delivery of supportive home and community-based services to older persons and their caregivers. The AoA administers the Older Americans Act and works through the national aging network of State Units on Aging, Area Agencies on Aging, Tribal and Native organizations representing 300 American Indian and Alaska Native Tribal organizations, and two organizations serving Native Hawaiians, plus thousands of service providers, adult care centers, caregivers, and volunteers.

Administrator - A person licensed to run a nursing home or residential/ board and care home.

Adult Day Care - Adult Day Care Centers offer social, recreational and health-related services to individuals in a protective setting who cannot be left alone during the day because of health care and social need, confusion or disability.

Advisory Council:  The AAA Advisory Council is a voluntary group of citizens who provide information, guidance, advice, and support to the Area Agencies on Aging to develop, coordinate, and administer services to elders. They represents the interest of older people by reviewing and commenting on policies, programs, and actions which affect older people, and by acting as an advocate on their behalf.

Aging Network - The agencies and organizations at the local, state, and national level involved in serving and/ or representing the needs of older people.

Alzheimer's Disease - A progressive, irreversible form of dementia. It is the most common form of dementia that affects 5% of those over 65 and 20% of those over 80. There is no cause of the disease known at this time. Symptoms begin with loss of memory and rational thinking. This disease mainly affects the mind, not the physical body.

Area Agency on Aging (AAA) - A governmental entity mandated by the Older Americans Act. A public or nonprofit private agency or office designated by the Department of Elder Affairs to coordinate and administer the Department's programs and to provide, through contracting agencies, service within a planning and service area (PSA). The area agencies on aging are used as the state network at the district level. Area Plan - document submitted by the Area Agency on Aging to the state unit on aging which identifies and prioritizes needs and specifies how needs will be met through service provision and other activities for the period of the plan.

Assessment - A written evaluation of needs completed by a social worker, nurse, or other professional and used to determine eligibility and priority for services and to help with developing a care plan.

Assisted Living Facility (ALF) - A facility that provides a combination of housing and personalized health care in a professionally managed group-setting designed to respond to the individual needs of persons who require assistance with activities of daily living. The facility provides care to residents who cannot live independently, but who do not require 24 hour nursing care. Terminology varies from state to state, and a facility that is called an Assisted Living Facility in one state might be called other things in other states, i.e. a Residential Care Facility (RCF), Board and Care Home, a Domiciliary Care Facility, an Adult Care Home, or a Community-Based Care Facility.

Assisted Technology -  Assistive technology is any service or tool that helps the elderly or disabled do the activities they have always done but must now do differently. These tools are also sometimes called “adaptive devices.” 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).


B

Beneficiary - A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity or other contract.

Benefit Trigger - A condition that must exist in order for an insurance company to pay benefits under a long-term care insurance policy.

Board and Care Home - A small to medium-sized group residence (usually a 6-bed home) that provides residents with a private or shared room, and meals. These homes offer some assistance with activities of daily living, but do not provide skilled nursing.


C

Caregiver - A generic term referring to a person, either paid or voluntary, who helps an older person with the activities of daily living, health care, financial matters, guidance, companionship and social interaction. A caregiver can provide more than one aspect of care. Most often the term refers to a family member or friend who aids the older person. When they are unpaid, they are also referred to as a “family caregiver.”

Care Manager - A health care professional, typically a nurse or social worker, who arranges, monitors, or coordinates long-term care services (also referred to as a care coordinator or case manager). A care manager may also assess a patient's needs and develop a plan of care, subject to approval by the patient's physician. Case managers work with family members and older adults to assess, arrange and evaluate supportive efforts of seniors and their families to remain independent.

Cash Surrender Value - The amount of money you may be entitled to receive from the insurance company when you terminate a life insurance or annuity policy. The amount of cash value will be determined as stated in the policy.

Catheter - A medical devise used to control urinary incontinence using a receptacle bag.

Certified - A long-term care facility, home health agency, or hospice agency that meets the requirements imposed by Medicare and Medicaid is said to be certified. Being certified is not the same as being accredited. Medicare, Medicaid and some long-term care insurance policies only cover care in a certified facility or provided by a certified agency.

Certified Nursing Assistant (CNA) - CNAs are trained and certified to help nurses by providing non-medical assistance to patients, such as help with eating, cleaning and dressing.

Chore Service - Chore service is available to persons who are physically unable to perform tasks, such as heavy cleaning, minor repair or yard work, and unable to neither secure assistance from family or friends nor have the means to pay privately.

Chronically Ill Individual - According to federal law, a person who, within the preceding 12-month period, has been certified by a licensed health care practitioner as:

·         being unable to perform, without substantial assistance from another person, at least two activities of daily living for a period of at least ninety consecutive days due to a loss of functional capacity; or

·         requiring substantial supervision to protect such a person from threats to health and safety due to severe cognitive impairment.

Chronic Illness or Condition - An illness or other condition with one or more of the following characteristics: permanency, residual disability, requires rehabilitation training, or requires a long period of supervision, observation, or care. Typically, it is a disease or condition that lasts over a long period of time and cannot be cured; it is often associated with disability.

Codicil - A written amendment to a will.

Cognitive Impairment - Deterioration of intellectual ability, such as disorientation as to people, places or time; impairment of short-term or long-term memory; and/or impairment of one's ability to reason; that has progressed to the extent that a person requires substantial supervision by another person. Cognitive impairment includes Alzheimer's disease and senile dementia. The existence of cognitive impairment is determined by clinical evidence and standardized tests that reliably measure the person's impairment. For more information, click on Senile Dementia symptoms.

Coinsurance - For Medicare, it is the percentage of the Medicare-approved amount that you have to pay after you pay the deductible for Part A and/or Part B. For other types of health insurance, it is usually a percentage of billed charges after you pay the deductible. For example, if you have paid the deductible and the insurance company then pays 70 percent of the remaining amount of your claim, your coinsurance is 30 percent.

Community-Based Services - Services designed to help older people live independently in their own homes, such as adult day care and senior centers.

Companionship Services - Companions visit isolated and homebound elders for conversation, reading, and light errands. May also be termed "friendly visitor" services.

Congregate Meal Programs - These meal programs provide older individuals with free or low cost , nutritionally sound meals served five days a week in easily accessible locations. Besides promoting better health through improved nutrition, meal programs provide daily activities and socialization for participants which help reduce the isolation of old age.

Conservator - Someone appointed by a court to assume responsibility for a child, or for an adult who is not capable of managing his or her own affairs.

Continence - Another activity of daily living - The ability to maintain control of bowel and bladder function. Or, when unable to maintain control these functions, the ability to perform associated personal hygiene (including caring for catheter or colostomy bag).

Continuing Care Retirement Community (CCRC) - A retirement community that offers a broad range of services and levels of care based on what each resident needs over time. Sometimes called "life care," it can range from independent living in an apartment to assisted living to full-time care in a nursing home. Residents move from one setting to another based on their needs. Care in CCRCs can be expensive, with a large payment often required before moving in, and monthly fees thereafter.

Coordination of Benefits - A provision in a health insurance plan that tells which health plan or insurance policy pays first if two health plans or insurance policies cover the same benefits. If one of the plans is Medicare, federal law may determine who pays first.

Copayment - A charge you pay for a specific medical service. For example, you may pay $10 for an office visit or $15 for a prescription and your health plan pays the remainder of the medical charges.

Covered Benefit or Service - A health service or item that is included in an insurance plan or policy, and that is paid for either partially or fully.

Covered Charge - Services or benefits for which a health plan makes either partial or full payment.

Cueing - Directing or supervising the actions of someone with cognitive impairment (for example, showing them how to eat, reminding them which medications to take at the appropriate times, giving visual or verbal reminders for dressing or toileting, etc.).

Custodial Care (Personal Care) - Care to help individuals meet personal needs such as bathing, dressing, eating, and other non-medical care that most people do themselves, such as using eye drops. Someone without professional training may provide this type of care. Medicare does not pay for custodial care and Medicaid pays very little.

D

Daily Benefit - The insurance benefit amount (in dollars) that a person selects as the basis for their long-term care insurance. However, the daily benefit may not be the actual amount paid for each day an insured person is eligible for a benefit. There are three different methods of computing benefits; but, each insurance policy will use only one of them.

1. Expense-Incurred Method – After you qualify for benefits, the insurance will pay the lower of: (1) the expenses you incurred for eligible long-term care services, or (2) the dollar limit of your policy. Most policies bought today pay benefits using the expense-incurred method.

Some expense-incurred policies protect a covered person from the situation where expenses exceed the daily limit on some days and are less than the daily limit on other days, by setting up a weekly pool of benefits. That is, the daily benefit is multiplied by 7 to establish a weekly pool of money that can be used to pay all eligible expenses until the pool is exhausted for that week. Under the pool of money approach, any unspent money is often added to the end of the policy to extent the period of coverage. (A few policies use a monthly pool of money.)

2. Indemnity Method – This method is not based on the specific service received or on the actual expenses incurred. After you qualify for benefits and receive eligible long-term care services, the insurance company will pay a fixed amount directly to you, up to the limit of the policy. The fixed amount is pre-determined by your insurance policy.

3. Disability Method – After you qualify for benefits, you will receive your full daily benefit even if you don't receive any specific long-term care services. These benefits are yours to spend as you wish.

Deductible - The amount you must pay, usually every year, before your health insurance or Medicare begins to pay benefits.

Dementia - Deterioration of intellectual abilities (e.g., vocabulary, abstract thinking, judgment, memory loss, physical coordination), the loss of which interferes with daily activities. Dementia can be caused by degenerative diseases (e.g., Alzheimer's, Huntington's and Parkinson's diseases), vascular diseases or stroke, metabolic disorders (thyroid, liver kidney dysfunction and certain vitamin deficiencies), AIDS, drugs and alcohol, and psychiatric disorders. Some dementias may respond to treatments, others do not.

Depression - This is one of the most undiagnosed conditions among seniors. But, with proper medical care, depression is a reversible psychiatric condition. Symptoms include a persistent sad, anxious or "empty" mood, loss of interest or pleasure in activities once enjoyed, and difficulty sleeping.

Discharge Planner - A social worker or other health care professional who assists hospital patients and their families in transitioning from the hospital to another level of care such as rehabilitation in a skilled nursing facility, home health care in the patient's home, or long-term care in a nursing home.

Domicile - A person's permanent legal residence for tax purposes; typically, this is also the address where the person maintains his or her voter's registration.

Donee - A person or organization who receives a gift.

Donor -  A person or organization who gives a gift.

Dressing - The third activity of daily living - Putting on and taking off all items of clothing and any necessary braces, fasteners or artificial limbs.

Durable Medical Equipment - Medical equipment that is ordered by a doctor for use in the home. These items, such as walkers, wheelchairs, and hospital beds, must be reusable. Durable medical equipment is paid for under Medicare, subject to a 20% coinsurance of the Medicare-approved amount.

Durable Power of Attorney for Healthcare -  A document, signed by a competent adult, i.e., "principal," designating a person that the principal trusts to make health care decisions on the principal's behalf should the principal be unable to make such decisions. The individual chosen to act on the principal's behalf is referred to as an "agent."

E

Eating - The fourth activity of daily living - Feeding oneself by getting food into the body from a receptacle (such as a plate, cup or table). It does not include preparation of meals.

Elder Abuse - Elder abuse is a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. The specificity of laws varies from state to state, but broadly defined, abuse may be physical, emotional, sexual, exploitation, neglect, and abandonment.

Elder Abuse Prevention Programs - Allegations of abuse, neglect and exploitation of senior citizens are investigated by highly trained protective service specialists. Intervention is provided in instances of substantiated elder abuse, neglect or exploitation.

Elder Care - A wide range of services provided at home, in the community and in residential care facilities, including assisted living facilities and nursing homes. It includes health-related services such as rehabilitative therapies, skilled nursing, and palliative care, as well as supervision and a wide range of supportive personal care and social services. Typically, elder care is provided over an extended period of time to people who need another person's assistance to perform normal activities of daily living because of cognitive impairment or loss of muscular strength or control. Regardless of where it is provided, most elder care is custodial care, the type of care that is not paid for by Medicare.

Eldercare Locator -  Developed by the U.S. Administration on Aging, the Eldercare Locator is a free nationwide directory assistance service. It helps older people and their caregivers find local support services to help them live independently in their own community.

Elimination Period - The length of time an insured person must pay for covered services before the insurance company will begin to pay benefits. Unless otherwise noted in the insurance policy, no benefits are payable for any days of an elimination period.

Estate - All of a person's assets and debts at the time of his or her death.

Estate Tax - A tax levied on a person's estate after that person's death.

Exclusion - A health condition, situation, item, service or expense that an insurance policy does not cover. Medicare excludes coverage for most prescription drugs, long-term care, and custodial care in a nursing or private home.

Executor - The person or institution appointed in a will, or by a court, to settle the estate of a deceased person.

Energy Assistance - These programs can provide low-income elderly homeowners and renters with funds to help pay home utility and heating costs. Eligibility requirements may vary from state to state.

F

Family (informal) Caregiver - A term referring to an unpaid person who helps an older person with the activities of daily living, health care, financial matters, guidance, companionship and social interaction.

Formal Caregiver -  a provider associated with a formal service system, whether a paid worker or a volunteer.

Free-Look Period - After an insurance policy is issued to you, you have a certain period of time (usually 30 days) during which you can change your mind and cancel the policy for any reason whatsoever. This is often called a "free-look period." If you cancel your policy during the free-look period, your premiums will be refunded in full, and no claims will be paid. (This type of cancellation is treated as though your policy never took effect.)
 

Friendly Visitors and 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. Usually a volunteer provides the service. Besides developing friendships, perhaps a more important aspect of these programs is the volunteer's ability to identify needs of the individual as they occur and notify those who can help.


G

Geriatric Care Managers -  Geriatric Care Managers specifically trained in geriatric care management, and provide case management services on a fee-for-service basis to individual clients.

Geriatrician - A physician who specializes in the care of the elderly, primarily those who are frail and have complex medical and social problems.

Gift Tax - A tax on gifts, usually only over $11,000, to non-charitable beneficiaries. For gifts that exceed the annual gift tax exclusion, the donor is required to file a gift tax return and pay all applicable taxes. The person who receives the gift does not have to pay any gift tax because of it.

Gift Tax Exclusion - The maximum amount one person is allowed to give to another person without incurring Federal gift tax. The current annual exclusion is $11,000 per year per recipient. There is no limit on the number of these gifts you can make to different people in a year. A husband and wife can give a total of $22,000 ($11,000 each) to the same person each year. To qualify for the exclusion, a gift must be of a "present interest," meaning that the recipient can make use of the gift immediately, and the donor must not have any control over the asset after it is given. There are no exclusion limits on gifts given to a spouse unless the spouse is not a U.S. citizen. Generally, if a gift qualifies for the exclusion, the donor does not have to file a gift tax return. The person who receives the gift does not have to pay any gift tax because of it.

Grace Period - This is the period of time (usually 30 days) during which you can still pay your premium after its due date. Your policy will remain in force during the grace period. But if you have a claim, the premium remaining due will be deducted from any payment of benefits. If you don't pay the premium by the end of the grace period, your policy will lapse.

Grantor - The person who creates a trust; also called a trustor.

Guaranteed Renewable - Most Medicare Supplement and long-term care insurance policies are guaranteed renewable. That is, the policy cannot be cancelled by the insurance company unless: (1) you committed fraud in your application for the policy, (2) you have not paid the required premium and the policy has lapsed, or (3) benefits have been exhausted. A guaranteed renewable policy cannot be cancelled because of a change in your health condition, or your marital or employment status. However, the insurance company may increase premiums, but only on an entire class of policies, not just on your policy, and never because of any claims paid to you.

Guardian -  An individual appointed by a court of law to manage a person’s financial and/or personal affairs because the court has found that the person is not competent to
manage his or her own affairs. A conservator is similarly appointed, but only for financial affairs.

Guardianship -  The process in which an individual is appointed by a court of law to manage a person’s financial and/or personal affairs because the person is not able to or is not competent to manage his/her own affairs.


H

Home and Community-Based Services - A variety of supportive services delivered in community settings or in an older person’s home are designed to help older persons remain living at home and avoid institutionalization.

Home Health Care -  Home health care is recognized as an increasingly important alternative to hospitalization or care in a nursing home for patients who do not need 24?hour day professional supervision. Many people find it possible to remain at home for the entire duration of their illness or at least to shorten their hospital stay. In many cases readmission to the hospital can be prevented or delayed. A variety of health services are provided in a home health care program in the patient's home, under the direction of a physician.

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.

Homemaker Service -  Homemaker service is extended to individuals who are unable to perform day-to-day household duties and have no one available to assist them. Services include light housekeeping, laundry, limited personal care, grocery shopping, meal preparation, and shopping assistance.

Hospice -  Usually a combination of at-home and hospital care of the terminally ill that combines medical and social services. It is designed to help both the patient and the family. Hospice care emphasizes pain control, symptom management, and emotional support rather than life-sustaining equipment.


I

Incontinence - The inability to control urination, bowel movements or both.

Inflation Protection - A policy option that automatically increases benefits to help pay for expected increases in the cost of long-term care. Two types of protection, simple or compounded, are often available; both are typically based on an inflation rate of 5% per year.

Inheritance Tax - A tax that is levied by a state or local government upon those who inherit property; paid by the recipient.

Instrumental Activities of Daily Living (IADLs) - These are tasks that, in addition to activities of daily living, you must be able to perform in order to live independently (without the assistance or substantial supervision of another person). Examples include grocery shopping, meal preparation, using the telephone, laundry, light housekeeping, bill paying, and managing your medications. Most long-term care insurance policies will not pay benefits for the loss of ability to perform IADLs.

Inter Vivos Trust - A revocable trust created during someone's lifetime to hold assets during that person's lifetime, thereby removing those assets from probate at death; also called a living trust.

Intestate - Dying without a legal will.

Irrevocable Trust - A trust that, once executed, cannot be revoked or changed without the consent of the beneficiary.

Information and Referral -  Information Specialists are available to provide assistance and linkage to available services and resources.

J

Joint and Survivor Annuity - An annuity issued on two individuals under which payments continue in whole or in part until both individuals die; also called a joint life annuity.

Joint Tenancy in Common - A type of joint tenancy of property without right of survivorship. Upon the death of any joint tenant, his or her ownership interest is transferred according to the terms of his or her will that may, or may not, provide for transfer to a surviving joint tenant(s).

Joint Tenancy with Right of Survivorship - A type of ownership of property by two or more persons in which each owns an interest in the whole. Upon the death of any joint tenant, his or her ownership interest automatically passes to the surviving joint tenant(s).

 
K



L

Lapse - Termination of a policy when a required premium has not been paid by the end of the policy's grace period.

Legal Assistance - Legal advice and representation is available to persons aged 60 and over for certain types of legal matters including government program benefits, tenant rights, and consumer problems.

Licensed Health Care Practitioner - A physician (as defined by the Social Security Act) or a registered professional nurse, licensed social worker, or any other health care worker who meets the requirements of the U.S. Treasury Department.

Life Tenancy - After the owner sells a home, he or she leases it back and receives a written guarantee (life tenancy) that he or she can continue to live in the home for the rest of his or her life. A life tenancy is often arranged with an annuity set up to pay the rent.

Lifetime Maximum - The maximum amount of policy benefits available to an insured person during his or her lifetime.

Limited Payment Option - Premiums are paid for only a set period of time. After the last premium payment, the policy becomes paid-up for the remaining duration of the policy. After it becomes paid-up, the insurance company cannot cancel the policy and they cannot ask for more premiums. The tradeoff? ... while premiums are being paid, limited payment plans are more expensive than continuous payment policies.

Living Trust - A trust created during someone's lifetime to hold assets during that person's lifetime, thereby removing those assets from probate at death. A living trust can be either revocable or irrevocable. It avoids probate and therefore gets assets distributed significantly faster than a will. Assets that a person wants to move to a living trust, such as real estate and bank or brokerage accounts, must be retitled.

Living Will - A legal document in which a person specifies which life-prolonging medical measures he or she does, and does not, want to be taken if he or she becomes terminally ill or incapacitated.

Long Term Care - A general term that describes a range of medical, nursing, custodial, social, and community services designed to help people with chronic health impairments or forms of dementia.

Long Term Care Insurance - This type of insurance policy is designed to cover long term care expenses in a facility or at home.

Long Term Care Ombudsman - Long term care ombudsmen, state and local, work cooperatively with nursing homes and board and care facilities to improve the quality of life for residents. They serve as patient's rights advocates, investigating and negotiating resolutions to concerns voiced by residents in matters of resident services and care.


M

Meals on Wheels - Local agencies provide low cost, hot, nourishing meals to the elderly and disabled, allowing frail, homebound people to remain in their own homes.

Medicaid - Medicaid is a health benefit program administered by States for people with low incomes who meet other eligibility requirements. The health insurance program is financed by the federal and state governments. Medicaid may also pay for 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.

Medigap - Medigap is designed specifically to supplement and 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 covered by Medicare.

Medicare Supplement Insurance - A private insurance policy that covers many of the gaps in Medicare coverage (also known as Medigap Insurance or Medicare Supplemental Insurance). Except in Minnesota, Massachusetts and Wisconsin, there are 10 standardized plans labeled Plan A through Plan J. (Not all insurance companies offer all 10 plans.) Medicare Supplement Insurance policies work only if you are enrolled in the Original Medicare Plan. But, they won't pay any benefits if you are enrolled in a Medicare HMO or another type of Medicare Plus plan. Medicare Supplement policies can minimize Medicare copayments and deductibles for covered services, but generally do not offer expanded coverage such as long-term care services or prescription drugs.

MMSE / Mini-mental state examination - The mini-mental state examination (MMSE) or Folstein test is a 30-point questionnaire test that is used to assess cognition.. It is commonly used by medical clinicians to screen for dementia.  It takes about 10 minutes to administer, assessing functions, including memory, arithmetic, and orientation. It was introduced by Folstein et al in 1975.

Minimum Distribution - The minimum annual required distribution amount for an IRA holder reaching age 70 1/2; also called Required Minimum Distribution (RMD).

N    

n4a -   The National Association of Area Agencies on Aging (n4a) is the umbrella organization for the 655 area agencies on aging (AAAs) and more than 230 Title VI Native American aging programs in the U.S.  n4a advocates on behalf of the local aging agencies to ensure that needed resources and support services are available to older Americans. The fundamental mission of the AAAs and Title VI programs is to provide services which make it possible for older individuals to remain in their home, thereby preserving their independence and dignity. These agencies coordinate and support a wide range of home- and community-based services, including information and referral, home-delivered and congregate meals, transportation, employment services, senior centers, adult day care and a long-term care ombudsman program.

Network - A group of doctors, hospitals, pharmacies, and other health care professionals hired by a managed healthcare plan to take care of its members.

Noncancellable Policies - Insurance policies that cannot be cancelled by the insurance company, except for non-payment of the required insurance premiums. And, the rates can never be changed by the insurance company.

Nonforfeiture Benefits - After a long-term care insurance policy has been in force for a sufficient period of time, your will be entitled to a nonforfeiture benefit if you let the policy lapse. Instead of canceling the policy, the nonforfeiture benefit allows you to keep it in force as a paid-up policy. Nonforfeiture benefits vary from policy-to-policy; they usually include (1) keeping the same benefit amounts, but making the benefit period shorter, or (2) keeping the same benefit period, but with reduced benefit amounts.

Nursing Home - A state-licensed residential facility that provides a room, meals, help with activities of daily living, recreation, and general nursing care to people who are chronically ill or unable to take care of their daily living needs. It may also be called a Long Term Care Facility. If it has been certified as such by Medicare, it is also referred to as a Skilled Nursing Facility.


O

Occupational Therapist - A rehabilitation professional who teaches people to compensate for functional limitations as a result of an injury, illness or disability by learning skills and techniques needed to perform activities of daily living and optimize independence.

Out-of-Pocket Maximum - The maximum amount of money you will be required to pay per year for your health insurance plan's deductibles and coinsurance. This maximum may apply to each family member, or to an entire family. The maximum amount is in addition to your premiums.

P

Paid-Up Policy - After your insurance policy has been in force for a period of time defined in the policy, you may be entitled to nonforfeiture benefits. If you have one of those policies and you prematurely stop paying the required premiums, your policy becomes paid-up. You don't pay any more premiums, but the benefits you receive under the policy will be determined based on the amount of premiums you have already paid, not on the level of benefits you originally purchased.

Paratransit Services - Specialized transportation, such as a wheelchair accessible van, for seniors and other people with disabilities. These services may offer transportation to senior centers, medical care, shopping malls, or specific appointments.

Partnership Policy - A type of long-term care insurance policy that allows you to protect (keep) some of your assets if you apply for Medicaid after using your policy's benefits. Only a few states have these policies.

Personal Emergency Response System - In case of a fall or other medical emergency, this electronic device enables the user to contact help 24-hours-a-day simply by pressing a button. A number of private companies offer these systems.

Physical Therapist - A rehabilitation professional who utilizes various therapies to help people maximize mobility, and restore strength and body movement after an illness or injury such as a stroke, fall, back injury, etc.

Plan of Care - The written plan that describes the services and care you need to maximize your health and independence.

Point-of-Service Plan (POS) - A type of managed care plan that combines aspects of health maintenance organizations and preferred provider organizations. POS offers the option of going to a network healthcare provider and paying a flat fee, or to an out-of-network provider and paying a deductible and/or a coinsurance charge. POS Plans are not currently available to Medicare beneficiaries.

Pour-over -  A provision in a person's will stating that certain assets are to be transferred (poured over) to a trust upon the death of that person.

Power of Attorney - A written legal document in which one person (the principal) appoints another person to manage the principal's financial affairs. Even though the intent is that the power of attorney will not take effect until the principle becomes unable to handle her own affairs, it actually takes effect on the date it is signed, unless otherwise specified. And, unless otherwise specified, the financial durable power of attorney applies only to assets owned directly by the principal, and not to any assets transferred into a trust by the principal.

Power of Attorney for Health Care - A written legal document in which one person (the principal) appoints another person to make health care decisions on behalf of the principal in the event the principal becomes incapacitated (the document defines incapacitation). This instrument can contain instructions about specific medical treatment that should be applied or withheld. While its purpose remains essentially the same from state-to-state, the name of this document can vary; for example, in Florida it is called a Designation of Health Care Surrogate.

Pre-existing Condition -  An illness or disability for which you were treated or advised within a certain time period (typically 6-12 months) before applying for an insurance policy. Any pre-existing condition would not be covered during a designated time period (again typically 6-12 months) after the effective date of the policy.

Preferred Provider Organization (PPO) - Another type of managed care plan. Members have a choice of utilizing healthcare providers in the PPO network, or hospitals, doctors and other healthcare professionals outside the plan for an additional cost.

Primary Care Physician - A doctor trained to give you basic care. Your primary care doctor is the one you see first for most health problems. He or she makes sure you get the care you need to stay healthy. He or she also may talk with other more specialized doctors and healthcare providers and refer you to them. In many Medicare managed care plans, you must see your primary care doctor before you see other healthcare providers.

Primary Caregiver - The person, usually the spouse or adult child, who takes on the primary day-to-day responsibility of caring for the physical, psychological and social needs of another person.

Probate - The process by which an executor (if there is a will), or a court-appointed administrator (if there is no will), manages and distributes a decedent's property to heirs or beneficiaries.

Provider -  A properly-licensed doctor, health care professional, hospital, or other health care facility, including a home health agency, that provides health care or related social services.

R

Respite Care - The provision of short-term relief (respite) to families caring for their frail elders offers tremendous potential for maintaining dependent persons in the least restrictive environment. Respite services encompass traditional home-based care, as well as adult day health, skilled nursing, home health aide and short term institutional care. Respite can vary in time from part of a day to several weeks.

S

Senior Centers - A vital link in the service delivery network which older persons may avail themselves of, senior centers are functioning 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. The significance of senior centers cannot be underestimated for they provide a sense of belonging, offer the opportunity to meet old acquaintances and make new friends, and encourage individuals to pursue activities of personal interest and involvement in the community.

State Agencies on Aging - The Older Americans Act mandates that each state have a state agency on aging which is part of state government. The State Agency on Aging is the designated focal point within the state government responsible for administering a complex service system designed to complement and support other human service systems in meeting the needs of the elderly.

State Health Insurance Information Counseling and Assistance Programs -
Known as SHIP, this program is comprised of 53 state programs and nearly 15,000 trained volunteers who offer unbiased, one-on-one counseling to assist Medicare beneficiaries understand their health insurance benefits and options.

Supplemental Security Income (SSI) -  A federal income supplement for older adults with limited income.  Typically SSI and Medicaid eligibility have similar income and asset thresholds. 

T

Transportation -  Programs that provide door-to-door transportation for people who may be elderly or disabled, who do not have private transportation and who are unable to utilize public transportation to meet their needs.

 

W

 

Will -  A will is a document that a person uses to regulate his belongings or family after his/her death.  It is the traditional document that’s been used for many centuries where you name the property or identify it some way, and name beneficiaries who receive the property. Almost all wills end up going through a process called probate, which is a court approval process, which is time-consuming and expensive.  There are two common ways to transfer property to people after your death: living trusts and wills.  You can draft a will without the assistance of an attorney.

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