This glossary covers terms related to elder care, retirement and estate planning. It also includes related financial, insurance and legal terms.
When one first starts investigating the world of options for seniors housing it can be confusing - bewildering is more like it. To make matters worse, some definitions are changing as you read this. Here are a number of definitions that may help.
We want to provide you with the best possible information. However, we are human and as a result, you may find a term missing. If that happens please let us know. Contact Us.
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Glossary
Glossary of Aging Terms.
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X Y Z
A
Access Services: Those services and activities designed to enhance and facilitate the awareness of and participation in programs available to elders. Examples are information and referral, outreach, and transportation (see definitions below).
Activities of Daily Living (ADLs): These activities include assistance with eating, feeding, transferring, dressing, bathing, walking, toileting and self-administration of medications. Widely used as a basis for assessing functional status.
Administration on Aging (AoA): The official federal agency dedicated to implement programs that provide supportive home and community-based services to older persons and their caregivers. Each year the Department receives millions of dollars in federal funds from AoA to contract with the regional area agencies on aging.
Administrator: A person licensed to run a nursing home; one who has received training in fiscal, legal, social and medical aspects of running an institution.
Adult Family Care Home: A full-time, family-type living arrangement, licensed by the Agency for Health Care Administration in which a person or persons provide room, board, and one or more personal services, as appropriate for the level of functional impairment for three or fewer non-relatives who are elders or disabled adults placed in the home by the Florida Department of Children and Families.
Advisory Council: 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. The Department of Elder Affairs also has an advisory council as do some service providers.
Aging Network: The agencies and organizations at the local, state, and national level involved in serving and/ or representing the needs of elders. Participants may be involved in service systems development, advocacy, planning, research, coordination, policy development, training and education, administration, and direct service supervision.
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. The cause of the disease is unknown at this time. Symptoms begin with loss of memory and rational thinking and usually progresses to total disability over a number of years. Its effects are mainly on the mind, not the physical body.
Ancillary Services: Those services needed by a nursing home resident, but not provided by the nursing home, such as podiatry and dental services. Ancillary services may not be included in the basic rate of the facility.
Area Agency on Aging (AAA): A quasi-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.
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 some services and to help with developing a care plan.
Assisted Living Facility (ALF): A residential facility which provides food service and one or more personal services for four or more adults who require such services or provides extended congregate care, limited nursing services, or limited mental health services when specifically licensed to do so by Agency for Health Care Administration.
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B
Bathing – An activity of daily living - Washing oneself by sponge bath, taking a shower, or taking a bath in a tub. This activity includes the task of getting into or out of the tub or shower.
Beneficiary – A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity or other contract. Someone covered by Medicare is also called a beneficiary.
Benefit Period – The number of years an insurance policy will provide benefits. Many long-term insurance policies offer buyers a choice of between three and five years; some offer lifetime benefits.
Benefit Trigger – A condition that must exist in order for an insurance company to pay benefits under a long-term care insurance policy.
Benefits – Monetary sums paid or payable to a person insured under an insurance policy, or to someone else, such as a health care provider, to whom the insured person has assigned the benefits.
Board and Care Home – A small to medium-sized group residence that provides residents with a private or shared room, and meals. These homes offer some assistance with activities of daily living, but not skilled nursing.
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C
Caregiver – An adult (typically a family member or friend) who provides unpaid assistance to another adult who can no longer independently attend to his or her personal needs and/or perform his or her normal activities of daily living.
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.
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 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 – Nutritional programs that provide lunches for older adults Monday through Friday in senior centers, community centers and schools.
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.
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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.
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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.
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F
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.
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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.
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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.
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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.
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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).
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K
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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.
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