Health-care terms can get tricky, especially when it comes to aging. Here are some definitions provided by Long Term Care. Gov to keep you in the loop. Can't find what you are looking for? Visit www.longtermcare.gov/LTC/Main_Site/index.aspx. Activities of daily living (ADLs): Basic actions performed by an independently functioning person on a daily basis: (a) bathing, (b) dressing, (c) toilet functions, (d) transferring (moving to and from a bed or a chair), (e) eating and (f) caring for incontinence. The need for assistance with ADLs or inability to perform ADLs is used to determine eligibility for many public programs, such as Medicaid-reimbursed long-term care services. Also, many long-term care insurance policies use the inability to do a certain number of ADLs (such as two of six) as criteria for paying benefits. Acute care: Care that has recovery as its primary goal; typically requires the services of a physician, nurse or other skilled professional and is usually provided in a doctor's office or hospital; usually short term. Adult day services: Services provided during the day at a community-based center. Programs are designed to meet the needs of functionally and/or cognitively impaired adults through an individual plan of care. These structured, comprehensive programs provide a variety of social and support services in a protective setting during any part of a day, but less than 24-hour care. Many adult day service programs include health-related services. Aging in place: An older adult's desire to live at home as long as possible rather than moving to housing designed for the older segment of the population, such as an assisted-living facility or nursing home. Assisted-living facility: Residential living arrangement that provides individualized personal care, assistance with Activities of Daily Living, help with medications and services such as laundry and housekeeping. Facilities may also provide health and medical care, but care is not as intensive as care offered at a nursing home. Types and sizes of facilities vary, ranging small homes to large apartment-style complexes. Levels of care and services also vary. Assisted-living facilities allow people to remain relatively independent. Benefit triggers: Criteria insurance companies use these to determine when you are eligible to receive benefits. The most common benefit triggers for long-term care insurance are: (1) needing help with two or more activities of daily living and (2) having a cognitive impairment. Board and care home (also called group home): Residential private homes that are designed to provide housing, meals, housekeeping, personal care services and support to frail or disabled residents. At least one caregiver is on the premises at all times. In many states, board and care homes are licensed or certified and must meet criteria for facility safety, types of services provided, and the number and type of residents they can care for. Board and care homes are often owned and managed by an individual or family involved in the everyday operation of the home. Care management services (also called care coordination services): Service in which a professional, typically a nurse or social worker, arranges, monitors or coordinates long-term care services. Caregiver: Family member, partner, friend or neighbor who helps care for an elderly individual or person with a disability who lives at home. The typical caregiver is a 46-year-old woman who is married and employed, and is caring for her widowed mother who does not live with her. Thirteen percent of caregivers caring for older adults are themselves age 65 or over. Half of all caregivers provide assistance with at least one activity of daily living; 26 percent perform three or more of these activities; and 80 percent provide assistance with activities like shopping, meal preparation and housework. Cognitive impairment: Deficiency in short or long-term memory; orientation to person, place and time; deductive or abstract reasoning; or judgment as it relates to safety awareness. (An example of a cognitive impairment is Alzheimer's disease). Continuing care retirement community: Retirement complex that offers a range of services and levels of care. Residents may move first into an independent living unit, a private apartment or house on the campus. The CCRC provides social and housing-related services and often also has an assisted living unit and an on-site or affiliated nursing home. If and when residents can no longer live independently in their apartment or home, they move into assisted living or the CCRC's nursing home. Countable assets: Assets whose value is counted when determining financial eligibility for Medicaid. They include vehicles other than the one used primarily for transportation, life insurance with a face value greater than $1,500, bank accounts, trusts and your home, if your spouse or child does not live there and its equity value is greater than $500,000 (in some states up to $750,000). Custodial care (also called personal care): Non-skilled service or care, such as help with bathing, dressing, eating, getting in and out of bed or chair, moving around and using the bathroom. May also include care that most people do themselves, such as using eye drops. Durable power of attorney: Legal document that gives someone else the authority to act on your behalf on matters that you specify. The power can be specific to a certain task or broad to cover many financial duties. The power can be given to start immediately or upon mental incapacity. To be valid, the document must be signed by you before you become disabled. Estate recovery: The process by which Medicaid recovers an amount of money from the estate of a person who received Medicaid. The amount Medicaid recovers cannot be greater than the amount it spent on the person's medical care. Exempt assets (also called non-countable assets): Assets whose value is not counted when determining financial eligibility for Medicaid. They include personal belongings, one vehicle, life insurance with a face value less than $1,500, and your home, if your spouse or child lives there or its equity value is less than $500,000 ($750,000 in some states). General Medicaid eligibility requirements: Residency and citizenship criteria for Medicaid applicants: You must be a resident of the state where you are applying; be either a United States citizen or a legally admitted alien; and be 65 or older or meet Medicaid's rules for disability or be blind. Hospice care: Short-term, supportive care for the terminally ill (life expectancy of six months or less) that focuses on pain management and emotional, physical and spiritual support for the patient and family. It can be provided at home, in a hospital, nursing home or a hospice facility. Hospice care is typically paid for by Medicare and is not usually considered long-term care. Income cap: Income level certain states impose on people applying for Medicaid payment of nursing facility services. People with income greater than the income cap are not eligible for Medicaid. As of August 2006, the following are income cap states: Alaska, Arizona, Colorado, Delaware, Georgia, Idaho, Kentucky, Mississippi, Missouri, Nevada, New Mexico, Ohio, Oklahoma, Oregon, South Dakota, Tennessee, Texas and Wyoming. Living will (also called health-care directive): Legal document used to specify whether you would like to be kept on artificial life support if you become permanently unconscious or are otherwise dying and unable to speak for yourself. It also specifies other aspects of health care you would like under those circumstances. Medicaid: Joint federal and state public assistance program for financing health care for the poor. It pays for health-care services for those with low incomes or very high medical bills relative to income and assets. It is the largest public payer of long-term care services. Medical power of attorney: Legal document that allows you to name someone to make health- care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions for yourself. Medicare: Federal program organized under the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965. It provides hospital and medical expense benefits for those individuals over age 65, or those meeting specific disability standards. Benefits for nursing home and home health services are limited. Nursing home (also called long-term care facility or convalescent care facility): Licensed facility that provides general nursing care to those who are chronically ill or unable to take care of daily living needs. Respite care: Temporary care given by a nursing home, adult day service center or private party for a person receiving long-term care services, which is intended to provide time off for those informal caregivers who care for that person on a regular basis. Respite care is usually short-term, typically 14 to 21 days of care per year. Reverse mortgage: New type of loan based on home equity that enables older homeowners (62 and up) to convert part of the equity in their homes into tax-free income without having to sell the home, give up title or take on a new monthly mortgage payment. Instead of making monthly payments to a lender, as with a regular mortgage, a lender makes payments to you. The loan, along with financing costs and interest on the loan, does not need to be repaid until the homeowner dies or no longer lives in the home. Spend down: Requirement that an individual use most of his or her income and assets to meet Medicaid eligibility requirements. Third-party notice (also called third-party designation or added protection upon lapse): Long-term care insurance benefit that lets you name someone who the insurance company would notify if your coverage is about to end because of lack of premium payment. This can be a relative, friend or professional, such as a lawyer. Reverse mortgage: New type of loan based on home equity that enables older homeowners (62 and up) to convert part of the equity in their homes into tax-free income without having to sell the home, give up title or take on a new monthly mortgage payment. Instead of making monthly payments to a lender, as with a regular mortgage, a lender makes payments to you. The loan, along with financing costs and interest on the loan, does not need to be repaid until the homeowner dies or no longer lives in the home. Spend down: Requirement that an individual use most of his or her income and assets to meet Medicaid eligibility requirements. Third-party notice (also called third-party designation or added protection upon lapse): Long-term care insurance benefit that lets you name someone who the insurance company would notify if your coverage is about to end because of lack of premium payment. This can be a relative, friend or professional, such as a lawyer. |