The terms explained here are commonly used by caregivers and agencies that assist older adults. More information about specific health conditions is available in the Cleveland Clinic Health Information Center.

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
Activities of Daily Living (ADLs)
Activities such as dressing, bathing, eating, walking, toileting and transferring out of a bed or chair. Inability to perform one or more of these functions often is used as eligibility criteria for long-term care services.

Acute Care
Care provided for a short period of time to treat a specific illness or condition. Acute care typically is delivered in a hospital, doctor's office or emergency department.

Administration on Aging
The agency of the U.S. Department of Health and Human Services that advocates for older adults and coordinates activities of the nationwide network of state and area Agencies on Aging.

Adult Day Care
Community-based programs designed to meet the activity and socialization needs of functionally and/or cognitively impaired adults no longer able to stay home alone. Adult day programs usually are run by social service agencies or long-term care facilities and provide services five days a week. Specialized programs assist individuals with Alzheimer's disease or related disorders; PACE Programs (see below) offer health maintenance as well as social and support services.

Adult Day Health Care
A type of adult day care that provides comprehensive, professional support for adults who require medical and/or psychiatric supervision. Programs include activities, socialization, medication monitoring and a wide range of therapeutic and rehabilitative activities, such as physical therapy or speech therapy.

Adult Protective Services
Adult Protective Services (APS) investigates reports of neglect (including self-neglect) and abuse of older persons. In all states, APS reports may be made anonymously by calling the county welfare department.

Advance Directive
A written and witnessed document in which a person states choices for medical treatment and care, or designates someone to make those decisions if the person is unable to do so.

Age Cohort
People born within the same time period - such as during the 1930s or after 1945 - who share similar life experiences and social characteristics.

Alzheimer's Disease
A progressive neurological disease that affects brain functions. It can lead to short-term memory loss, inability to reason, and the deterioration of language skills and the ability to care for oneself. An estimated 3 percent of people between ages 65-74 have Alzheimer's, while almost half of all people 85 and over show signs of the disease. Currently, Alzheimer's disease is treatable but not curable.

Angina (also called Angina Pectoris)
Temporary discomfort or pressure, usually in the chest or upper body, caused by inadequate blood reaching the heart muscle. It usually occurs during periods of physical or emotional stress and is relieved by rest.

Antihypertensive Drug
A drug that reduces hypertension (high blood pressure).

Area Agency on Aging (AAA)
An agency created by the U.S. government and designated by each state's Department on Aging to plan, develop and administer a comprehensive and coordinated program of aging services.

Assisted Living Facility (ALF)
A residential complex that provides a combination of housing, social activities, some personalized health care services and (usually) 24-hour on-call assistance. Most ALFs are private pay.

Assistive Equipment
A range of products, devices and tools - such as walkers, elevated toilet seats, emergency assistance devices, etc. - that help older adults live independently.

>> back to top

B
Beneficiary
The individual or organization entitled to the benefits of a program or the proceeds of a will, trust or insurance policy.

Brain Death
Brain damage so severe and extensive that the brain has ceased functioning.

>> back to top

C
Care Management (also called Case Management)
A service, typically provided by a nurse or social worker, that assists older adults and their caregivers in planning, arranging, monitoring and/or coordinating long-term care services.

Care Manager (also called Case Manager)
A professional who finds and coordinates appropriate social and medical services for older people, those with disabilities and their families. (See also Geriatric Care Manager and Social Worker)

Care Plan (also called Treatment Plan)
A medical document outlining the follow-up care, medications, and therapeutic or rehabilitative services that a patient should receive to achieve the treatment goal.

Caregiver
Individuals, typically family members or friends, who provide assistance to help meet the physical, psychological and/or social needs of another person.

Centenarian
A person who has lived 100 years or more.

Centers for Medicare and Medicaid Services (CMS)
Formerly the U.S. Health Care Financing Administration, the Centers for Medicare and Medicaid Services administers the Medicare program and works in partnership with the states to administer Medicaid and monitor Health Insurance Portability and Accountability Act (HIPAA) standards.

Chronic Care
Ongoing provision of medical and psychological care to enable people with serious, persistent conditions to maintain functional independence and well-being.

Chronic Illness
A long-term or permanent illness, such as diabetes or heart disease, that often results in some degree of disability and requires ongoing treatment.

Chronological Age
The number of years a person has lived.

Clinical Trial
Research done with people to compare and validate the effect of an unproven intervention or treatment with a control intervention or treatment. For more information on clinical trials, visit www.clinicaltrials.gov.

Cognitive Impairment
A deficiency in a person's short-term or long-term memory; orientation as to person, place and time; deductive or abstract reasoning; and/or judgment. Typically this impairment is caused by an illness or injury, such as Alzheimer's disease, stroke or traumatic brain injury.

Co-morbidities
Multiple disease processes occurring at the same time.

Community-based Services
Services, such as adult day care programs, senior centers or respite programs available within a community. Services provide support for caregivers and help for older and functionally impaired people seeking to remain at home.

Companionship Services
Friendly visitor services - companionship, reading, light errands, etc. - provided by social service organizations, home care agencies or volunteer organizations.

Continence
The ability to maintain control of bowel and bladder function. The inability to maintain this control is incontinence.

Continuing Care Retirement Community (CCRC)
Typically, a residential campus that provides a continuum of care - from independent apartments to assisted living to skilled nursing care - all in one location. The primary advantage of this model is that an individual or couple does not need to relocate as health care needs change over time.

Continuum of Care
A range of housing options and community and institutional services developed, organized and provided to address the variety of needs individuals have as they age.

Custodial Care
The provision of assistance with activities of daily living and related non-medical care. Medicare prohibits reimbursement for custodial care services provided in a private home or nursing home.

>> back to top

D
Dementia
A group of symptoms that describes the loss of intellectual ability - abstract thinking, judgment, memory, etc. - and interferes with carrying out daily activities. Symptoms can be caused by degenerative diseases, such as Alzheimer's, Huntington's or Parkinson's diseases; vascular diseases or stroke; metabolic disorders, such as kidney dysfunction or certain vitamin deficiencies; adverse medication reactions; drug or alcohol abuse; and/or psychiatric disorders. Some dementia-related disorders may respond to treatment.

Depression
A psychiatric disorder characterized by an inability to concentrate, difficulty sleeping, fatigue and feelings of hopelessness, sadness and/or guilt. Eighty percent of older persons who seek treatment for depression improve.

Discharge
The formal termination of inpatient care in a hospital or skilled nursing facility.

Discharge Planner
A nurse or social worker who assists patients and their caregivers in the transition from a hospital to another setting. Services usually include assistance in locating skilled nursing care, rehabilitation services, medical devices and agencies that can provide in-home services.

Do Not Resuscitate (DNR) Order
An advanced directive indicating that no cardiopulmonary resuscitation (CPR) is to be done if a person's heart and lungs stop functioning normally.

Durable Medical Equipment (also called Home Medical Equipment)
Equipment used to serve a medical purpose - such as walkers and wheelchairs - that can withstand repeated use, are appropriate for home use, and generally are not useful to anyone who is not injured, ill or recuperating.

Durable Power of Attorney (also called Power of Attorney for Health Care)
A written document - an advance directive - in which people name an "agent" or "proxy" to make medical and health care decisions for them if they are unable to speak for themselves.

>> back to top

E
Elder Abuse
The legal definition varies from state to state. In general, elder abuse is defined as people age 60 or older being neglected or abandoned, or significantly neglecting their own physical and health needs; being physically or financially coerced or exploited; or being subjected to physical or financial abuse. Emotional abuse sometimes is considered elder abuse.

Eldercare Locator
A free, U.S. government-sponsored directory assistance service that helps older people and their caregivers locate support resources and services in their area. To use the service, call 800.677.1116.

Emergency Response System
Electronic monitors carried by a person or located in the home to provide an automatic response to medical or other emergencies.

>> back to top

F
Formal care
Care that is supervised and/or arranged by a physician, nurse or licensed therapist. Under such supervision, formal care can be provided by a long-term care facility or by a variety of agencies, including home health or home care aides and social service agencies.

Functional Disability
A physical or mental impairment that limits an individual's ability to live independently.

>> back to top

G
Geriatric Assessment
An assessment/evaluation of an older adult's medical, mental, physical and psychological status. Most evaluations take two or more hours and include a physical examination, mental status and psychological evaluation, and laboratory tests. Information from the assessment is used to help older patients and their caregivers manage current medical conditions and make plans for future care and housing.

Geriatric Assessment Team
A multidisciplinary team of health care professionals, led by a geriatrician or specially trained nurse, that provides evaluative and diagnostic services to older adults.

Geriatric Care Manager
A professional, usually a social worker or nurse with experience in geriatric care, who coordinates an older person's care. For more information, contact the National Association of Geriatric Care Managers at 520.881.8008 or www.caremanager.org.

Geriatrician
A physician who specializes in care of the elderly. Most patients seen by a geriatrician are frail and/or have complex medical conditions.

Geriatrics
The branch of medicine specifically concerned with the prevention and management of diseases and conditions associated with old age.

Gerontology
The multidisciplinary study of the processes of aging and its impact on the individual and society.

Guardian/Guardianship
An individual appointed by the court to take over the management (guardianship) of a person's personal and/or financial affairs because the person no longer is competent to do so. A conservator can be appointed to handle financial affairs only.

>> back to top

H
Health Insurance Portability and Accountability Act (HIPAA)
Federal health insurance legislation passed in 1996 that set standards for patient privacy and rights, as well as for health coverage 'portability'. Under specified conditions, HIPAA allows long-term care insurance policies to be qualified for certain tax benefits.

Heart Attack (myocardial infarction)
Permanent damage to the heart muscle caused by a lack of blood to the heart over an extended period of time. The severity of damage varies from mild to severe.

Heart Failure
A chronic, progressive disease in which the heart muscle (myocardium) weakens and cannot pump blood effectively.

Home Health Agency
An agency that provides health maintenance services in the home. Services may be provided by a nurse; occupational, speech or physical therapist; social worker, or home health aide (see below).

Home Health Care
The provision of supportive services - from intensive medical support to assistance with self-care - in the home.

Home Health Aide
Individuals who provide health-related services or care - medication monitoring, simple wound care, etc. - in the home. In Ohio and many other states, home health aides are required to have at least 75 hours of supervised, hands-on training.

Homemaker Service (also called Home Chore Service)
Services - such as shopping, laundry, meal preparation and transportation assistance - provided in the home on an hourly basis.

Hospice/Hospice Care
Hospice is a holistic program, not a specific place. It addresses the physical, emotional, psychological, social and familial needs of patients and their families. Hospice services - home healthcare, administration of pain medications, respite programs for caregivers, etc. - can be provided at home, in the hospital, or in a long-term care facility. Typically, hospice care is offered in the last six months of a patient's life, while follow-up services are offered to the family for at least a year after the patient has died.

>> back to top

I
Informed Consent
A process – based on full disclosure of information and patient competence – used to make decisions about treatment options and care plans.

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

Independent Living Centers
Community-based resource centers for individuals with chronic diseases and disabilities who wish to live independently. Centers offer information about public benefits and local resources, support, and advocacy organizations. To find the center nearest you, go to www.ILUSA.com or www.OhioSILC.org.

Informal care
Care provided by an unlicensed caregiver, such as a spouse or friend.

Inpatient
A person who has been admitted to a hospital or other health care facility for an overnight stay related to a diagnostic procedure or medical treatment that can be delivered only in that setting.

Instrumental Activities of Daily Living (IADLs)
Shopping and getting to appointments, preparing meals, managing money and performing housekeeping duties are instrumental activities of daily living. Ability to perform many IADLs indicates a high level of function and predicts a high level of independence.

>> back to top

L
Life Expectancy
How long, on average, a person born in a specific year is expected to live. Life expectancy is calculated at birth and increases incrementally as an individual ages.

Life Span
The longest number of years any member of a species has been known to survive. For humans, the maximum life span is based on the life of Jeanne-Louise Calment, who died in 1997 at the age of 122.

Living Will
A legal document that states medical preferences and decisions for people unable to speak for themselves because of medical incapacitation. (See also Advance Directive)

Long-Term Care (LTC)
The provision of a wide range of services at home, in the community, and in residential care or skilled nursing facilities. Services may include some or all of the following: medical or nursing care, social services, rehabilitative or therapeutic services, palliative care, and/or supervised care over an extended period of time. (See also Custodial Care)

Long-Term Care Insurance
Private insurance designed to cover long-term care expenses at home or in a facility. People are eligible to use the benefit when they require assistance with two or more activities of daily living. For more information on Long-Term Care Insurance, visit www.helpguide.org/elder/senior_housing.htm. (See also Activities of Daily Living)

Long-Term Care Ombudsman Program
A federally funded program charged with investigating and resolving complaints made by or on behalf of residents of nursing homes and other residential care facilities. The program's goal is to improve the quality of life, health, safety and rights of residents. To locate the nearest program, visit www.LTCombudsman.org or
http://goldenbuckey.com/families/ombudsman.html.

>> back to top

M
Medicaid
A joint federal-state program that covers health services - including medical long-term care assistance - for low-income individuals. Medicaid is the primary payer for nursing home care. Coverage and eligibility requirements vary from state to state.

Medicare
The federal health insurance program for people 65 and older, certain younger people with disabilities and people with end-stage renal disease (permanent kidney failure). Medicare provides for acute hospital care, physician services, brief stays in skilled nursing facilities, and short-term skilled home care for a medical problem. Medicare coverage is determined by the nature of services required by the patient, not the specific diagnosis. Coverage does not include custodial care at home or in a nursing home.

Medicare Part A: Insurance that helps pay for inpatient hospital care, limited skilled nursing care, hospice care and some home health care. Monthly premiums vary depending on the plan chosen.
Medicare Part B: Insurance that helps pay for doctor's services, outpatient hospital care and some medical services not covered by Medicare Part A. Monthly premiums vary depending on the plan chosen.
Medicare Part D: Insurance that helps cover the costs of prescription medications. Monthly premiums vary depending on the plan chosen.
Medicare Supplemental Insurance (also called Medigap): Private insurance purchased by Medicare-eligible individuals that pays Medicare's deductibles and co-insurance fees. It also may cover services not covered by Medicare.

Minimally Invasive Procedure
The use of techniques and instruments to reduce the trauma associated with some diagnostic tests and surgical procedures. Diagnostic procedures are done using imaging scans and ultrasounds. Surgical procedures are done using tissue-sparing techniques, smaller surgical instruments and smaller incisions - all of which allow the patient to recover faster.

>> back to top

N
Noncompliance
Failure to follow instructions given by health care providers, such as not taking medications as prescribed, not attending follow-up appointments, or not keeping appointments for rehabilitation sessions.

Noninvasive Procedure
Tests or procedures - such as blood pressure checks or MRIs - that do not penetrate the body. Most noninvasive procedures are considered low-risk and painless. (See also Minimally Invasive Procedure)

Nursing Home
The generic term for a skilled nursing facility (SNF). Typically, they provide nursing services, personal care, social services and programs for individuals who require continuing, supervised care. (See also Traditional Nursing Home)

>> back to top

O
OBRA
The federal nursing home reform act (OBRA 1987) that created a set of national minimum standards of care and rights for people living in certified nursing facilities. (OBRA is an acronym for Omnibus Budget Reconciliation Act.)
Occupational Therapist
A rehabilitation professional who assists individuals to compensate for physical and functional limitations by teaching them the skills and techniques needed to perform activities of daily living and optimize independence.

Older Americans Act (OAA)
Federal legislation created in 1965 to establish the U.S. Administration on Aging. The OAA funds specific aging-related services administered by state departments on aging. It also created the Area Agencies on Aging network, which provides programs to address senior nutrition, housing, in-home care and other needs. The OAA must be reauthorized by Congress every three years to ensure funding for existing and new programs.

Ombudsman
A person designated by a facility to help clients and family members investigate and solve problems related to the facility's environment, staff or services. To contact the Cleveland Clinic Ombudsman's Office, call 216.444.2544 or toll-free 800.223.2273, ext. 42544.

Outpatient
A patient who receives care or services at a hospital, clinic or other health care facility without being admitted to the facility.

>> back to top

P
Palliative Care
Medical care or treatment designed to reduce the severity of a patient's symptoms, manage the patient's pain or discomfort, and/or slow the disease's progress. Palliative care's aim is to improve quality of life rather than provide a cure.

Paratransit Services
Specialized transportation services - such as wheelchair-accessible vans or mini-buses - for seniors and/or people with disabilities.

Pastoral care
Care and counseling provided by pastors, chaplains and other religious leaders to members of their church, congregation, etc. Care can range from a bedside visitation to formal counseling in an office setting.

Person-Centered Care (also called Person-First Care)
A holistic approach to care for patients that considers their spiritual, psychological and familial needs, as well as their physical needs. (See also Palliative Care)

Personal Care
Non medical care provided to an individual - such as bathing or feeding - that addresses personal needs.

Personal Emergency Response System (PERS)
An electronic device that enables the user - on a 24-hour basis - to contact help in case of a fall or other medical emergency.

Pharmacist
A degreed and licensed specialist who works with a geriatrician or primary care physician to ensure that medications do not have adverse interactions or side effects.

Physical Therapy/Physical Therapist
A structured program of rehabilitative exercises and activities planned and supervised by a physical therapist to assist an individual to recover maximum physical strength, flexibility and mobility following an illness or injury.

Pre-Existing Condition
An illness or disability treated or diagnosed before a person applies for a new insurance policy. A pre-existing condition usually will be covered, but coverage will be prohibited for a designated period of time.

Prevention-Primary
Identifying and altering risk factors - such as smoking or being overweight -- to prevent the onset of or lessen the impact of conditions and diseases to which a person may be environmentally or genetically pre-disposed.

Prevention-Secondary
Treating and rehabilitating patients after they experience an 'attack' or injury - such as a heart attack or a bone break caused by osteoporosis.

Primary Care Physician (PCP)
The physician initially consulted for healthcare. Often called "gatekeepers", PCPs coordinate a person's care and make referrals to healthcare specialists.

Primary Caregiver
The person (usually a spouse, adult child or friend) who has assumed the main, or day-to-day, responsibility of caring for the physical, psychological and/or social needs of another person.

Program of All-Inclusive Care for the Elderly (PACE)
PACE is a specialty care program that helps older adults with long-term care needs remain in their community and maintain independence. PACE provides access to a continuum of healthcare services, including preventive, primary, acute and long-term care.

>> back to top

R
Rehabilitation
The combined and coordinated use of medical, educational, physical and vocational therapies and strategies to retrain a person who has been disabled by disease or injury. The goal is to return the person to the highest possible level of function.

Residential Care Facility
A generic term for a group home, rest home (see below), assisted living complex or other facility that provides a range of care services for individuals no longer able to live on their own.

Rest Home
A type of long-term care facility that can provide assistance with activities of daily living and some personal care services, but which is not allowed to offer nursing services.

Respite Care
A program that provides temporary or intermittent care for individuals with disabilities, illnesses, dementia or other health concerns so that their caregivers can take a break from caregiving responsibilities. Respite care can be provided in the home, through a community program (such as an adult day care), or through assisted living or long-term care facilities. Some programs are free or low-cost, while others are offered on a daily-fee basis.

Risk Factor
A trait a person is born with or acquires that is linked to - and often pre-disposes the person to - development of a condition or disease. Some risk factors - such as the risks for diabetes or lung cancer - can be modified by lifestyle changes.

>> back to top

S
Senescence
The normal decline of the body's organ systems, typically beginning around age 30. The period between birth and age 30 is referred to as "maturation".

Skilled Nursing Care
Therapeutic services outlined in a treatment plan by a physician and delivered by or under the direction of a nurse or trained healthcare professional, such as a physical therapist.

Skilled Nursing Facility (SNF)
A residential care facility offering a protective, therapeutic environment for individuals who require rehabilitative care and/or for those no longer able to live independently because of chronic conditions that require round-the-clock care. SNFs must be licensed by the state and are subject to state and federal regulations. To find information on the facilities in your area, go to www.medicare.gov/NHCompare.

Social Worker
A person who provides social services, especially psychological counseling and guidance. A social worker also may be able to coordinate appropriate social and medical-related services for elderly persons and their families. (See also Care Manager and Geriatric Care Manager)

Speech Therapist
A rehabilitation professional who provides therapy to help patients overcome speech, communication and swallowing problems.

Special Care Units
Separate units within long-term care facilities designed for the specific needs of persons who have had a stroke or are dealing with severe Alzheimer's disease, dementia or other disorders.

Subacute Care (also called Postacute or Transitional Care)
A level of hospital care for those not suffering from life-threatening conditions, but still requiring 24-hour monitoring or skilled care. Subacute care may be provided by a trained professional on a routine basis in a skilled nursing facility or at home.

Support Group
A group of people who meet on a regular basis to share insights, information, concerns and feelings around a common topic: a disease, a disorder, caregiving responsibilities, etc. Groups may or may not be facilitated by an expert. Many support groups are available online.

>> back to top

T
Terminal Condition
An irreversible, incurable condition from which there is no recovery, and for which death is likely to occur soon. Nursing and medical care are administered to provide comfort. (See also Hospice/Hospice Care)

Toileting
An activity of daily living focused on getting to and from the toilet and performing personal hygiene-related tasks.

>> back to top

V
Ventilator Care
Care provided to individuals dependent on ventilators - artificial breathing devices - to move air in and out of their lungs.

Visiting Nurse
A nurse who comes into the home to provide services and deliver care and patient education.

>> back to top