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Glossary of Terms

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24-Hour Controlled Access

Control of all points of entry/exit 24 hours a day for the security of a facility’s residents.

Activities of Daily Living (ADLs) ++

Physical functions that an independent person performs each day, including bathing, dressing, eating, toileting, walking or wheeling, and transferring into and out of bed.

Activity Director

An individual who plans group activities such as singing, art projects or exercises. Activities such as these help residents of a long-term care facility stay active, alert and sociable.

Acute Care

A medical setting such as a hospital, intensive care unit or emergency department.

Adaptive/Assistive Equipment

An appliance or gadget that assists the user in the operation of self-care, work or leisure activities.

Administration on Aging

A government agency that is part of a newly created organization formed by the Department of Health and Human Services called the Administration for Community Living (ACL). ACL brings together the efforts and achievements of the Administration on Aging, the Administration on Intellectual and Developmental Disabilities and the HHS Office on Disability to serve as the federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities.


In most cases, a licensed professional who undertakes the duty of managing day-to-day operations of a senior housing facility such as a skilled nursing facility or assisted living facility.

Adult Day Care

See Adult Day Program.

Adult Day Program

Programs designed to meet the needs of older adults and support their strengths, abilities and independence. Adult day programs offer opportunities for social engagement and participation in a safe and supervised environment; they also give a caregiver a break from their responsibilities. Offerings will vary, but many adult day programs provide activities, personal care, nutrition, education and occasionally transportation to the site. Adult day programs are typically p paid for privately. Commonly referred to as: Adult Day Care, Day Program.

Adult Family Home

Facility that provides a home-like setting, typically in a residential neighborhood, and serves a limited number of residents who receive care from live-in caretakers. Group meals are served, and help is given with ADLs. Usually, housekeeping and laundry are taken care of, and some activities are provided. Amenities and nursing services vary widely in these facilities, and some homes provide services for adults with impairments other than dementia. Commonly referred to as: Group Home, Personal Care Home, Board and Care Home, Residential Care Facility and Adult Foster Care.

Adult Foster Care

See Residential Care Facilities.

Advanced Directives

A written statement of an individual's preferences and directions regarding health care. Advanced directives protect a person's rights even if he or she becomes mentally or physically unable to choose or communicate his or her wishes. Commonly referred to as: DNR Order.

Aging & Disability Resource Centers (ADRC)

Programs that provide information and assistance to individuals and professionals seeking assistance on behalf of their clients planning for their future long-term care needs. ADRC programs serve as the entry point to publicly administered long-term support and can include those funded under Medicaid, the Older Americans Act, Veterans Health Administration and state revenue programs.

Alzheimer’s Association Chapters

Physical offices and/or staff of the Alzheimer's Association who provide supportive programs and services to help people with Alzheimer's and their caregivers deal with the disease and its impact on their lives. Chapters focus on a specific community or geographic area.

Alzheimer’s Disease

A type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

Americans with Disabilities Act (ADA)

Passed by Congress in 1980, this law establishes a clear and comprehensive prohibition of discrimination on the basis of disability.

Area Agencies on Aging (AAA)

A public or private nonprofit agency designated by the state to address the needs and concerns of all older persons at the regional and local levels. “Area Agency on Aging” is a generic term — specific names of local AAAs may vary. AAAs are primarily responsible for a geographic area, also known as a PSA, that is either a city, a single county or a multi-county district. AAAs may be categorized as county, city, regional planning council or council of governments or private, nonprofit. AAAs coordinate and offer services that help older adults remain in their home, aided by services such as Meals on Wheels, homemaker assistance and other services to make independent living a viable option.


Also called resident assessment. A standardized tool that enables senior housing facilities to determine a patient's abilities, what assistance the patient needs and ways to help the patient improve or regain abilities. Patient assessment forms are completed using information gathered from medical records, discussions with the patient and family members and direct observation.

Assisted Living Communities

A residential care facility that generally provides 24-hour staff, recreational activities, meals, housekeeping, laundry and transportation. Definitions of assisted living and the specific regulations differ from state to state. Residents may choose which services they receive, such as house cleaning, help with grooming or medication reminders. Services offered and costs vary widely, so check each facility for specifics. Commonly referred to as: Assisted Living Facility, Supportive Living Facility, Congregate Housing and Residential Care.

Assisted Living Facility

See Assisted Living Communities.

Board and Care Home

See Adult Family Home.


Anyone who provides care to a person with Alzheimer's disease or another dementia. Caregivers can be family members, friends or paid professionals. Caregivers may provide full- or part-time help to the person with Alzheimer's.

Case Management

A term used to describe formal services planned by care professionals who help the patient or the family determine and coordinate necessary health care services and the best setting for those services.

Center for Medicare and Medicaid (CMS)

Formerly the U.S. Health Care Financing Administration, CMS is the part of the Department of Health and Human Services that finances and administers the Medicare and Medicaid programs. Among other responsibilities, CMS establishes standards for the operation of nursing facilities that receive funds under Medicare or Medicaid.


An individual who offers spiritual counseling to people in nursing homes and hospitals.

Charge Nurse

An RN or LPN who is responsible for the supervision of a unit within a nursing facility. The charge nurse schedules and supervises the nursing staff and provides care to facility residents.

Commission on Accreditation of Rehabilitation Facilities - CARF International

An independent nonprofit organization that promotes quality, value and optimal outcomes of services through a consultative accreditation process centered on enhancing the lives of the persons served. CARF, through the Continuing Care Accreditation Commission (CCAC), is the nation’s only accreditor of continuing care retirement communities (CCRC) and aging services networks.

Concierge Service

An individual or individuals who provide personal service, similar to the concierge in a hotel. At a facility, the concierge will typically run errands, schedule transportation, help with activities, etc.

Congregate Housing

A form of housing similar to independent living except that it usually provides convenience or supportive services like meals, housekeeping and transportation in addition to rental housing. Commonly referred to as: Assisted Living Communities.

Continuing Care Retirement Community (CCRC)

This form of housing offers several levels of assistance, including independent living, assisted living and skilled nursing care on one campus. Residents move from one setting to another as their needs change but stay in the same CCRC community. Fees vary, but it is not uncommon for a significant payment to be required (called an endowment) prior to admission, as well as monthly fees. Often there is a lifetime contract that ensures care through the progression of care needs. Commonly referred to as: Life Care Community and Retirement Community.

Continuum of Care

Care services available to assist individuals throughout the course of a disease. This may include independent living, assisted living, nursing care, home health, home care, and home- and community-based services.

Convalescent Home

See Skilled Nursing Facility.

Custodial Care

Board, room and other personal assistance services (including assistance with activities of daily living and taking medicine).

Day Program

See Adult Day Program.


Problems an inspector notes while visiting a nursing home or other facility. The facility must correct any deficiencies. If not, its Medicare/Medicaid participation may be affected.


An overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease is the most common type of dementia.


An individual who makes sure that a facility's residents eat a healthy, nutritious diet.

Director of Nursing (DON)

An individual who oversees all nursing staff in a nursing home and is responsible for formulating nursing policies and monitoring the quality of care delivered, as well as the facility's compliance with federal and state regulations pertaining to nursing care.


The release of an individual from a hospital or other facility such as a nursing home. The attending doctor must give an order for the discharge.

Do Not Resuscitate (DNR) Order

A document signed by a doctor based on a patient’s wishes that instruct medical personnel to avoid life-saving CPR or other procedures to restart the heart or breathing once they have ceased. Once signed, the DNR directive must be placed in the patient’s chart.

Dual Eligibility

Someone who is qualified for both Medicaid and Medicare.

Elder Care Manager

See Geriatric Care Manager.

Elder Law Attorneys

An individual who handles general estate planning issues and counsels clients about planning for the future with alternative decision-making documents. The attorney can also assist the client in planning for possible long-term care needs, including nursing home care. Not all attorneys specialize in elder law. Your local bar association, the National Academy of Elder Law Attorneys or your local Alzheimer’s Association chapter can refer you to elder law attorneys in your area.

Exit-Seeking Behavior

A tendency to look for ways to exit the building that is part of the “wandering” trait associated with dementia and Alzheimer’s disease. It is important that individuals who exhibit this trait are cared for in facilities that have locked doors and, if possible, alarms on exits. Commonly referred to as: Wandering.

Family Style Food

A term used in care facilities to describe meal times that are served family style in a group dining setting.

Feeding Tube

A plastic or rubber tube to give food and water to someone who cannot eat or drink. A feeding tube can be put in through the nose (nasogastric) or the stomach wall (PEG tube).

Financial Counseling Program

Helps individuals to manage their finances, bills and completing Medicaid, Medicare or insurance forms.

Financial Planner

A practicing professional who prepares plans covering various aspects of personal finance. A financial planner can help identify potential resources and outline a plan to make those resources last.

Functional Impairment

Being unable to dress, use the toilet, eat, bathe or walk without help.

Geriatric Care Manager

An individual who helps to create a plan of care that meets the needs of an older adult and will explain what resources and options are available. Commonly referred to as: Elder Care Manager, Senior Healthcare Manager and Professional Care Manager.

Geriatric Psychiatrist

An individual trained to diagnose and treat mental disorders in older adults. These disorders include dementia, depression, anxiety and late-life schizophrenia.

Group Home

See Adult Family Home.


An individual who manages a resident's money and makes health care and living decisions. Becoming a guardian or conservator requires a court order and generally occurs when a person who can no longer make decisions for him or herself, has no relatives or the relatives disagree about health care and living decisions.

Health Care Directive

A written legal document that allows a person to appoint another person (agent) to make health care decisions should he or she is unable to make or communicate decisions. Also referred to as health care power of attorney.

Home Care

Agencies that typically provide non-medical personal care services and assistance with daily activities such as bathing, dressing and meal preparation. Some home care agencies also provide home health care services, which can vary by provider. Home care services are typically not covered by Medicare or Medicaid and are paid for privately. Commonly referred to as: Home Companion, Private Duty Aide, Live-in Aide, Private Nurse and In-Home Care.

Home Companion

See Home Care

Home Health

See Home Health Care.

Home Health Aides

Individuals who provide non-medical health care to people at home. Training or certification requirements vary from state to state, but typical services include assistance with activities of daily living, managing medications and some household tasks.

Home Health Care

Services that can include skilled nursing, physical therapy, speech-language pathology, occupational therapy, medical social work, home health aide and medical supplies when they are medically necessary to help treat, restore, rehabilitate or sustain a patient in the home. Physician orders are required for home health care, and the patient must meet certain guidelines to qualify. Medicare, Medicaid and private insurance may cover these services when the appropriate criteria are met. Commonly referred to as: Home Health and In-Home Care.


A suite of services for patients diagnosed with a terminal illness and a medical prognosis of six months or less life expectancy. Hospice care can include pain management, nursing care, home health aide, social work, spiritual care and medical supplies. Services are provided in a person’s home, residential facility or nursing home or, in some cases, in an in-patient hospice facility. Physician orders are required to initiate hospice services.


An institution that provides medical, surgical or psychiatric care and treatment for the sick or the injured.

Housing and Urban Development (HUD) Subsidy

A federal program that provides affordable independent housing for the elderly and disabled. Most individuals that qualify for HUD must pay approximately 30 percent of their monthly income to rent. HUD takes care of the remaining 70 percent. Eligibility requirements may include income, assets and age. Also called HUD Senior Housing.

Independent Living (IL) Communities

A multi-unit, senior housing development that may provide supportive services such as meals, housekeeping, social activities and transportation. Independent living typically encourages socialization by providing meals in a central dining area and scheduled social programs. It may also be used to describe housing with few or no services. Commonly referred to as: Senior Apartment, Senior Residence, Senior Housing, and Retirement Community.

In-Home Care

See Home Care, Home Health Care.

Instrumental Activities of Daily Living (IADLs)

Secondary level of activities (different from ADLs, such as eating, dressing and bathing) important to daily living, such as cooking, writing and driving.

Licensed Nursing Care

Care provided by registered nurses (RN), licensed practical nurses (LPN) and nurses’ aides. Some facilities such as nursing homes and skilled nursing facilities are designed for those who need 24-hour nursing care and have on-site medical teams that set them apart from other types of senior housing. Part-time licensed nursing care may also be provided at assisted living and adult family home facilities and can be contracted to serve independent living communities.

Life Care Community

See Continuing Care Retirement Community.

Live-In Aide

See Home Care.

Living Will

A document that expresses how a physically or mentally incapacitated person wishes to be treated in certain medical situations. It is generally something that an individual prepares and signs prior to his or her impairment.

Long-Term Care

Care given in the form of medical and support services to persons who have lost some or all of their capacity to function due to an illness or disability.

Long-Term Care Facilities

See Skilled Nursing Facilities.

Long-Term Care Insurance

An insurance policy designed to help alleviate some of the costs associated with long-term care. Benefits are often paid in the form of a fixed dollar amount (per day or per visit) for covered expenses and may exclude or limit certain conditions from coverage.


The federally supported, state-operated public assistance program that pays for health care services to people with a low income, including elderly or disabled persons who qualify. Medicaid pays for long-term nursing facility care and some limited home health services, and may pay for some assisted living services, depending on the state.

Medical Director

An individual who coordinates with a person’s personal physician to ensure that the facility delivers the care that is prescribed. In some instances, the medical director may be a resident's primary physician. A staff medical director assumes overall responsibility for the formulation and implementation of all policies related to medical care.

Medical Transportation

See Transportation.


See Transportation.


A federal health insurance program generally for people age 65 or older who are receiving Social Security retirement benefits or who are younger than 65 and have received Social Security disability benefits for at least 24 months.

Medicare Part A

Hospital insurance that helps pay for inpatient hospital care, limited skilled nursing care, hospice care and some home health care. Most people get Medicare Part A automatically when they turn 65.

Medicare Part B

Medical insurance that helps pay for doctors' services, outpatient hospital care and other medical services that Part A does not cover (like some home health care). Part B helps pay for these covered services and supplies when they are medically necessary. A monthly premium must be paid to receive Part B.

Medicare Part D

Medical insurance that adds prescription drug coverage to original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Medicare Supplemental Insurance

Private insurance (often called Medigap) that pays Medicare's deductibles and co-insurances and may cover services not covered by Medicare. Most Medigap plans will help pay for skilled nursing care, but only when Medicare covers that care.

Medigap Insurance

A term commonly used to describe Medicare supplemental insurance policies available from various companies. Medigap is private insurance that may be purchased by Medicare-eligible individuals to help pay the deductibles and co-payments required under Medicare. Medigap policies generally do not pay for services not covered by Medicare.

Memory Care

A term used to describe facilities that have trained staff to respond to issues surrounding Alzheimer’s disease and other dementias. Policies and procedures have been implemented to ensure the health and safety of residents with the disease.

Music Therapy

An established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive and social needs of individuals. Studies have shown that music may reduce agitation and improve behavioral issues that are common in Alzheimer’s disease.


A term used to describe a person with the inability to move independently due to being bedridden or hospitalized.


An individual, who works in a nursing home, takes care of residents and oversees certified nurses' aides (CNAs) and custodial caregivers. A registered nurse (RN) is a graduate trained nurse who has been licensed by a state authority after passing qualifying examinations for registration. A licensed practical nurse (LPN) is a person who has undergone training and obtained a state license to provide routine care for the sick. Some states use the term licensed vocational nurse or LVN.

Nurse Practitioners (NPs) and Physician Assistants (PAs)

These individuals are specially trained and may help oversee residents' care. In many states, doctor-supervised NPs and PAs write orders for treatment and medication.

Nursing Care

See Skilled Nursing Facilities.

Nursing Home

See Skilled Nursing Facilities.

Occupational Therapist (OT)

An individual who helps residents change their activities or environment so they can eat, dress and bathe. An OT may also help with other tasks, such as cooking, taking medication or driving. OTs may guide family members and caregivers.


An individual in a long-term care facility helps residents and their families keep their rights and resolve complaints.

Palliative Care

Care that includes medical or surgical methods to ease the pain of a serious or incurable illness.

Personal Care

Care that involves services rendered by a nurse's aide, dietician or other health professional. These services include assistance in walking, getting out of bed, bathing, toileting, dressing, eating and preparing special diets.

Personal Care Home

See Adult Family Home

Physical Therapy

Services provided by specially trained and licensed physical therapists in order to relieve pain, restore maximum function and prevent disability or injury. These can include massage, regulated exercise and treatments involving water, light, heat and electricity.


This individual helps develop a medical care plan for each resident of a long-term care facility. Physicians (or doctors) make medical decisions, such as what medications residents take.

Power of Attorney

A legal document allowing one person to act in a legal matter on another's behalf pursuant to financial or real-estate transactions.

Pre-Admission Screening

An assessment of a person's functional, social, medical and nursing needs to determine if the person is appropriate for the facility.

Private Duty Aide

See Home Care.

Private Nurse

See Home Care.

Private Pay

Patients who pay for their own care out of private funds, using funds of their own, from family or from another third party such as an insurance company. The term is used to distinguish patients from those whose care is paid for by governmental programs (Medicaid, Medicare and Veterans Administration).

Professional Care Manager

See Geriatric Care Manager.


Someone who provides medical services or supplies, such as a physician, hospital, X-ray company, home health agency or pharmacy.


An individual detects and treats emotional problems. A psychologist may provide treatment in individual, family and group therapy sessions. Psychologists in long-term care facilities also teach staff members how to interact with residents.

Psychotropic Drugs

Antidepressants, anti-anxiety drugs and anti-psychotic drugs used for delusions, extreme agitation, hallucinations or paranoia.

Quality Assurance Director

An individual who coordinates quality assurance programs and policies for the facility. This person is responsible for quality assurance only and must be a licensed nurse.

Recreational therapist

An individual who provides activities and services designed to restore or maintain a person’s level of functioning and independence in life and social activities.


Therapeutic care for persons requiring intensive physical, occupational or speech therapy in order to restore to the patient to a former capacity. Commonly referred to as: Skilled Nursing Facilities.

Relocation Manager

An individual who provides assistance in moving or changing residences and transitions impacting senior citizens. Commonly referred to as: Senior Move Manager.


Someone who lives in a long-term care facility, such as a nursing home.

Resident Assistant (RA)

An individual who often works in assisted living residences, providing direct personal care services to residents. An RA is not a Certified Nurses’ Aide. Depending on the state, this position is also available in some nursing facilities.

Resident Care Plan

A written plan of care for a nursing facility resident. Developed by an interdisciplinary team that specifies measurable objectives and timetables, the plan is designed to meet a resident's medical, nursing, mental and psychosocial needs. Families can participate in the development of the care plan.

Residential Care Facility

Group living arrangements that are designed to meet the needs of people who cannot live independently but do not require nursing facility services. These homes offer a wider range of services than independent living options. Most provide help with some of the activities of daily living. In some cases, private long-term care insurance and medical assistance programs will help pay for this type of service. Commonly referred to as: Group Home, Personal Care Home, Board and Care Home, Adult Family Home and Adult Foster Care.

Respite Care

A type of care that provides temporary relief from caregiving tasks. This could include in-home assistance, a short nursing home stay or adult day care.

Retirement Community

See Continuing Care Retirement Communities, Independent Living Communities.

Secured Care Unit

Facility is fully fenced and gated for purposes of controlled entry and exit.

Senior Apartment

See Independent Living Communities.

Senior Health Care Manager

See Geriatric Care Manager.

Senior Housing

Age-restricted multi-unit housing for older adults who are able to care for themselves. Usually no additional services such as meals or transportation are provided. Commonly referred to as: Independent Living Communities.

Senior Residences

See Independent Living Communities.

Skilled Nursing Care

Nursing and rehabilitative care that can be performed only by, or under the supervision of, licensed and skilled medical personnel.

Skilled Nursing Facility (SNF)

A facility that is licensed to provide custodial care, rehabilitative care (such as physical, occupational or speech therapy) or specialized care for people with Alzheimer's. SNF may also offer social, recreational and spiritual activities. Commonly referred to as: Nursing Home, Nursing Care, Convalescent Home and Rehabilitation.

Social Worker

An individual who offers residents and their family’s therapy, support services and planning for discharge. Social workers may also teach and counsel staff members.

Speech Therapy

A type of service to help individuals overcome communication conditions such as aphasia, swallowing difficulties and voice disorders. Medicare may cover some of the costs of speech therapy after client meets certain requirements.

State Units on Aging (SUAs)

Agencies of state and territorial governments that are designated by governors and state legislatures to administer, manage, design and advocate for benefits, programs and services for the elderly and their families and, in many states, for adults with physical disabilities. The term "state unit on aging" is a general term; the specific title and organization of the governmental unit will vary from state to state and may be called a department, office, bureau, commission, council or board for the elderly, seniors, aging, older adults and/or adults with physical disabilities. Regardless of the exact title, these state government agencies all share a common agenda of providing the opportunities and supports for older persons to live independent, meaningful, productive, dignified lives and maintain close family and community ties. SUAs are located in every state and United States territory.

Sub-Acute Care

A comprehensive inpatient care program for patients with a serious illness, injury or disease who do not need intensive (acute care) hospital services. Examples include infusion therapy, respiratory care, cardiac services, wound care and rehabilitation services.

Subsidized Senior Housing

A program that accepts federal and state money to subsidize housing for older people with low to moderate incomes.

Support Group

A group of people who connect to share experiences, provide support and give advice. Support groups can meet face to face with a support group leader, online or by telephone.

Supportive Living Facility

See Assisted Living Communities.

Title VI Agencies

Services for Native Americans including nutrition, supportive services, including caregiver support services.


Services that help individuals travel from one location to another. Transportation services vary in capacity and may be licensed for medical transport or can be simple as taxi service. These are typically paid for with private funds. Commonly referred to as: Medi-car, Medical Transportation, Wheelchair Transportation.

VA Benefits

Benefits allowed to veterans for housing and care.


A condition in which a person with Alzheimer's or dementia may not remember his or her name or address, and can become disoriented and lost, even in familiar places. Anyone who has memory problems and is able to walk is at risk for wandering. Commonly referred to as: Exit-Seeking Behavior.


A type of Alzheimer’s that affects people younger than age 65. Many people with younger-onset (formerly known as early-onset) are in their 40s and 50s.