Glossary of Terms
Changes in terminology and language are constant. The field of aging is very fluid right now with the so-called Baby Boomers. In the past, people over age 65 were referred to as “elders,” “the elderly,” “senior citizens,” “seniors.” The most general term that is accepted right now is “older adult.” The term “elderly” tends to be reserved for more frail older adults, or those who are over age 80. In addition, when older adults utilize services, they then are given another label. Typically in medical institutions (hospitals, clinics) they are patients. In senior centers or residential communities, they may be members. In other residential communities and in nursing facilities they are residents. In outpatient settings, adult day centers, and to care managers/consultants, they are usually clients.
Adapted and expanded on from the White House Conference on Aging
Activities of Daily Living (ADLs)
Activities usually performed for oneself in the course of a normal day including bathing, dressing, grooming, eating, walking, using the telephone, taking medications, and other personal care activities.
Administration on Aging
The Administration on Aging (AoA), an agency in the U.S. Department of Health and Human Services is the official Federal agency dedicated to policy development, planning and the delivery of supportive home and community-based services to older persons and their caregivers. The AoA administers the Older Americans Act and works through the national aging network of State Units on Aging, Area Agencies on Aging, Tribal and Native organizations representing 300 American Indian and Alaska Native Tribal organizations, and two organizations serving Native Hawaiians, plus thousands of service providers, adult care centers, caregivers, and volunteers.
Adult Day Care (ADC)
Adult Day Care Centers offer social, recreational and health-related services to individuals in a protective setting who cannot be left alone during the day because of health care and social need, confusion or disability.
Advance Directives (AD)
Most often this refers to a set of legal documents which formally express your wishes for “heroic” means at a time when you are terminally ill or permanently unconscious. It also includes Power of Attorney, Power of Attorney for Health Care, Voluntary Conservatorship, and other declarations. Each US State has different laws and names for what rights are assignable to others. Executing Advance Directives is your right and you should do it. You should advocate for your loved ones to do the same.
Area Agency on Aging (AAAs – not to be confused with the Auto club)
Under the Older Americans Act, the Administration on Aging distributes funds for various aging programs through state agencies on aging with in turn fund local area agencies on aging. Area Agencies on Aging address the concerns of older Americans at the local level. They play an important role in identifying community and social service needs and assuring that social and nutritional supports are made available to older people in communities where they live. In most cases, Area Agencies on Aging do not provide direct services. Instead, they subcontract with other organizations to facilitate the provision of a full range of services for older people.
Assisted Living Facilities (ALFs)
A facility that provides a combination of housing and personalized health care in a professionally managed group-setting designed to respond to the individual needs of persons who require assistance with activities of daily living. The facility provides care to residents who cannot live independently, but who do not require 24 hour nursing care. Terminology varies from state to state, and a facility that is called an Assisted Living Facility in one state might be called other things in other states, i.e. a Residential Care Facility (RCF), Board and Care Home, a Domiciliary Care Facility, an Adult Care Home, or a Community-Based Care Facility.
Assistive technology is any service or tool that helps the elderly or disabled do the activities they have always done but must now do differently. These tools are also sometimes called “adaptive devices.” Such technology may be something as simple as a walker to make moving around easier or an amplification device to make sounds easier to hear (for talking on the telephone or watching television, for instance).
Also known as “Boomers,” people born between the years of 1946 and 1964 (per the US Census Bureau) were so numerous that they represented a “boom” in the population. Some researchers and authors consider people born between 1943 and 1960 as boomers – people who were too young to remember WWII, but included in a generation that believed the world could continue to improve with their efforts.
Care or Case Management
Case managers work with family members and older adults to assess, arrange and evaluate supportive efforts of seniors and their families to remain independent. Also see Geriatric Case Manager.
Caregiver/ Carer/Care Partner
A generic term referring to a person, either paid or voluntary, who helps an older person with the activities of daily living, health care, financial matters, guidance, companionship and social interaction. A caregiver can provide more than one aspect of care. Most often the term refers to a family member or friend who aids the older person. This is a person who assumes some responsibility for the well-being of another person. Many family members assume some caregiving roles without even realizing it is happening (perhaps it starts with heavy chores like cleaning the gutters or mowing the lawn). Some older people are at risk of institutionalization without a caregiver, and others cannot live without a caregiver to perform vital needs. Caregivers can be local or long distance caregivers; they can be simple helpers or direct caregivers performing complete care.
Center for Medicare & Medicaid Services (CMS)
This is a division in the US Health and Human Services Administration. CMS is responsible for everything from nursing home and home care standards, inspections and licensing to paying for health services and insuring eligible beneficiaries.
Certified Nurse Aide (CNA) or Nursing Aide (NA) or Personal Care Attendant (PCA)
State by state, the qualifications and roles of a CNA vary. Nurse aides usually receive some limited medical training and are responsible for gathering vital information about patients (compared to orderlies, companions and home makers, who are non-medical). They also perform functions to assist with ADLs and IADLs. In most areas, the difference between this provider and a non-medical one is whether or not the patient/client needs “hands-on” assistance.
Chore service is available to persons who are physically unable to perform tasks, such as heavy cleaning, minor repair or yard work.
These meal programs provide older individuals with free or low cost, nutritionally sound meals served five days a week in easily accessible locations. Besides promoting better health through improved nutrition, meal programs provide daily activities and socialization for participants which help reduce the isolation which can sometimes accompany aging.
A sudden-onset change in memory and cognition, usually lasting a short period is referred to as delirium. It is often caused by infection, acute illness and problems with medications (including anesthesia after surgery). If delirium doesn’t clear up, the symptoms are reclassified as dementia.
A loss of intellectual functions such as reasoning, judgment and memory – generally, memory plus one other form of cognition that impacts daily function. The most common form of dementia is Alzheimer’s disease (AD) and second is vascular dementia (VaD). Nearly half of elders over age 85 have some form of dementia, and according to the Alzheimer’s Association, by the year 2050, there will be 16 million Americans with dementia if we don’t find a cure for Alzheimer’s. A study released in 2006 indicated that dementia is the thing that aging Americans fear the most.
This is a clinical condition, diagnosed by a physician, where sad mood persists beyond two weeks and affects thinking, sleeping and initiative and other domains. Depression is broken into different categories and then treatments depend on the category and patient abilities. Depression is often linked to memory changes because it can cause a pseudo-dementia. Memory changes with depression can look very similar to dementia, but depression is often treatable and associated memory problems may not decline progressively.
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, financial exploitation, neglect, and abandonment. Allegations of abuse, neglect and exploitation of older adults are investigated by highly trained protective service specialists. Intervention is provided in instances of substantiated elder abuse, neglect or exploitation.
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.
This refers to a patronizing tone and caregivers’ referring to older adults as “sweetie,” “honey,” “dear,” or other terms of affection without the request of the older adult. It also includes belittling forms of disregard, such as medical professionals who address the adult child and not the older patient; or other acts of ageism. Research shows that elder speak hastens a downward spiral with decreased self-esteem, depression and increased dependence.
These are forms of assistance that are performed by hired providers. An example of formal services could be anything from adult day care to home care if it is paid help.
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.
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.
Medical doctors with Board Certification in the care and treatment of older adults are geriatricians. In some communities there are none. Just as you would only send your child to a pediatrician, geriatricians are essential in the comprehensive and holistic care of older adults.
Professionals with expertise in the study of aging are gerontologists. This term is frequently confused with “geriatrician” which is the title of a specialized physician.
Families in which grandparents or other relatives are primarily responsible for caring for (a) related child(ren) who live(s) with them, often referred to as kinship care.
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.
In Connecticut we use the term Conservator instead of guardian. And in CT we have Conservators of Person (COP) and Conservators of Estate (COE). An individual might need one or the other, or both. The Judge of Probate decides, based on an application or “petition” made to the court, and with evidence from a physician and/or psychiatrist. Please check with your Area Agency on Aging for information on the terms and requirements in your area.
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.
Home and Community-Based Services
This represents a variety of supportive services delivered in community settings or in an older person’s home. They are designed to help older persons remain living at home and avoid institutionalization.
Home Delivered Meals
Sometimes referred to as “meals on wheels,” home delivered meals are hot and nutritious meals delivered to homebound persons who are unable to prepare their own meals and have no outside assistance.
Home Health Aide (HHA)
Home health aide certification varies state to state, as do their titles. In most areas, home health aides represent formal care providers with some minimal medical training. They are usually “certified nurse aides” or “personal care attendants.” See Certified Nurse Aide for more information.
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.
Adaptation and/or renovation to the living environment intended to increase ease of use, safety, security and independence. There are local, State, Federal and volunteer programs that provide special grants, loans and other assistance for home remodeling, repair and modification.
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.
Usually a combination of at-home and nursing home or hospital care of the terminally ill that combines medical and social services, hospice 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, when the patient has a life expectancy of less than six (6) months. Hospice is not a place. It also refers to an insurance benefit, such as available through Medicare and some private insurance companies.
These are forms of assistance provided by non-paid providers. An example of informal services would be anything completed by a family member or unpaid neighbor to help the older adult.
Information and Referral
Information Specialists are available to provide assistance and linkage to available services and resources. Information and referral may be available at your local Area Agency on Aging, senior center or elder services agency.
Many programs that provide service in a holistic manner utilize interdisciplinary teams. Team members may include physicians, nurses, social workers, recreation therapists, dietitians, nurse aides, and other specialists. A true interdisciplinary team should also include the patient and the caregiver/family if that patient approves or has a surrogate decision-maker.
Being or occurring between generations. Intergenerational programming in elder services usually refers to those programs which include older adults and children or teens.
Kinship Care – (see grandfamilies)
Kinship Navigator Programs
State or local programs that link grandparents and other relatives raising children to information, support services, and available benefits.
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.
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.
People who work in any field of elder care are considered mandatory or mandated reporters of suspected elder abuse.
Medicaid is a health benefit program administered by States for people with low incomes who meet other eligibility requirements. The health insurance program is financed by the federal and state governments. Medicaid may also pay for nursing home care if the individual’s income and assets are within certain limits. It is also referred to as Title 19.
The national health insurance program for eligible people 65 and older and some disabled individuals is called Medicare. Part A covers hospital costs. Part B covers doctor bills and other medical costs. Part D covers prescriptions. Medicare is also referred to as Title 18. Medicare eligibility is determined based on whether or not someone has “paid into the system” for 40 quarters (10 years of taxable income). If someone is under age 65, he or she may qualify under a “Compassionate Allowance” depending on the diagnosis (such as younger-onset Alzheimer’s, Fronto-temporal Lobe Dementia, Lou Gehrig’s disease or end-stage renal disease).
Medigap is designed specifically to supplement and complement Medicare’s benefits by filling in some of the gaps of Medicare coverage. Medigap insurance policies are non-group policies that may pay for Medicare deductibles, prescription copays, or other services not covered by Medicare.
This refers to the ability of the brain to make new pathways through neurons, synapses and neurotransmitters (the parts of the brain and the chemicals that move information from one cell to the next). In the past, the brain was thought to be a static organ. Studies now prove that the brain can compensate and make new connections, and that it can remain moldable into adulthood.
Nursing Home or “skilled nursing facility” (SNF) used to be referred to as convalescent homes. Long term care (LTC) facility is also a common name for nursing homes, but LTC can also mean a combination of community based programs, not just SNFs.
Power of Attorney (POA)
This is a legal document giving another person certain rights to act for you. It can be given for a specific period of time (like when I gave my attorney “POA” to sign for me at my closing) or can be open-ended. POAs can perform one or several actions as they are outlined in the document. Individuals can appoint one or more people to act as POA either “jointly” or “severally.” POA laws changed recently in CT. This will also be reviewed in class.
Protective Services for the Elderly, or Elderly Protective Services
See elder abuse above. This is the agency that investigates, intervenes and monitors reports of abuse.
The provision of short-term relief (respite) to families caring for their frail elders offers tremendous potential for maintaining dependent persons in the least restrictive environment. Respite services encompass traditional home-based care, as well as adult day health, skilled nursing, home health aide and short term institutional care. Respite can vary in time from part of a day to several weeks.
A vital link in the service delivery network which older persons may avail themselves of, senior centers are functioning as meal sites, screening clinics, recreational centers, social service agency branch offices, mental health counseling clinics, older worker employment agencies, volunteer coordinating centers, and community meeting halls. The significance of senior centers cannot be underestimated for they provide a sense of belonging, offer the opportunity to meet old acquaintances and make new friends, and encourage individuals to pursue activities of personal interest and involvement in the community.
State Units on Aging (SUAs)
The Older Americans Act mandates that each state have a state agency on aging which is part of state government. The State Agency on Aging is the designated focal point within the state government responsible for administering a complex service system designed to complement and support other human service systems in meeting the needs of the elderly.
State Health Insurance Information Counseling and Assistance Programs
Known as SHIP, this program is comprised of 53 state programs and nearly 15,000 trained volunteers who offer unbiased, one on one counseling to assist Medicare beneficiaries understand their health insurance benefits and options.
A permanent alternative to adoption that allows eligible children, who are leaving state child welfare systems or who are at risk of being placed in foster care, to live permanently with grandparents or other relatives.
Programs that provide door-to-door transportation for people who may be elderly or disabled, who do not have private transportation and who are unable to utilize public transportation to meet their needs.
Veterans Administration (VA)
A vital resource for many older adults, the Veterans Administration provides programs, health services and financial resources for Veterans and some spouses of Vets.
Visiting Nurse Associations (VNA)
Started over a century ago, agencies that provide nursing services in private homes (including assisted living apartments) are available in most communities. Some are non-profit and are traditional “VNA” agencies, and others are for-profit agencies. Also, see “home care.”
White House Conference on Aging
Although good, this list is certainly not exhaustive.
For further information, please visit the following reliable websites: