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  CareGiving Navigator

2019 Long Island Edition

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Glossary of Key Terms




A

Activities of Daily Living (ADLs)
Basic tasks that people do independently every day—including eating, toileting, transferring (i.e., from bed to chair), bathing, dressing, and maintaining continence.

Acute Care
Medical required for a short period of time to cure a certain illness and/or condition.

Adult Day Care
Structured, community-based programs, including a variety of health, social and related support services, offered during any part of the day but for less than 24 hours, for adults who need some supervision and/or support. Social model adult day care programs provide socialization, personal care, supervision, recreation, and a healthy meal, within a protective setting. Medical model programs are designed to meet the additional needs of those elderly who require medical and rehabilitative services. 

Adult Home
An adult care facility that provides long-term, supportive residential services, activities, and personal care to five or more elderly adults and non-elderly adults with disabilities. 

Advance Directives
(Health care) include a Living Will, a Durable Power of Attorney for Health Care, or actionable medical orders, including Do Not Resuscitate Orders or Medical Orders for Life Sustaining Treatments for those who are seriously ill or near the end of their lives.

Alzheimer’s Disease
A progressive, neurodegenerative disease, leading to loss of mental functions such as memory and learning. Alzheimer’s is the most common cause of dementia.

Ambulatory Aids
Often paid for by Medicare/Medicaid or private insurance, these devices help seniors move about safely and independently when additional support is needed, including walkers, forearm crutches, canes, wheelchairs, and motorized scooters. 

Assisted Living Residences
Certified adult homes or enriched housing programs that are additionally licensed by the state health department to provide ongoing care and services for persons who cannot live independently and need assistance in the activities of daily living (ADLs), but who do not require around-the-clock nursing care or extensive medical supervision. 

Assistive Equipment
A range of products and technology designed to help elders or those with disabilities lead more independent lives. Examples include special telephones for people with hearing impairments, walking aids, elevated toilet seats, and communication devices.




B




C

Care Plan
The detailed formulation of a program of action that addresses the needs of a care recipient.

Certified
A long-term care facility, home health agency, or hospice agency that is certified meets the requirements set by Medicare and Medicaid. Medicare, Medicaid and some long-term care insurance policies only cover care provided in a certified facility or by a certified agency.

Chronic Illness
A physical or mental disability that continues or recurs frequently over a long period of time, often associated with a particular disability. A chronically person is one who is unable to perform without substantial assistance at least 2 ADLs (Activities of Daily Living) for a period of at least 90 days due to a loss of functional capacity,

Cognitive Impairment
Deterioration of intellectual ability; 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. Such impairment includes Alzheimer’s disease and senile dementia. 

Community-Based Services
Care services designed to help older people live independently in their own homes, including adult day care and senior centers.

Companion Services
Volunteers, business and agencies that provide part-time or full-time support and companionship for seniors in their homes, such as conversation, light housekeeping and meal preparation, running errands, assistance with paying bills, and driving to doctor’s appointments. Personal companions generally do not provide medical services and are not trained as home health aides or nurses. 

Congregate Housing
Apartment houses or group accommodations that provide health care and other support services to older persons who need some assistance, but not nursing care.
Continuing Care Retirement Community (CCRC). A retirement community that offers a broad range of services and levels of care based on the needs of each resident 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. 
Custodial Care. Non-medical care, also referred to as personal care, that helps a person with daily living activities, including, dressing, eating, and personal hygiene.




D

Dementia. The loss of mental capacity to the extent that a person’s daily functioning is affected.  It is not a disease in itself, but rather a group of symptoms that may accompany certain diseases or physical conditions, including Alzheimer’s Disease, Multi-infarct Dementia, Huntington’s Disease, Pick’s Disease, and Parkinson’s Disease.

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.

Do Not Resuscitate Order (DNR). An order that instructs health care professionals not to attempt cardiopulmonary resuscitation in the event a person suffers cardiac or respiratory arrest. This does not mean that the individual does not receive care.  Continuing care is provided as it would to any individual, such as medications for pain or antibiotics, except as stated above.

Durable Medical Equipment. Medical equipment ordered by a doctor for use in the home, such as walkers, wheelchairs, and hospital beds, paid for under Medicare, subject to a 20% coinsurance of the Medicare-approved amount.




E

Elder Law Attorney. An attorney who specializes in the laws and regulations dealing with the legal rights and issues of health, finances, and well-being of the elderly.

Emergency Monitoring System. An electronic device, usually worn as a pendant or bracelet, which can be activated at the touch of a button in an emergency situation. When the alarm is activated, it sends a signal to a 24-hour emergency response center where an operator attempts to establish two-way contact with the client and dispatch appropriate assistance.  Emergency monitoring services are usually private pay, rarely covered by Medicare/Medicaid.

Enriched Housing. An adult care facility licensed to provide long-term residential care to five or more adults, primarily senior persons 65 years of age or older, in community-integrated settings resembling independent housing units. Residents live in an apartment setting, and they have access to a package of services such as meals, housekeeping, laundry/linen service, transportation, socialization activities, some supervision and personal care assistance.

Expanded In-Home Services for the Elderly Program (EISEP). Provides non-medical in-home services, such as homemaker/personal care, or housekeeper/chores, to people 60 years of age and over who are above Medicaid eligibility.  




F




G

Geriatric Care Management. Planning and advisory services provided by a professional, typically a licensed nurse or social worker, to assess, coordinate and monitor the overall medical, personal and social services needed by a person requiring long term care.

Geriatrician. A medical doctor with special education and training in the diagnosis, treatment, and prevention of disabilities in older people.




H

Health Care Proxy. This document allows an individual to appoint an “agent,” typically a trusted family member or close friend, to make important health care decisions for them if they become incapacitated and unable to make such decisions for themselves.

Health Insurance Information Counseling Assistance Program (HIICAP). Free, federally-funded program for Medicare beneficiaries, administered by county aging offices, where trained volunteers respond to questions and requests for help in navigating the private and public insurance systems.

Health Insurance Portability and Accountability Act (HIPAA).  A law requiring that your confidential personal health information be protected under federal and applicable state laws.  The law may require an individual to sign a HIPAA release form to have certain individuals access their confidential health information. 

Home Health Care. A broad range of health services provided in the homes of the elderly, disabled, sick or convalescent. The types of services provided include nursing care, social services, home health aide and homemaking services, and various rehabilitation therapies (for example, speech, physical and occupational therapy). Often provided through home health agencies, these services can be for short-term purposes, such as rehabilitative care after a hospital discharge, or care for the terminally ill.

Hospice Care. A comprehensive medical and social program for terminally ill patients and families provided either at home or in a facility.  The program emphasizes pain control, symptom management, and emotional support rather than life-sustaining treatment.  Eligibility for the Medicare Hospice Benefit is based upon a six-month life expectancy and prognosis.




I

Independent Senior Housing. Self-contained apartments designed to promote independence, while providing common space and activities. Also called Independent Living Facilities.




J




K




L

Licensed Health Care Practitioner. A person trained and licensed to practice medicine, such as a medical doctor or nurse.

Live-In Home Care.  Care is provided by a caregiver who lives round-the-clock with a senior.  The caregiver may provide a wide range of medical or non-medical assistance, depending on the type of care required and the caregiver’s level of experience.  This type of intensive support allows seniors to remain in their homes rather than relocate to an assisted care facility or nursing home.

Living Trust. A trust created during the life of the grantor.  An irrevocable living trust is often used in estate and tax planning.  All assets become the property of the trust and, generally, the trust is liable for income tax payable on amounts earned by those assets, but may result in removing assets from the estate and, therefore, reducing possible estate tax liability. 

Living Will. An advance directive or document by which a person makes known their wishes regarding medical treatments in the event that they later become incapacitated or unable to communicate their wishes. These documents are most useful if a person has no appointed health care agent, but they cannot be honored by Emergency Medical Services personnel. 

Long-Term Care. A general term describing a range of medical, nursing, custodial, social and community services designed to help people with chronic health impairments or forms of dementia. These services can consist of care in the home by family members assisting through voluntary or employed help (such as home health agencies) or care in long-term care facility.

Long-Term Care Insurance. Insurance available through private companies as a means of paying for needed care as a person ages. This type of insurance policy is designed to cover long term care expenses in a facility or at home, not covered by Medicare or Medicare supplemental insurance (Medigap).




M

Medical Orders for Life Sustaining Treatment (MOLST). Medical orders, including Do Not Resuscitate Orders or Do Not Intubate Orders, that are signed by a doctor that travel with the patient, if they are seriously or chronically ill, or near the end of life. MOLST is honored by Emergency Medical Services in the community and across all health care settings.




N

Nursing Home/Skilled Nursing Care. A state-licensed 24-hour residential facility that provides a room, meals, help with activities of daily living, recreation, and general nursing care to people who are chronically ill or unable to take care of their daily living needs.  If it has been certified as such by Medicare, it is also referred to as a skilled nursing facility.

NY*Connects. In partnership with the New York State’s NY*Connects program, the Nassau and Suffolk county offices for the aging administer free, locally-based Connects programs (Nassau*Connects and Suffolk*Connects) that provide practical information, referrals, and assistance in accessing long-term care services and support for the frail elderly. Trained specialists provide objective, individualized assistance to seniors and their caregivers.




O




P

Palliative Care. Interdisciplinary team care provided to individuals who are chronically or terminally ill, aimed at improving quality of life, pain and symptom management, and communication between physicians and patients.  Palliative care is not based upon the patient’s life expectancy or prognosis and is available in most hospitals, nursing homes, certain home care agencies, and in hospices.

Patient Care Plan. A plan formulated by a Registered Nurse in conjunction with a doctor for the optimal on-going care and rehabilitation of a nursing home resident.

Plan of Care. The written plan that describes the services and care needed to address their health problem.  The plan of care must be prepared or approved by a doctor.

Power of Attorney. A written legal document authorizing a person to manage the affairs of another. The individual can delegate as much or as little power as desired and end the arrangement at any time.




Q




R

Residential Care Facility. Generic term for a group home, specialized apartment complex or other institution that provides 24-hour personal care services to its residents. The term comprises a range of residential care options, including assisted living facilities and skilled nursing facilities.

Respite Care. Temporary caregiving services provided when a primary, unpaid caretaker needs relief from caregiving responsibilities.  These services can be provided in-home or at an alternative location for a short stay.




S

Sub-Acute Care. Typically provided after a hospital stay, this care for serious, but not urgent or life-threatening, medical conditions. This type of care may include various procedures provided on a routine basis, either at home or by trained staff at a skilled nursing facility.




T

Telephone Reassurance. Calls made by agencies or volunteers to an elderly person, typically at a predetermined time each day, to check up on them and offer reassurance, contact and socialization.




U




V

Visiting Physician. Visiting physician services, reminiscent of the traditional doctor’s “house calls,” may be available for seniors who are ill or who have severe physical limitations, making   visits to a doctor’s office extremely difficult. Visiting physicians can provide a broad range of medical care, from routine exams to more comprehensive treatment in the patient’s home.




W




X




Y




Z

I’m one of hundreds of thousands of Long Islanders in recent years who have taken on the tasks of caring or finding care for an older relative or friend. My three brothers and I took care of our mom, a brave and remarkable woman who successfully aged in place before eventually succumbing to Alzheimer’s. We went through practically every phase of caregiving: helping our mother stay safe and independent for as long as possible; then managing the complex process of long-term care legal and financial planning, overseeing a wide variety of services as Mom became increasingly frail, from choosing home care aides and adult day care programs, to overseeing doctors’ visits, wound care and sub-acute rehabilitation services, physical therapy and other in-home health-care providers; and finally, engaging hospice care. 

PART I

PREPARING A PLAN

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