If you are the caregiver for an aging loved one, you have probably wondered what many of the acronyms and terms used in the long-term care industry mean. The terminology can be confusing and difficult to understand. Here are a few of the more common terms. ADL: If you have started exploring long term care, you’ve likely come across this term. It stands for “Activities of Daily Living.” These are the tasks a senior needs to complete on a daily basis. They include: eating, bathing, dressing, grooming, toileting, walking, and transferring to a chair or bed. In long term care, the amount of assistance a resident requires with ADLs is used to determine their need for skilled nursing care. Ambulatory: When long term care facilities are evaluating if a resident or potential resident is able to walk independently or not, they refer to it as ambulation. The term “ambulatory” indicates an older adult is able to walk without assistance. Non-ambulatory denotes a person who is unable to walk without help or is confined to a wheelchair or bed. Personal Care: This term is used to describe bathing, grooming, dressing, and other personal hygiene tasks. Most adults who live in long term care facilities require at least some assistance with these activities.
Respite Care: These short-term stays in an assisted living community are designed to help support both the senior and the family caregiver. When the family caregiver needs a break, respite care may be an option. An older adult can typically stay in a senior living community up to one month.
Advance Directive: Legal documents that allow you to plan and make your own end-of-life wishes about health care and treatment known in the event that you are unable to communicate. Advance directives consist of a living will and a medical (health care) power of attorney.
Case Manager: A nurse, social worker, or other healthcare professional who plans and coordinates services for an individual’s care.
Care Plan: A detailed written plan that describes what is needed for an individual’s care and provided by a range of health professionals, including nurses, therapists, social workers, nursing or personal assistants. Creating the care plan should involve an interdisciplinary team of the care recipient, caregivers, including the nursing assistant, as well as the family as appropriate.
Certified Nursing Assistant (CNA): A person trained and certified to assist individuals with non-clinical tasks such as eating, walking, and personal care. In a hospital or nursing home the person may be called a nursing assistant, a personal care assistant, or an aide.
Hospice: A program of medical and social services for people diagnosed with terminal (end-stage) illnesses that focuses on comfort, not curing an illness. Hospice services can be given at home, in a hospital, hospice residence, assisted living community, or nursing home. They are designed to help both the patient and his or her family. Hospice care stresses pain control and symptom management. It also offers emotional and spiritual support. Medicare will pay for hospice if a doctor states that a person probably has six months or less to live. Hospice care can last longer than six months in some cases.
Incontinence: Loss of bladder (urine) or bowel movement control. This condition can be transient, intermittent, or permanent. Physicians can diagnose the kind of incontinence that is present and suggest ways to effectively manage the situation through exercises and timed toileting programs.
Long-Term Care (LTC): A term used to describe the care needed by someone who must depend on others for help with daily needs. LTC is designed to help people with chronic health problems or dementia live as independently as possible.
Medicaid: The federally- and state-supported, state-operated public assistance program that pays for healthcare services to low-income people, including older adults or disabled persons who qualify. Medicaid pays for long-term nursing home care and some limited home health services, and it may pay for some assisted living services, depending on the state. It is the largest public payer of long-term care services, especially nursing home care. Each state can determine the breadth and extent of what services it will cover above a certain federally required minimum.
Medical Director: A physician who oversees the medical care and other designated care in a healthcare organization or care setting. The medical director is responsible for coordinating medical care and helping to develop, implement, and evaluate resident care policies and procedures that reflect current standards of practice.
Nurse Practitioner (NP): A registered nurse with advanced education and training. NPs can diagnose and manage most common, and many chronic, illnesses. They do so alone or in collaboration with the health care team. NPs can prescribe medications and provide some services that were formerly permitted only to doctors.
Nursing Home or Skilled Nursing Facility (SNF): A residential care setting that provides 24-hour care to individuals who are chronically ill or disabled. Individuals must be unable to care for themselves in other settings or need extensive medical and/or skilled nursing care.
Ombudsman/Long-term Care Ombudsman: An Ombudsman is an advocate for residents of nursing homes, board and care homes, and assisted living. Ombudsmen provide information about how to find a nursing home or other type of LTC facility and what to do to get quality care. They are trained to resolve problems. An ombudsman can assist you with expressing complaints, but this requires your permission because these matters are held confidential. Under the federal Older Americans Act (OAA), every state is required to have an Ombudsman program that addresses complaints and advocates for improvements in the long-term care system. To find the ombudsman nearest you, visit the National Long-Term Care Ombudsman Resource Center at www.ltcombudsman.org.
Palliative Care: Care that focuses on the relief of the pain, symptoms, and stress of serious illness. The goal is to improve quality of life for patients and families. Palliative care is appropriate at any point in an illness, not just for end-of-life care, and it can include treatments that are intended to cure as well as comfort.