When you first enter the world of home care, you will be confronted by a universe of terminology that will be new and confusing. One of our goals at Salus Homecare is to help ease your transition into our home caregiving world. In our view, the more you know about home care, the better the outcomes will be for you and your loved ones.


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Accountable Care Organization (ACO)

A healthcare organization, similar to an HMO, that is a payment and care delivery business model. ACOs have a high priority on accountability of costs and results, by connecting payments to quality improvements in order to reduce overall costs. Medicare has provided ACOs with a strong financial incentive for improved results based on lower hospital readmission rates.

Affordable Care Act (ACA)

Also known as “Obamacare,” the ACA has dramatically altered the landscape of healthcare in the United States. The greatest impact that the ACA has on home care and home health is to promote accountability with hospitals and ACOs through Medicare contracts. This accountability ties a lower hospital readmission rate to a better financial compensation awarded to hospitals and ACOs through Medicare. By creating contracts administered through the Medicare Shared Savings program (MSSP) hospitals and ACOs are penalized for high readmission rates. The effective application of home health and home care programs has been identified as a significant factor to reducing readmission rates by raising the overall quality of continuity of care for the patient, even after discharge from the hospital.

Activities of Daily Living (ADLs)

The types of activities that people accomplish without assistance. ADLs provide a measurement to gauge how a senior, who is living independently at home, is able to successfully and safely care for themselves. ACLs include and are not limited to: personal grooming, washing and bathing, dressing, eating, preparing meals, transferring from bathtub to bathroom, toileting, walking, exercising, transportation to doctor’s appointments and light housekeeping. Home care providers should perform an assessment to determine the ADL needs of a senior citizen who is living independently and being considered for home care assistance.

Acute Care

Home Care that is performed for a patient who has had a medical episode and is expected to recover. The patient may be able to resume a normal lifestyle, but may not have the full range of daily activities that were present prior to the medical episode.

Adult Day Care Center

A structured and professionally managed day care program for the elderly. This usually takes place away from the home residence. Activities include socializing, crafts, games, exercise, meals and educational opportunities. Health care, dietary education and therapeutic/rehabilitation services may also be included. Programs are usually administered during working hours to provide respite services for adult children who are acting as primary caregivers for their parents.

Advance Directives

A document that establishes the desires of an individual regarding the administration of medical care and the individual’s preference to receive or reject treatments. This type of document is prepared prior to a medical event. The document prescribes how a medical decision should be reached if the author loses the ability to make their own decisions regarding the administration of medical procedures. The document protects the author’s rights in the event of an incapacitating medical episode or if the individual loses the ability to make or communicate his or her own decisions. The intent of this document is to give the author the ability to accept or refuse medical care in the case they cannot communicate their desires. The document format can be a simple set of instructions, or incorporated in Living Wills and/or a Durable Power of Attorney.

Alzheimer’s Disease

Alzheimer’s Disease is a progressive, degenerative disease that often is associated with aging. The rate of the disease varies with individuals. The disease affects the patient’s brain and causes problems with memory, impaired thinking and abnormal behavior. Alzheimer’s also causes a loss of short-term memory and degrades the patient’s reasoning capacity. The patient’s ability for self-care degenerates as well as language skills. Alzheimer’s symptoms include: disorientation, changes in personality, memory loss, reduction of communication skills, poor judgment, difficulty in learning, language deterioration and loss of ability to perform daily tasks.

Area Agency on Aging (AAA)

Local and state programs that act as a resource for age related questions. These agencies often have informative websites that help seniors and adult children find resources and answers for aging issues. AAA can provide information on dietary support services, employment, congregate meals, protective services, legal assistance, home-delivered meals, Office of Ombudsman services, senior centers, senior transportation, adult care agencies, skilled nursing care, physical therapy, in home care and counseling.

Assisted Living (Non-Medical Senior Housing)

Living arrangements for the elderly or others who need consistent assistance with activities of daily living. The assisted living facility can still allow for individuals to live independently within the facility and utilize services when needed. The complex is professionally managed and requires the residents to pay a monthly fee for rent and services as they are utilized.

Assistive Equipment

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

Case Manager

The home care case manager will develop, implement, manage and provide evaluations of the home care patient’s customized plan of care. The case manager will also serve as a liaison between families, patients, clients, skilled nurses and caregivers. The case manager acts as a health care advocate for the patient, defending the patient’s social and health welfare. The case manager may be a registered nurse or a social worker.

Catheter

A tubular medical instrument. For in home health care usage, the catheter is most commonly a soft, thin tube that is used in the urinary tract or for insertion into the patient’s body to transfer medication into the blood stream. For urinary usage, the catheter is inserted into the bladder and used to evacuate the bladder of urine. For blood stream applications, the catheter is used to deliver medications or drain excess fluids. Licensed and trained personnel such as skilled nurses must administer all catheters.

Centers for Medicare and Medicaid Services (CMS)

As a federal agency, the CMS is an organization that manages health care programs including Medicare, Medicaid, and the Children’s Health Insurance Program. The CMS also provides certification and recertification of home health agencies, laboratories, acute and continuing care providers, hospitals and other facilities.

Certified (Certification)

The process where a state government agency will inspect, rate and certify a health care organization. The types of organizations can include any health care provider, hospitals, nursing facilities, and dialysis facilities. Upon receiving a positive evaluation upon the completion of the inspection, the inspected facility/organization is approved and certified. This certification is not the same as receiving accreditation by a rating bureau. Medicare and Medicaid require certification in order for the facility to receive reimbursement for serves rendered to patients covered by those programs.

Chronic Illness or Condition

A long-term affliction of a patient due to a specific disease or medical condition that typically cannot be cured. This may include permanency of condition and residual disability. The chronically ill patient requires constant medical supervision, medical care and professional observation for long periods of time. Chronic illnesses and conditions require skilled nursing and therapy that can be administered in a hospital, nursing home or in the home of the patient.

Co-Housing

A new idea where groups of people share a common residence, with space for individuals as well as common social areas. This concept has been successfully applied for seniors who desire a home setting that has a communal element.

Cognitive Impairment

This condition, which includes Alzheimer’s Disease, is an affliction of the brain that deteriorates the patient’s intellectual ability. The deterioration results in disorientation in the way the afflicted person perceives people, places or time. The patient experiences the impairment of short-term or long-term memory, including the impairment of the ability to reason. The person afflicted with cognitive impairment requires moderate to substantial supervision by a caregiver.

Coinsurance

The amount the patient is required to pay for medical and health care procedures that are covered by insurance or Medicare. For Medicare, it is the percentage of the approved charges that the patient is responsible for after payment of the primary deductible for Part A and/or Part B. Health insurance outside of Medicare may require the patient to a pay a set percentage of the covered costs after the deductible has been paid.
Community-Based Services: Senior oriented services that are designed to enable the elderly to live independently. This often applies to seniors who are living in their own homes and require additional services to continue their independence. These may include in-home care, adult day care programs and public senior centers.

Companion

A person who is assigned to keep a senior citizen company. The companion can provide other specified services, such as meal preparation, housekeeping, shopping assistance and other non-personal daily living needs.

Conservator

A legally appointed representative for a person who cannot competently represent themselves in legal and financial matters. A conservatorship occurs when a municipal court or regulatory authority appoints the conservator to supervise a person’s affairs. In order for a conservator to be appointed, the person in need must be deemed gravely disabled and unable to conduct his or her own affairs due to medical and/or psychological conditions.

Continuing Care Retirement Communities (CCRCs)

Housing communities that provide a variety of care levels. This type of housing provides living accommodations based on the needs of the residents. These can include accommodations for those with skilled nursing requirements, or occasional assistance with activities of daily living. The residents can move from one setting to another based on their needs, all within their CCRC community. Due to high down payments and monthly fees, some CCRCs can be considered too costly for the elderly with fixed incomes.

Continuity of Care

The ongoing, interactive, health management process between the patient, family, physicians, nurses, therapists, hospitals and health care facilities. All participants cooperate to deliver consistent and reliable care services for the patient throughout the cycle of care. The process relies on a high level of coordination of care between all parties, aided by an accurate tracking of patient information.

Creutzfeldt-Jakob Disease

A brain disease that is rare and fatal. This affliction is referred to as mad cow disease. A transmissible, infectious virus causes this disease.

Delirium

A sudden onset of acute mental confusion. This condition is usually temporary in nature. The condition may involve quick changes between mental states. The symptoms of delirium may include but are not limited to: hallucinations, delusions, tremors, disorientation and anxiety. Delirium is caused by physical or mental illness.

Dementia

A term used to describe an affliction of the brain caused by a group of symptoms stemming from a variety of disorders. The dementia patient may not be able to accomplish normal activities and can loose control over their emotions and their intellectual ability to solve problems. The patient undergoes personality changes due to a loss of the ability to control their emotions. They may easily experience anxiety and frustration when faced with an unfamiliar situation. The loss of intellectual functions can affect speaking, abstract thought process, judgment, memory and movement. Some of the diseases that are categorized as dementia are Alzheimer’s disease, Creutzfeldt-Jakob disease, Huntington’s disease, Parkinson’s disease and Pick’s disease. The diseases can be degenerative, vascular, stroke related, metabolic disorders, externally influenced (AIDs, drugs, alcohol) and psychiatric.

Depression

A serious disorder of the brain that can be caused by many different factors. These factors include but are not limited to: genetic, psychological, biochemical and environmental. The symptoms of depression are manifested in emotional and physical ways, including general sadness, a marked decrease in activity levels, feelings of hopelessness and can include suicidal thoughts and actions. Many seniors are affected by depression and the symptoms may go undetected. If accompanied by other conditions, including dementia, strokes, Parkinson’s and Alzheimer’s, the influence on personality and intellectual capacity may be magnified.

Discharge Planner

A hospital, rehabilitation facility or skilled nursing facility will have a process for discharging the patient back to their home. The discharge process is managed by the facility’s designated discharge planner. The process of discharge is critical for a smooth transition from facility to home. A properly executed discharge will preserve the continuity of care for the patient and present less stress for the family. An in home health care agency can play an essential role in the transition by an early involvement with the discharging facility.

Durable Medical Equipment (DME)

Doctors may prescribe medical equipment and devices for use in a patient’s home if they determine the equipment will help the patient recover and/or address a chronic condition. The types of equipment commonly prescribed are walkers, wheelchairs and hospital beds. DME prescriptions may also include prosthetics, orthotics and supplies.

Durable Power of Attorney

Commonly used in estate planning, a durable power of attorney enables seniors to plan for times when they are incapacitated and cannot make decisions on their own. In this legal document, the senior appoints a designated agent to manage financial affairs and make important health care decisions in the event that the senior cannot do so.

Elder Abuse

Seniors are often targets of abuse. This activity, know as elder abuse, consists of the mistreatment and/or harm of an elderly patient by a person in a position of trust. Some of the common signs of elder abuse are: the appearance of unexplained injuries, passive and withdrawn behavior, lack of reaction to pain and lack of personal cleanliness.

Elder Care Attorney

These are attorneys who have specialized knowledge of senior issues. The primary function of the elder care attorney is to protect the independence, ensure the quality of life and the financial security of their senior clients.

Elder Care

The fulfillment of the special needs of senior citizens is known as elder care. This can cover a wide range of services. These services may be provided in multiple locations, such as senior community centers, residential communities specifically designed for senior citizens, and in the home of the senior. Home care services can be provided by an in home senior care agency. Services can be provided based on the senior’s level of ability to perform their own personal care needs.

Fee-For-Service

This is the general term for methods of payment where health care providers are compensated for the services they perform. There are private Medicare supplemental plans, offered by private insurance companies that fall into this category. This type of insurance provides the senior with additional benefits that are above and beyond what the original Medicare Plan covers. The fee-for-service model requires you to pay the monthly Medicare Part B premium, in addition to any additional premiums that the plan may charge as designated by the terms of the agreement.

Fiduciary Services

Financial services that are provided to seniors by a trustee or guardian who has the legal authority to manage and make financial decisions for the senior and for the estate of the senior.

Frailty

Within the arena of in home senior care, frailty is a common condition of the elderly, where the body progressively declines in robustness and the ability to recover from injury declines. Identification of the onset of frailty is important in the early stages in order to prevent functional declines and to stabilize and/or improve the senior citizen’s overall level of health and preserve their independence.

Gatekeeper

A term used to describe a HMO primary care physician or a person who has assumed the responsibility for the health and financial well being of an elderly person. In the case of a gatekeeper assuming overall responsibility of an aging adult, that person is usually an adult child who becomes deeply involved in guiding their elderly parent in making better, more informed life decisions. The gatekeeper’s mission is to provide the senior with options and alternatives for living and health care that may not be readily apparent to the senior citizen.

Geriatric Care Management

A type of care provided by a professional geriatric care manager (GCM) who is a senior health and human services specialist. The GCM provides advice and guidance to families of seniors and to the seniors themselves. This is most beneficial when the senior is in need of planning and coordination of care services, such as in home senior care and in home health care. The GCM should have experience and training in a variety of areas related to care management.

Geriatrician

This is a specialty of internal medicine where the physician focuses on the unique health needs and health care of the elderly. The geriatrician has experience in treating diseases, disabilities and social concerns in the elderly.

Guardian

A guardian is a court appointed position that requires the guardian to provide oversight and management for the general welfare and safety of an elderly person who has been determined to be incapable of effectively taking care of their own affairs. The duties of the guardian can be comprehensive, including how to spend the senior’s financial resources, what type of in home senior care that person can receive, and other important issues that affect the freedom and independence of the elderly person who is under court appointed guardianship.

HMO (Health Maintenance Organization)

The HMO is a corporation that provides comprehensive medical services for its members in exchange for a monthly premium. The HMO is similar to a health insurance corporation with the addition of the ability to provide the actual medical services.

Home Care

A person who is aging or recovering from a medical event at home often requires assistance with activities of daily living. Home care is the general description of the act of providing assistance for those needs, including meal preparation, ambulation, toiletry, personal grooming, transportation, light housework, socialization and companionship. Home care provides benefits to seniors who prefer to age at home but need non-medical assistance to do so. Home care also provides help for the primary caregivers of those seniors. Most often, they are the adult children that can be relieved of the everyday stress of acting as the primary caregiver for their aging parents.

Home Health Agency

A licensed and accredited service company that provides in home care services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, medical social services and home health aide services. The in home health care agency can only provide services by the written prescription of a medical doctor.

Home Health Aide

An in home health care agency caregiver who can provides services such as changing bandages and dressing wounds, applying topical medications, and personal care activities such as bathing, dressing and grooming. Medicare does not cover home health aide services unless the patient is also receiving skilled nursing care and/or therapy delivered in the home.

Home Health Care

Doctor prescribed treatments that require skilled nurses, physical therapists or medical social workers and are administered in the patient’s home are collectively known as home health services. Home health care services are covered under Part A Medicare benefits.

Homebound

A patient who requires home administered treatments that will be covered by Medicare or insurance must show that their conditions qualify them as homebound patients. There are stated requirements that must be met. Medicare defines these in specific terms, including requirements such as the patient must be under a doctor’s care, the doctor must certify that the patient cannot leave home without a considerable and taxing effort, and the patient’s condition requires special help in order to safely leave the home.

Hospice

A hospice program is comprised of health and personal care services that are oriented towards patients who are dying from a life-limiting illness. The hospice patient no longer responds to treatments and medications intended to cure their life-limiting condition. Hospice care can be delivered in the patient’s home by a team of home health care professionals.

Hospital Discharge Planner

When a patient is discharged from a hospital after a medical event, the transition from hospital to home, rehabilitation facility or nursing home is managed by the hospital discharge planner. The discharge planner works with the hospital medical staff to provide discharge instructions to manage the post-hospitalization recovery, healing and living requirements for the patient. The discharge planner provides information for the patient’s family and the next care team that will be administering to the patient’s needs.

Housekeeping Services

Services include house keeping, meal preparation, shopping, interior house cleaning, exterior yard and house maintenance, home repair, appliance maintenance and transportation of the care recipient. Medicare does not reimburse for this type of home service.

Huntington’s Disease

This is an inherited disease that causes degeneration and loss of functionality of the nerve cells in the brain of the patient. Huntington’s Disease (“HD”) is an inherited, degenerative brain disease that affects the mind and body. People with HD begin to show symptoms in their 40s and 50s. Medications are available to help manage the symptoms but there is no treatment to stop the overall decline of the patient’s health. Symptoms can include changes in personality, loss of memory, speech difficulties and impairment of judgment.

Incontinence

The body’s inability to control evacuation functions is referred to as incontinence. This may occur at any age, with prevalence in the elderly. Incontinence can affect both urination and defecation. It may also have varying degrees of severity. A home caregiver is trained to administer to the needs of the patient with incontinence issues.

Intermittent Care

Also known as part-time requirements, intermittent care is the term Medicare uses to describe occasional visits of a skilled nurse to a patient’s home to administer doctor prescribed treatments. Medicare limits intermittent care visits to 28 hours per week, any number of days per week, so long as they are less than 8 hours per day. If the combined services of a skilled nurse and a home health aide are required, the total hours per week increase to 35 hours, but less than 8 hours per day. The additional increase in hours is subject to review by a Medicare administrator.

Layering of Services

By combining multiple health care and home care services and treatments, the quality of life and comfort of a patient who is recovering at home can be greatly improved. Another benefit of layering of services is the reduction of hospital readmission rates, which is extremely important in light of the recent Affordable Care Act. According to the ACA, Medicare will penalize hospitals and doctor groups for high hospital readmission rates for Medicare covered patients. Layering of services is effectively provided by an in home health care agency.

Licensed Vocational Nurse (LVN)

An entry-level, licensed health care provider. This type of nurse is charged with providing basic nursing care and may work under the direction of a physician or a registered nurse. Also known as an Licensed Practical Nurse (LPN.)

Live-in Home Care

When appropriate, care giving needs can be supplied 24 hours per day at the residence of the care recipient. The care giving coverage can be split into shifts or provided by one caregiver who is assigned to live at the residence.

Living Trust

A living trust is a legal document that centralizes all assets of the involved parties and specifies how the assets should be managed in the event of incapacity or death of the persons specified in the trust. The trust removes assets from probate at death, which affects the speed of distribution of funds and the amount of taxation.

Living Will

A legal document that can specify the preferences for medical care of the living will’s author. A living will is most often used to ensure that the author’s medical preferences are followed in regards to treatments administered during the end of life.

Long-Term Care Facilities

A type of medical facility that provides nursing care to patients who require an elevated level of nursing care over a set period of time. The long-term care facility is most often used as the next step after hospitalization, providing a less expensive and more specialized recovery facility for post medical event recoveries.

Long-Term Care Insurance

This type of insurance is designed to provide for long-term care costs and is especially applicable for home care situations that involve the need for in home assistance with activities of daily living. Long-term care insurance is usually purchased far in advance of when the persons covered need to utilize the benefits.

Long-Term Care

A wide range of heath and social care services, both medical and non-medical, delivered over a long period of time, to people with chronic illnesses, disabilities or injuries. These people cannot care for themselves. Care activities delivered may include skilled nursing, rehabilitative therapies, speech therapies, medical social services and personal care.

Managed Care

A system of heath care that serves as the primary method of delivering and paying for health care services through a network of providers. Managed care is a comprehensive approach to the payment and delivery of all health care services. A managed care plan will utilize its own network of health care providers.

Medicaid

A joint federal-state program designed to assist the low-income population to pay for health care costs. The federal government provides funding to the individual state governments, which design the program according to their own local needs.

Medical Social Services

A specialty of social work that treats the psycho-social relationship of patients and their families. Services delivered by the Medical Social Worker include supportive counseling, grief counseling and help with dealing with the stress of short and long term care.

Medically Necessary

Health care services, provided by a physician, that are necessary for the health and well being of the patient. The medically necessary treatment cannot be elective or at the convenience of the doctor or patient.

Medicare Supplemental Insurance

Private insurance that supplements the areas of coverage that Basic Medicare does not provide. This separate insurance policy fills the gaps of Basic Medicare and requires the subscriber to pay monthly enrollment fees, deductibles and co-insurance amounts.

Medicare-covered Home Health Care Services

Medicare Part A and Medicare Part B can provide coverage for specified types of home health care services. These include skilled nursing care, physical therapy, speech-language pathology services and occupational therapy services. Services may be intermittent and long-term, with limits to the weekly/daily hours of services provided.

Medicare

A Federal program providing health care insurance for people over 65 years of age or older. Medicare also provides coverage for younger people with specified disabilities and patients with permanent kidney failure – End-Stage Renal Disease (ERSD.) Medicare is divided into two major components: Part A provides coverage for inpatient care, skilled nursing facility care, hospice care and specified home health care. Part B provides coverage for physician services, outpatient hospital care, durable medical equipment medical supplies and preventive care services.

Medigap Policies

A term used to describe a supplemental insurance policy purchased by individuals who are eligible for Basic Medicare. This type of policy insures for costs that are not covered by Basic Medicare and is sold by private insurance companies.

Nurse Registry

An employment agency that is specifically structured to provide nurses to work in temporary positions at hospitals, doctor offices, out patient facilities, skilled nursing facilities, rehabilitation facilities or the homes of individual patients.

Nursing Home

A privately owned facility that provides health care and personal care services for its residents. The nursing home provides each patient a room, meals, recreational activities, help with daily living, and protective supervision. The resident of a nursing home will have physical or mental conditions preventing them from living independently. Nursing homes are certified to provide different levels of care, including custodial, skilled nursing, rehabilitation therapy and acute care.

Occupational Therapy

Activities of therapy that are designed to help the recipients to recover from an injury and regain skills. Services may also include support for aging adults who are experiencing physical and cognitive changes. The goal of the occupational therapist is to restore the patient’s ability to perform daily activities independently.

Ombudsman

A person who investigates and mediates health care problems involving a patient’s complaints in relation to the delivery of health care services. The ombudsman is the patient’s representative and is part of a nationwide, federally funded service. The main outcome of the involvement of an ombudsman is to resolve disputes and disagreements between residents and assisted living facilities, nursing homes and other residential care facilities.

Palliative Care

A treatment or medical care procedure designed to reduce the symptoms rather than curing the disease. Palliative care is used to improve the quality of life for patients who are suffering from complex conditions and illnesses.

Paratransit Services

Specialized transportation services that are specifically designed for people with movement challenges. This includes wheelchair accessible vans for the elderly and people with disabilities. These services may offer door-to-door transportation to senior centers, off site medical care, shopping malls or social events.

Parkinson’s Disease

A progressive disorder of the central nervous system affecting control of an individual’s movement. The condition is caused by a lack of dopamine, an essential neurotransmitter that enables the brain to control muscle activity. Parkinson’s cannot be cured but can be controlled by medications that can substantially improve the patient’s symptoms. Parkinson’s symptoms include tremors, stiffness in limbs and joints, speech impediments and difficulty in initiating physical movement.

Pediatric Home Care

Doctor prescribed home care that is delivered for medically fragile children. Medicare is a major funding of pediatric home care services. Four of the most common conditions requiring pediatric home care are Cerebral Palsy, failure to thrive, developmental delay and preterm birth.
Physical Therapist: A health care professional who provides rehabilitation therapies to help people maximize mobility, restore strength and body movement. Home physical therapy is a doctor prescribed treatment that is performed after an illness, injury or medical procedure. Physical therapies can be beneficial for aging adults who are experiencing discomfort due to the effects of medical conditions and/or a lack of movement due to confinement to bed rest.

Plan of Care

A document developed after a patient assessment that is a written plan. The plan of care specifies the services and types of care needed for a health problem or for in-home living support. The plan serves as a road map for the administration of personal care and home health care services. The plan of care accounts for the condition of the patient, the condition of the home environment and any doctor prescribed treatments to be administered.

Power of Attorney for Health Care

The process where an individual takes legal responsibility and health care decision making powers for another person who is incapacitated or unable to responsibly make decisions on their own. The authority to take power of attorney for health care decisions is expressed in a written legal document.

Primary Care Giver

A person who has taken the responsibility for the care and well being of another. The primary care giver is often an adult child who is supervising the care of an aging parent. Primary care givers may assume an active role in providing assistance with activities of daily living for a loved one.

Primary Care Physician

A physician who is trained and specializes in providing basic medical care. The primary care physician is the first health care provider to diagnose and provide treatments for most health problems. The primary care physician can refer patients to more specialized doctors and healthcare providers if needed.

Private Duty

Home care and home health services that are not covered by insurance and are paid from private sources. The services may include a range of in-home care providers, from non-medical to skilled.

Private Pay

A method of payment where the patient and/or the patient’s family pays for service from out of pocket, private sources. Private pay can also refer to non-Medicare / Medicaid payment arrangements for home care and home health services.

Qualified Long-Term Care Insurance Policy

An insurance policy that provides for long term care reimbursement and conforms to federal law, offering potential federal tax advantages for some people.

Qualified Long-Term Care Services

ervices that are determined to be necessary for the treatment and maintenance of a patient who is covered by long-term insurance. Examples of these services include diagnostic treatments, preventive therapy and treatments, therapeutic treatments, curing, and rehabilitative therapies. Home services include maintenance or personal care services that are required by a chronically ill patient and are specified in a plan of care prescribed by a physician.

Registered Nurse (RN)

A nurse who has graduated from a college or university nursing program and has taken and passed a national licensing examination. A registered nurse is able to care for the sick and injured in a variety of health care settings, including in the patient’s home. A registered nurse must pass a state board examination and is licensed by a state agency.

Rehabilitation

The health care services performed on a patient with the objective of restoring that individual to a condition of good health with the ability to resume normal life activities. Home rehabilitation services include therapeutic care treatments for patients requiring intensive physical, occupational or speech therapy ordered by a doctor’s prescription.

Residential Care Facility

A specialized apartment complex or living facility that offers care services for the occupants of that facility. This can include a range of residential care options such as assisted living facilities, board and care homes and skilled nursing facilities.

Respiratory Therapy

Therapeutic treatments specifically designed to restore and improve lung and breathing functions.

Respite Care

A home care service that provides the primary care giver a break from the duties of caring for a loved one. Respite care is most often administered to patients with disabilities, illnesses, dementia or other health problems and can be provided at home or in a facility.

Reverse Mortgage

A type of home equity loan that is commonly used to provide funds for home care for the elderly. The homeowner borrows money from a bank, using the home as collateral. The loan against the property can be drawn in a lump sum or in monthly payments. The loan does not need to be repaid until the homeowner dies or the home is sold.

Skilled Nursing Facility (SNF)

A nursing facility that administers to the chronically ill, providing long-term skilled nursing care, rehabilitation therapy, speech and language therapy treatments, and medical social services. SNFs are commonly designed to treat elderly patients who can have their treatments covered by Medicare.

Skilled Nursing Home Care

Nursing care that is provided by a skilled nurse in the home environment. A registered nurse provides direct care by administering treatments, managing treatments, observing the patient, evaluating the patient’s care, and providing education regarding health issues to the patient and the patient’s family. Medicare provides coverage for intermittent home health skilled nursing care.

Speech Therapist

A care provider that is trained in administering treatments for communications and swallowing disorders, commonly due to a stroke. A speech therapist uses exercises and audio-visual aids to improve muscular strength and restore communications skills. The treatments can be administered to a patient recovering in the hospital or home.

Standby Assistance

Assistance provided by a home caregiver to an elderly person. The standby assistant can aid the patient if there is a need for assistance and stabilization while performing activities of daily living. The caregiver stands within arm’s reach to the elderly person. Standby assistance by a caregiver can be performed for an elderly patient while showering, toileting, transfer to and from the bed and while eating.

Stroke

A medical condition that creates a blockage and/or rupture of an artery leading to the brain. The result of the blockage is deprivation of oxygen to the brain and can lead to permanent damage to the patient’s brain. Elderly stroke patients recovering in the home may require home nursing, physical therapy, speech therapy and assistance for activities of daily living.

Subacute Care

A level of treatment that is between chronic and acute. Subacute care can be administered in the home following a stay in a hospital. Sub-acute care procedures may include administering and supervision of inhalation therapy, administering tracheotomy care, performing intravenous tube feedings and administering complex wound management.

Terminal

Terminal designates that the patient is in the final stages of life and cannot recover.
Therapy Services: Medically prescribed services that can significantly improve, develop and restore a patient’s condition. Therapy services are designed to restore physical functions of a patient that have been lost through disease or a medical event. Therapy services can be performed in the hospital or home by licensed physical, occupational and speech therapists.

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