Caregiving Glossary

April 2011

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Activities of Daily Living (ADL's)
The basic activities that a person performs daily. These include bathing, dressing, getting in and out of bed or a chair, walking, cleaning, using the toilet and eating. Many older adults who require help with such activities are predominantly independent, requiring help with just one or two ADL’s. In such cases, intermittent help from a family member or friend may be all that is needed. However, in other cases, particularly when needs are more extensive and/or the importance of scheduling these activities is critical, informal care from unskilled individuals may not be enough.

Acute Care
Providing care after a severe injury, illness, or surgery. This period of treatment usually lasts for a short time.

Adult Day Care Facilities
Adult Day Care facilities are designed for adults who have a need for significant medical attention and supervision, but who do not require institutionalization in a nursing home. Where available, Adult Day Care centers are typically utilized for between three and 12 hours per day, up to seven days per week.

Advance Directives
A set of legal documents that explicitly describes an individual’s wishes for care, such as medical power of attorney/health care proxy, living will, funeral directive and hospital visitation directive.

Ambulatory Care
Ambulatory care is any medical care, including diagnosis, observation, treatment and rehabilitation, provided to persons who are able to walk and do not require admission to a hospital.

Area Agencies on Aging (AAA)
Local agencies created to coordinate services and programs that make it possible for older adults to remain in their homes and communities as long as possible.

Assisted Living
Assisted living is a type of facility-housing designed for people who are relatively independent but may still require some level of assistance with activities of daily living, such as bathing or cleaning.


Bereavement is the time period after a death or loss, during which grief is experienced and mourning occurs. The amount of time spent in bereavement often depends on the person's relationship to the person who died, and how much time was spent anticipating the loss.


Case Manager
The person who coordinates the care-recipient’s care and appointments with medical and service providers. While often a nurse, doctor, or social worker, these responsibilities often assumed by family or friends.

Case Management
The monitoring and coordination of treatment rendered to patients who have a specific diagnosis or who require extensive services.

Congregate Care
Care to elderly, disabled or chronically-ill individuals who live in a variety of multi-unit housing settings, such as adult homes and assisted-living facilities.

Certified Home Health Agencies (CHHA's)
Certified Home Health Care Agencies provide part-time, supportive services to patients who need intermediate and skilled health care. Certified Home Health Care Agencies can also provide long-term nursing and home health aide services, and arrange for other services including physical, occupational and speech therapy, medical supplies/equipment, nutritional services, and social workers. CHHA services can be paid with or in part by Medicare.


Durable Power of Attorney
Also called a "health care proxy" or "medical power of attorney," this document allows people to appoint an individual of their choice (the "agent") who will be legally empowered to make medical decisions for an them if they become unable to do so.

Dual Eligible
A Medicare beneficiary who also receives the full range of Medicaid benefits.

Drug Formulary
A list of prescription drugs covered by a given health plan and provided by approved pharmacies.


Emotional Support
An aspect of caregiving that primarily focuses on providing companionship. Common forms of support include friendly visiting programs, telephone calls, or video chatting.

End-of-Life Care
Medical care of those with a terminal illness or terminal condition that has become advanced, progressive and incurable.


Family of Choice
Diverse family structures, usually created by LGBT people, immigrants, and racial or ethnic minorities, that include but are not limited to life partners, close friends, and other loved ones not biologically related or legally recognized but who are the source of social and care giving support.

Family of Origin
Persons who are biologically-related, such as parents and children, siblings, grandparents, and other relatives.

Funeral Directive
A written document that allows people to be explicit about their preferred funeral arrangements and disposition of their remains, including giving a designated person decision-making authority for those particular preferences.


Health Insurance Portability and Accountability (HIPAA)
HIPAA is a federal law designed to protect patients' medical records and other health information that is provided to health plans, doctors, hospitals and other health care providers. Developed by the Department of Health and Human Services, these new standards give patients access to their medical records and more control over how their personal health information is used and disclosed.

Health Care Proxy
Also called a "medical power of attorney" or "durable power of attorney," this document allows people to appoint an individual of their choice (the "agent") who will be legally empowered to make medical decisions for an them if they become unable to do so.

A program that provides care for the terminally ill at home or in a facility. Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional and spiritual needs of the patient. Hospice care also provides bereavement support and counseling to the patient’s family or caregiver. Hospice care is covered under Medicare Part A.

Home Health Care
A full range of nursing, rehabilitation therapy, social work and home health aide services offered by a provider in a patient’s home.

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. In some states, only licensed home health aides can provide hands-on assistance.

Hospital Visitation Directive
A document that allows individuals to designate who can (and cannot) visit them in the hospital. Sometimes this directive is incorporated into the Medical Power of Attorney/Health Care Proxy.


Infusion Therapy
Infusion therapy involves the administration of fluids, nutrients, medications, blood products intravenously for various reasons such as pain management, treatment of infections, chemotherapy, as well as treatment and management of various diseases and conditions.

Instrumental Activities of Daily Living (IADL's)
Instrumental activities of daily living are more complex than activities of daily living, but don’t need to be performed daily. IADL’s include grocery shopping, paying bills, cleaning, laundry, and snow removal.


Living Trust
A living trust is a legal arrangement that allows a person to transfer property to their beneficiaries after their death, without court involvement. The successor trustee—the person you appoint to handle the trust after your death—simply transfers ownership to the beneficiaries named in the trust.

Living Will
A written document that allows people to specify what types of life-sustaining measures should be taken in the event they are unable to express those wishes. A living will can be very specific or very general. More specific living wills may include information regarding an individual's desire for services like analgesia (pain relief), antibiotics, hydration, feeding, and the use of ventilators or cardiopulmonary resuscitation.


Medicaid is a program funded jointly by the federal and state (and some city) governments. People of all ages whose income and assets fall below a specified level can qualify for Medicaid coverage. Medicaid provides comprehensive medical coverage for all of its recipients, but because many health care providers do not accept Medicaid, access to medical care is often limited. For adults over the age of 65, the picture is somewhat different; these adults are generally covered by Medicare, and the vast majority of health care providers accept Medicare. Those who accept Medicare often also accept Medicaid for their older patients. In these cases, Medicaid provides coverage that fills the gaps in Medicare, while Medicare continues to provide basic medical care benefits.

Medicare is a national health insurance program provided by the US federal government and is designed primarily for seniors. Virtually every permanent resident of the United States who is 65 or older is eligible for Medicare, even non-citizens. Services wishing to be reimbursed must be documented.

Medicare Part A
Medicare Part A is generally known as Hospital Insurance, and pays for hospital stays, food, tests, and doctors fees. Part A also covers limited home and nursing home care if certain criteria are met, including length of stay, and diagnosis. Part A does not cover unskilled care, such as the assistance of activities of daily living. Coverage under Part A is paid for through a premium, but can be waived for those who meet certain eligibility requirements.

Medicare Part B
Medicare Part B, also known as Medical Insurance, pays for physicians, lab tests, and outpatient hospital care. Part B also covers certain areas that Part A does not, including physical and occupational therapy, and some home health care services. Coverage under Part B is paid for in part by a premium, but can be waived for those who meet certain eligibility requirements.

Medicare Prescription Drug Plan (DPD or MPDP)
This part of Medicare covers, in part, the cost of prescription and is provided by private insurance companies. Anyone currently eligible for Medicare is also eligible for the Prescription Drug Plan. Insurees choose from a number of offered plans, and pay the set premium. Those who do not enroll in the plan when first eligible, but decide to enroll at a later date may pay a penalty.

Meals on Wheels
Meals on Wheels is a national assistance program designed to meet the needs of people who are largely homebound. Under these programs, nutritious hot meals are delivered to patients for a nominal fee. For many people who are homebound, these meal deliveries provide not only the nutrition they need, but also the only human contact they may have that day.


Naturally Occurring Retirement Community
A Naturally Occurring Retirement Community, or NORC, is a housing development that has become home to a large concentration of seniors who are aging in place.


Occupational Therapist (OT)
Occupational therapists work with patients to help them regain the physical skills they need to function in their day-to-day activities. An occupational therapist might teach a stroke patient how to dress, or recommend a grab bar is installed in the shower to prevent falls while bathing.


Palliative Care
A form of care that focuses on improving the quality of life for a patient by relieving pain, suffering and other symptoms of a patient, rather than treating the disease or illness.

Patient Review Instrument (PRI)
An assessment performed by a registered nurse used to determine the level of care and the type of living facility needed for an older adult. Valid for 30 days, areas of assessment include current medical condition, prescription drugs, physical and mental abilities and limitations, ability to perform self-feed, walk, using the bathroom, as well as behavioral traits such as aggressiveness or disruptiveness.

Power of Attorney
Power of attorney is a legal document giving one person (called an "agent" or "attorney-in-fact") the power to act for another person (the principal). The agent can have broad legal authority or limited authority to make legal decisions about the principal's property and finance. The power of attorney is frequently used in the event of a principal's illness or disability, or when the principal can't be present to sign necessary legal documents for financial transactions.

Personal Care Workers
Personal care workers, or home attendants, provide assistance with ADL’s and IADL’s, such as bathing, eating, and dressing. They do not perform the health-related functions carried out by a home health aide, such as taking a patient's temperature.


Quality of Life
Quality of life is an important consideration in medical care and refers to the patient's ability to enjoy normal life activities. Some medical treatments can seriously impair quality of life without providing appreciable benefit, while others greatly enhance quality of life.


Respite Services
A service designed to provide relief to family caregivers who tend to the day-to-day needs of a sick or frail person. The respite period can be for a few hours, a day, or even longer, depending on the program. Many families find that occasional respite services are a helpful break from their daily care-giving responsibilities. Dependent on certain requirements, Medicare will pay for up to 80 hours of respite services per year.

Rehabilitation Therapy
Rehabilitation therapy services are normally ordered by a physician to help a patient recover from an illness or injury. These kinds of services are typically provided by physical, occupational and speech therapists.


Sandwich Generation
Adults who are providing care for both their parents as well as their own children.

Skilled Services
Services given by a licensed medical professional, typically a nurse, which include administering shots, taking temperatures, changing dressings/bandages, dispensing medication, or changing/inserting catheters. Many assisted-living facilities specifically offer skilled nursing services.

Social Day Care
Social Day Care facilities are for adults who have no significant medical needs but may benefit from socialization opportunities and need supervision during the day.

Significant Others, Friends, Families and Allies who frequently provide practical, financial, professional and/or emotional support, assistance, and/or services to one or more transsexual, transgender, or intersex persons.


Aging Parents and Elder Care: Glossary of Terms

National Resource Center for LGBT Aging Level 1 Curriculum for Aging Providers and LGBT Organizations. PHI and National Resource Center for LGBT Aging.

Visiting Nurse Service of New York: Glossary.