What does that word mean?

Senior care glossary

The terms you'll hear from hospitals, Medicaid offices and facilities in the first week, explained without jargon.

Activities of daily living (ADLs): Also called: ADLs; The six basic self-care tasks: bathing, dressing, eating, using the toilet, moving from a bed or chair (transferring), and continence. Needing help with two or more is the usual trigger for long-term care insurance and a common test for Medicaid and VA benefits.
Adult day services: Also called: adult day care; A daytime program outside the home with supervision, meals and activities, sometimes with nursing or therapy. It gives family caregivers a break and can delay a move.; Related resources
Adult foster care: Also called: adult family home, board and care; Care in a private home licensed to house a small number of adults, often two to six. Names vary by state. Some state Medicaid programs pay for the care.
Adult protective services (APS): The state or county agency that investigates abuse, neglect, self-neglect and financial exploitation of older and disabled adults. Anyone can report, and you don't need proof.; Related resources
Advance directive: Also called: living will; A legal document that records the medical care a person does or doesn't want if they can't speak for themselves, and usually names someone to decide for them. Every state has its own form.; Related resources
Aging and disability resource center (ADRC): Also called: No Wrong Door; A local, free front door to long-term care help, often run with the Area Agency on Aging. They explain options, screen for programs and help with applications.; Related resources
Aid and Attendance: Also called: A&A; An extra amount added to a VA pension for a veteran or surviving spouse who needs help with daily activities, is bedbound, is in a nursing home, or has significantly limited eyesight. It can help pay for assisted living or home care.; Related resources
Area Agency on Aging (AAA): The local public or nonprofit agency that coordinates services for older adults in a region: meals, in-home help, caregiver support, benefits counseling. There's one for every part of the country. The Eldercare Locator finds yours.; Related resources
Assisted living: Housing with meals, activities and help with daily tasks like bathing, dressing and medications, for people who don't need round-the-clock nursing. States license it under different names, such as residential care facility, personal care home or adult care home.
Care plan: Also called: service plan; The written plan a community or agency makes for each resident: what help they need, when, and from whom. Ask to see it and to be part of updating it.
Community spouse: When one spouse needs long-term care paid by Medicaid, the spouse who stays at home. Federal rules let the community spouse keep the home, a share of savings and a minimum monthly income, so they aren't impoverished.; Related resources
Continuing care retirement community (CCRC): Also called: life plan community; A campus with independent living, assisted living and nursing care, so residents can move between levels as needs change. Most require an entrance fee plus monthly fees.
Custodial care: Also called: personal care, non-medical care; Help with daily living, like bathing, dressing and eating, that doesn't need a nurse or therapist. Medicare doesn't pay for custodial care on its own. Medicaid, long-term care insurance, VA benefits and private money do.
Durable power of attorney: Also called: POA, financial power of attorney; A legal document that lets a named person handle someone's money and property, and keeps working if they lose capacity. It has to be signed while the person can still understand it.; Related resources
Elimination period: Also called: waiting period; The number of days a long-term care insurance policy makes you wait, after you qualify, before it starts paying. Families pay for care during that time.
Estate recovery: After a Medicaid recipient 55 or older dies, the state must try to recover what it paid for their long-term care from their estate. There are protections, for example while a spouse or a disabled child is alive, and rules differ by state.
Guardianship: Also called: conservatorship; A court process that appoints someone to make decisions for a person who can no longer make them and has no power of attorney in place. It's slower, costlier and more public than a power of attorney.; Related resources
Health care proxy: Also called: health care power of attorney, medical power of attorney, health care agent; A document naming someone to make medical decisions when a person can't. Often combined with an advance directive.
HIPAA authorization: A signed form that lets doctors and hospitals share medical information with a named family member. Without it, staff may refuse to talk to you.
Home and community-based services (HCBS): Also called: waiver, HCBS waiver; Medicaid long-term care provided outside a nursing home: at home, in adult day, or in some states in assisted living. Many states run these as 'waiver' programs with limited slots and waitlists.; Related resources
Home care: Also called: in-home care, private duty; Non-medical help at home: bathing, dressing, cooking, companionship. Usually paid privately; Medicaid programs pay in some cases.
Home health care: Skilled care at home from nurses and therapists, ordered by a doctor for someone who is homebound. Medicare covers it when the rules are met. It's different from home care, which is non-medical.
Hospice: Comfort-focused care for someone with a life expectancy of six months or less if the illness runs its usual course. Medicare covers it, and it can be provided at home, in assisted living, in memory care or in a nursing home.; Related resources
Independent living: Senior apartments or cottages with conveniences like meals, housekeeping and activities, but no personal care. Generally paid privately.
Inpatient vs. observation status: Whether a hospital formally admitted your parent (inpatient) or kept them for monitoring (observation). It matters because Original Medicare only pays for rehab in a nursing facility after 3 days as an inpatient, and observation days don't count. Ask the hospital directly.; Related resources
Instrumental activities of daily living (IADLs): Also called: IADLs; The tasks of running a household: cooking, cleaning, shopping, managing money and medications, using the phone, getting to appointments. Trouble here is often the first sign someone can't safely live alone.
Level of care assessment: Also called: functional assessment, nursing facility level of care; An evaluation by a nurse or social worker of how much help someone needs. Medicaid waivers usually require 'nursing facility level of care', meaning needs serious enough for a nursing home, even if the person lives elsewhere.
Long-term care insurance: Private insurance that pays toward care at home, in assisted living or in a nursing home once someone needs help with daily activities or has a cognitive impairment.; Related resources
Long-term care ombudsman: A free, independent advocate for residents of nursing homes and, in most states, assisted living. They resolve complaints, explain rights and can visit. Every state has one.; Related resources
Look-back period: The time Medicaid (60 months in most states) or the VA pension (36 months) reviews for gifts and transfers of money or property. Giving assets away during it can cause a penalty period with no coverage.
Medicaid: The joint federal and state health program for people with low income and assets. It's the largest payer of nursing home care in the country and, in many states, helps with care at home and in assisted living. Every state runs its own version.; Related resources
Medicare: Federal health insurance for people 65 and older and some younger people with disabilities. It covers hospitals, doctors, short rehab, home health and hospice, but not long-term custodial care.; Related resources
Medicare Advantage: Also called: Part C; Private plans approved by Medicare that replace Original Medicare. They may have networks, prior approvals and their own rules for rehab stays. Call the plan before a discharge.
Medigap: Also called: Medicare supplement; Private insurance that fills gaps in Original Medicare, like deductibles and coinsurance. It doesn't pay for long-term care.
Memory care: A secure setting, either a separate community or a wing of assisted living, designed for people with Alzheimer's or other dementias, with specially trained staff and structured days.
Miller trust: Also called: Qualified Income Trust, QIT, income trust; In states with a hard income cap for long-term care Medicaid, a special trust that receives the income over the cap, so the person can still qualify. The money in it goes toward the cost of care.
Nursing home: Also called: skilled nursing facility, SNF; A licensed facility with nurses on duty around the clock, for people with serious medical needs or who need extensive help. Used for short rehab after a hospital stay and for long-term care.
PACE: Also called: Program of All-Inclusive Care for the Elderly; A program for people 55 and older who need nursing-home-level care but can live safely in the community. It provides all their medical and long-term care, usually through a day center. Not available everywhere.; Related resources
Palliative care: Care focused on relieving symptoms and stress of a serious illness, at any stage, alongside treatment. Unlike hospice, it doesn't require stopping curative treatment.
Personal needs allowance: The small monthly amount a Medicaid nursing home resident keeps from their own income for personal expenses. The rest of their income goes toward the cost of care. States set the amount.
POLST: Also called: MOLST, POST; A medical order, signed by a clinician, that records a seriously ill person's wishes about treatments like CPR. Unlike an advance directive, emergency responders follow it directly.
Representative payee: A person or organization the Social Security Administration appoints to receive and manage someone's benefits when they can't. A power of attorney doesn't give this authority on its own.
Respite care: Short-term care that gives the regular caregiver a break, from a few hours to a few weeks, at home, in adult day or in a community.
Room and board: Rent and meals. Medicaid programs that help with assisted living almost always pay for the care only, and the resident pays room and board from their own income.
Senior Medicare Patrol (SMP): A free program in every state that helps people spot and report Medicare fraud, errors and scams.
SHIP: Also called: State Health Insurance Assistance Program; Free, unbiased Medicare counseling in every state. Counselors don't sell anything. Many states give their SHIP its own name.; Related resources
Special Focus Facility: A nursing home that Medicare has flagged for a persistent record of serious quality problems. The list is public.
Spend-down: Reducing savings or income to Medicaid's limits by paying for care and other allowed expenses. In some states, people with income over the limit qualify by 'spending down' part of their income on care each month.
SSI state supplement: Also called: SSP, optional state supplement; An extra payment some states add to federal SSI, sometimes specifically for low-income people living in assisted living or residential care.
Survey: Also called: inspection report, deficiency; The state's inspection of a licensed facility. Problems found are called deficiencies or citations. The reports are public records.
Waitlist: Also called: interest list, registry; Many Medicaid waiver programs have a fixed number of slots. When they're full, new applicants wait, sometimes for years. Getting screened early puts your parent in line sooner.