Learn the meaning of some common terms in aging life care management

Everyday functions and activities that people usually do without help. These include dressing, eating, bathing, toileting, transferring, and continence.

A facility that provides an aggressive level of rehab, often up to three hours a day. Some older adults start in acute rehab and then transfer to skilled nursing facilities for continued, slower-paced rehabilitation.

A day program that provides structured activities for older adults who may require supervision due to limited physical or cognitive abilities and/or who are in need of socialization in a structured setting. Programs provide meals, transportation, medication monitoring, administration, and social services. Enrolling an older adult in an adult day health program can provide needed respite for care partners.

A human services professional who specializes in assisting older adults and their families meet their short- and long-term needs. Visit the Aging Life Care Association for more information.

The state of Massachusetts is divided into 30 home care regions. The ASAP is often a good point of entry for learning about services and benefits for older adults in their community. ASAPs provide information and referral services and case management of low income older adults. View a list of ASAPs available in your community.

A progressive disease that destroys cells in the brain and is the leading cause of dementia. Visit the the Alzheimer's Association, Massachusetts Chapter website [www.alzmass.org], for more information.

Money you have or property you own, such as cash, bank accounts, personal property, vehicles, real estate, and the cash surrender value of life insurance.

Assisted living facilities consist of individual apartments, usually studio or one bedroom units, with some two bedroom apartments available. Each apartment has a bathroom equipped with walk in showers and grab bars, emergency call buttons, and often a small kitchenette. The facilities offer three meals a day, personal care (generally 45 minutes to one hour each day), activities, assistance with medications, homemaking, and scheduled transportation. Some have on-site medical services, hair salons, and fitness facilities.

Assisted living is paid for with private funds on a monthly basis. There are some facilities that participate in one or both of the subsidy programs available to low income older adults. Group Adult Foster Care (GAFC) is a Medicaid program that subsidizes older adults below a certain income level who require daily personal care assistance. Low income tax subsidy programs also exist in some facilities for low income older adults. Visit the Massachusetts Assisted Living Facilities Association for more information.

Someone who provides social contact. A companion might just visit at home or go out with an older adult. Usually no personal care is rendered.

An individual who volunteers or is appointed by the court to manage the estate/finances of another person.

A CCRC or Life Care Retirement Community is a retirement community that usually requires an entrance fee, some of which is generally refunded to your estate when the contract is terminated. The communities vary in the array of services that are available. Some have assisted living programs or home health services available to those in independent apartments and all have nursing facilities that can be accessed for short- and long-term care. An older adult needs to be independent without any diagnosis of dementia prior to entering a CCRC.

Severe impairment or loss of intellectual capacity and personality integration, due to the loss of or damage to neurons in the brain. Dementia is not a disease itself but rather a group of symptoms caused by one or several disease processes.

Durable medical equipment is medically necessary equipment that a physician prescribes for use in the beneficiary’s home such as walkers, wheelchairs, and hospital beds. In order to be considered durable medical equipment, the equipment must be able to withstand repeated use, serve a medical purpose, and be appropriate for use in the home. “Home” is one’s house, apartment, relative’s home, a home for the aged, or some other type of institution in which a beneficiary resides (i.e. a hospital or skilled nursing facility). NOTE: This does not include nursing home. See more information about what DMEs Medicare pays for.

Someone who is at least 60 years of age. An elder is also known as older adult senior, senior citizen, aged, or elderly.

Massachusetts law (MGL Ch. 19A, Sec. 14-26) defines elder abuse as acts or omissions resulting in serious physical or emotional injury to an adult age 60 or over. This includes physical abuse, Emotional abuse (harassment, threats, verbal abuse), sexual abuse, financial exploitation, and care partner neglect. Protective Services Program investigates and, when appropriate, intervenes in cases where there is evidence that an older adult has been neglected, abused, or financially exploited by someone in a domestic setting. The protective services system is anchored by a 24-hour, seven day a week emergency hotline. It is empowered by Massachusetts General Law Chapter 19A to take steps that ensure that older adult victims of physical and emotional abuse, neglect, and financial exploitation receive protective and supportive services. Older adults must consent to services but in situations where an elder lacks the capacity to provide consent, court ordered services are provided.

The Executive Office of Elder Affairs contracts with 22 nonprofit agencies throughout the Commonwealth to provide problem focused and goal oriented casework services to older adults who are considered to be seriously at risk. These individuals are no longer able to meet essential needs for food, clothing, shelter, personal care, or medical care due to physical and/or mental impairments, substance abuse, or other serious problems, preventing them from remaining safely in the community without intervention.

Elder law attorneys focus on the legal needs of older adults and have a special knowledge of the law as it pertains to estate and Medicaid planning, alternative decision making, and long-term care needs. Learn more and see a list of attorneys in your area on the National Academy of Elder Law Attorneys website.

Someone who accompanies an older adult to medical or social appointments.

Income limits set by the US government each year as a measure of poverty, used to decide eligibility for some assistance programs. For current dollar amounts, view the Poverty Guidelines from the US Department. of Health and Human Services.

A volunteer who visits an older adult weekly for socializing.

A physician who specializes in the care of older adults, primarily those who are frail and have complex medical and social problems.

A legal document that allows you to declare someone who can make health care decisions for you in the event that you are not capable of making them yourself.

Provides personal care and some household services under the direction of a nurse from a home health agency. HHAs are able to assist with transfers, bathing, and ostomy care. They cannot administer medications or injections.

Skilled services in the home including nursing, physical therapy, occupational therapy, speech therapy, and home health aides.

A person who can do light house cleaning, shopping, laundry, meal preparation, and errands (no heavy chores).

Care that addresses the physical, spiritual, emotional, psychological, social, financial, and legal needs of the dying patient and his/her family. A concept that refers to enhancing the dying person's quality of life. Hospice care can be given in the home, a special hospice facility, or a combination of both.

Apartments that have been allocated for older adults and people with disabilities. They can, but don’t necessarily, have organized services such as meal sites and activities. They often include some social work coverage, emergency call buttons inside the apartment, and bathrooms that include equipment such as grab bars.

A court appointed individual responsible for the financial and physical well-being of a person deemed incompetent.

A document (not legally binding in Massachusetts) that spells out one’s wishes for end of life care.

Insurance that can cover the expenses of home care, assisted living facilities, and long-term care. Every policy is different and not all policies provide benefits for all services.

Provide nutritious hot meals to older adults who are homebound. The meals are delivered for a nominal fee.

A joint federal/state program that pays for health care for individuals and families with low incomes and low assets. Coverage and eligibility requirements vary from state to state. Medicaid is the primary payer of nursing home care. Some states also offer some home and community-based long-term care services for eligible individuals through their Medicaid programs. These additional services are at the option of the state and are not mandated by federal law.

The federal program that provides hospital and medical care to people age 65 or older and to some younger people who are very ill or have a disability. Benefits for nursing home and short-term home health services are limited and are generally available only to people while they are recovering from an acute illness. Coverage is restricted to medical care and does not include custodial care at home or in nursing homes.

A residential facility in which a full range of medical, housing, food, and social services are provided 24 hours a day. To enter a nursing home in many states, an assessment of need must be completed to establish medical eligibility.

A rehabilitation professional who teaches people to compensate for functional limitations as a result of an injury, illness, or disability by learning skills and techniques needed to perform activities of daily living and optimize independence.

In case of a fall or other medical emergency, this electronic device enables the user to contact help 24 hours a day simply by pressing a button. A number of private companies offer these systems.

A rehabilitation professional who utilizes various therapies to help people maximize mobility and restore strength and body movement after an illness or injury such as a stroke, fall, or back injury.

The legal designation of someone to be responsible for your financial decisions at the point that you are no longer able to manage your own affairs.

Usually basic accommodations including private bedrooms and baths (although some have shared baths), three meals a day, shared living room and dining room, activities, emergency pull cords, and assistance with medication. Some Rest Homes accept Medicaid for payment and some have endowments for low income older adults not on Medicaid.

Apartment units for older adults in a community of independent but often aging-in-place older adults. These communities are generally available for monthly rental and do not require an entrance fee. The apartments usually have full kitchens and emergency pull cords and provide housecleaning and one or two meals each day. There are activities in the building and outside trips. While the communities do not have assisted living programs, often people can access services through private organizations to allow them to remain in their apartments.

A community facility for older adults that provides a variety of activities for their members including any combination of recreational, educational, cultural, or social events. Some centers also offer nutritious meals and limited health care services.

Also known as a nursing home. These facilities provide 24-hour nursing coverage and total care of a person’s needs. They also provide short-term rehabilitation services for people returning to the community.

Medicare certified agencies that are working under the orders of one’s doctor to provide nursing care and, potentially, physical, occupational, and speech therapy as well as home health aide services.