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Accredited facility
An accredited facility is a nursing home, assisted living center or hospital that meets very high standards of care. These standards are set by organizations such as the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). To stay accredited, a facility must be inspected every 18 months to three years.
Activity director
An activity director plans group singing, art projects and other activities. Such activities help residents of a long-term care facility stay active, alert and sociable.
Activities of daily living (ADLs)
Activities of daily living (ADLs) include eating, bathing, grooming, dressing and going to the toilet. People with dementia may need aid to perform these tasks. Questions about ADLs help decide what type of care a person needs.
Acute care (hospital care)
Acute care is a medical setting such as a hospital, intensive care unit or emergency department.
Administrator
An administrator runs a facility, such as a nursing home.
Adult day care
Adult day care is a community program for disabled adults. In this safe setting, people can socialize, participate in activities and get health care. Day care centers are open during business hours on weekdays. Some programs also run during the evenings and on weekends.
Advance directive
An advance directive is a legal document. It tells what kind of medical treatment you would like if your life is in danger and you can't communicate. Advance directives include:
- a living will that explains your wishes about medical treatments at the end of life
- a health-care power of attorney that lets you choose someone to make medical decisions for you
Allowable cost
Allowable cost is the highest fee the state will pay for people on Medicaid. Other insurance plans may also set allowable costs for the services they cover.
Alzheimer's disease
Alzheimer's disease is the most common cause of dementia. Over months or years, this disease cripples the brain's nerve cells. Alzheimer's disease destroys memory and learning.
Assessment
An assessment of mental status is a test of a person's ability to think, feel and react to others. A doctor usually performs a mental status assessment.
Assistive device
An assistive device is an aid, such as eyeglasses, a cane, a wheelchair or a hearing aid.
Attorney (elder law)
An elder law attorney handles general estate planning issues and counsels clients about planning for the future with alternative decision-making documents. The attorney can also assist the client in planning for possible long-term care needs, including nursing home care. Not all attorneys specialize in elder law. Your local bar association or the National Academy of Elder Law Attorneys and your local chapter can refer you to elder law attorneys in your area.
Audiologist
An audiologist deals with ear problems, including hearing loss, tinnitus (ringing in the ears or "head noise") and lack of balance. Audiologists provide hearing aids and other listening devices.
Bed-bound or bed-fast
A person who is bed-bound cannot walk or get out of bed without help from another person or a mechanical lift.
Case management
Case management describes the care and services planned by health care workers.
Catheter
A catheter is a bendable plastic tube that goes into the bladder to help a person urinate.
Centers for Medicare and Medicaid (CMS)
Centers for Medicare and Medicaid is the government program that oversees nursing home care. CMS inspects nursing homes and enforces safety rules.
Certified nursing assistant (CNA); also certified nurse's aide
A certified nursing assistant helps feed and care for disabled adults. To learn these skills, CNAs attend at least 75 hours of classes. A CNA works under a nurse's supervision and must keep taking classes to stay certified.
Chaplain
A chaplain offers spiritual counseling to people in nursing homes and hospitals.
Charge nurse
A charge nurse supervises the staff and residents of a floor or unit of a nursing home. The charge nurse's shift usually lasts eight hours. On each shift, day or night, a charge nurse should be available.
Contractures
Contractures — shortenings of the tendons and muscles — can make the knees, arms, hands or feet curl up. Physical therapy can sometimes prevent or treat this condition. But contractures following a stroke or dementia may be permanent.
Custodial care
Custodial care helps a person accomplish the activities of daily living (ADLs). Custodial care can also include preparing special diets and giving medications.
Decubitus ulcers (pressure ulcers, pressure sores or bedsores)
Decubitus ulcers are skin sores caused by constant pressure.
Deficiencies
Deficiencies are problems an inspector notes while visiting a nursing home or other facility. The facility must correct any deficiencies. Otherwise, it may be fined and dropped from Medicare or Medicaid participation.
Dementia
Dementia is a disturbance in thinking and remembering that affects daily life. The symptoms of dementia can include changes in personality, mood and behavior. Disease and injury cause irreversible dementia. But dementia caused by drugs, alcohol, hormone imbalances, vitamin deficiencies or depression may be reversible.
Dentist
A staff or contract dentist cares for the teeth and gums of a facility's residents. Medicare does not cover dental services, but Medicaid covers some dental expenses. Regular dental care is a key to staying healthy.
Dietician
A dietician makes sure that a facility's residents eat a healthy, nutritious diet.
Director of nursing services (DON)
The Director of Nursing oversees all nursing activities. These include scheduling and making sure staff members get continuing education. The DON is a registered nurse who has graduated from an accredited school of nursing.
Discharge
Discharge is the release of an individual from a hospital or other facility such as a nursing home. The attending doctor must give an order for the discharge.
Do Not Resuscitate (DNR) order
A DNR order tells the health care facility or doctor not to revive a patient whose heart or breathing has stopped. A DNR order requires the signature of the person or a substitute (see Advance directive).
Elder law attorney
An elder law attorney handles general estate planning issues and counsels clients about planning for the future with alternative decision-making documents. The attorney can also assist the client in planning for possible long-term care needs, including nursing home care. Not all attorneys specialize in elder law. Your local bar association or the National Academy of Elder Law Attorneys and your local chapter can refer you to elder law attorneys in your area.
Family/designated representative or other caregiver
“Family members” can include people who are important to the resident, whether or not they are related.
Feeding tube
A feeding tube is a plastic or rubber tube to give food and water to someone who cannot eat or drink. A feeding tube can be put in through the nose (nasogastric) or the stomach wall (PEG tube).
Financial Planner
A financial planner can help the client make decisions that make the most of financial resources while at the same time help negotiate the financial barriers that inevitably arise in every stage of life.
Functional impairment
Functional impairment means being unable to dress, use the toilet, eat, bathe or walk without help.
Geriatric care manager
A geriatric care manager will help create a plan of care that meets the needs of the older adult and will explain what resources and options are available.
Geriatric psychiatrist
A geriatric psychiatrist is trained to diagnose and treat mental disorders in older adults. These disorders include dementia, depression, anxiety and late-life schizophrenia.
Geri chair
A geri chair is a high-backed cushioned recliner with a leg and foot rest. The staff can push it on wheels, but the resident cannot move it. A geri chair is a restraint, so it can be used only on a physician's order.
Guardian/conservator
A court-appointed guardian or conservator manages a resident's money and makes health care and living decisions. Becoming a guardian or conservator requires a court order.
Hospice
A program that offers support for dying persons to live as fully and comfortably as they can.
Instrumental activities of daily living (IADLs)
Instrumental activities of daily living (IADLs) are important daily living activities, such as cooking, shopping and managing finances.
Long-term care facility
A long-term care facility is a nursing home or assisted living center designed for disabled adults.
Medicaid
Medicaid is a government health program for low-income people.
Medicaid-certified
A Medicaid-certified facility can offer services to people who are on Medicaid.
Medical director
The medical director is a doctor who oversees medical care in a facility, such as a nursing home. The medical director may be the attending doctor for some residents and may offer emergency medical care for other residents.
Medicare
Medicare is a government health insurance program for people aged 65 and older and for disabled people.
Medicare-certified
A Medicare-certified facility can offer services to people who are on Medicare.
Mini Mental State Examination (MMSE)
The Mini Mental State Examination (MMSE) is a short test to measure a person's basic skills. These skills include short-term memory, long-term memory, writing and speaking.
Minimum Data Set (MDS)
The Minimum Data Set (MDS) summarizes information on the abilities of people who live in long-term care facilities. To keep their Medicare and Medicaid certification, long-term care facilities must submit their MDS data regularly.
Nurse
A nurse who works in a nursing home takes care of residents and oversees certified nurses' aides (CNAs) and custodial caregivers. A registered nurse (RN) is a graduate trained nurse who has been licensed by a state authority after passing qualifying examinations for registration. A licensed practical nurse (LPN) is a person who has undergone training and obtained a state license to provide routine care for the sick. Some states use the term licensed vocational nurse or LVN.
Nurse practitioners (NPs) and physician assistants (PAs)
Nurse practitioners (NPs) and physician assistants (PAs) are specially trained and may help oversee residents' care. In many states, doctor-supervised NPs and PAs write orders for treatment and medication.
Occupational therapist (OT)
An occupational therapist helps residents change their activities or environment so they can eat, dress and bathe. An OT may also help with other tasks, such as cooking, taking medication or driving. And OTs may guide family members and caregivers.
Ombudsman
An ombudsman in a long-term care facility helps residents and their families keep their rights and resolve complaints.
Owner/operator
The owner is the individual, agency or company that owns the facility. The owner may hire an operator to direct the facility.
Palliative care
Palliative care includes medical or surgical methods to ease the pain of a serious or incurable illness.
Personal health record
A personal health record (PHR) is a regularly updated collection of important health information. If you have dementia or are caring for someone with dementia, a PHR will help you work with your care team.
Pharmacist
A pharmacist offers information about prescriptions, reviews patients' drugs, teaches caregivers and gives out medications.
Physical therapist
A physical therapist treats physical disabilities and works with residents to improve general fitness. A physical therapist may also teach a resident how to use a walker, artificial limb or wheelchair.
Physician
A physician, or doctor, helps develop a medical care plan for each resident of a long-term care facility. Physicians make medical decisions, such as what medications residents take. They visit nursing home residents. They may also meet with a resident's family to discuss medical conditions or treatments.
Power of attorney
A power of attorney is a legal form that names someone to act as your substitute.
Psychologist
A psychologist detects and treats emotional problems. Personality and intelligence testing can help a psychologist diagnose these problems. Treatments include individual, family, and group therapy sessions. Psychologists in long-term care facilities also teach staff members how to interact with residents.
Quality indicators
Quality indicators describe the care in a long-term facility. For example, one quality indicator is the percent of residents whose need for help with daily activities has increased. The government's Nursing Home Compare Web site uses quality indicators to score every nursing home in the United States.
Recreational therapist
A recreational therapist helps residents enjoy activities. For example, the recreational therapist might offer special tools, such as large-print songsheets, to encourage participation.
Resident
A resident is someone who lives in a long-term care facility, such as a nursing home.
Respite care
Respite care provides temporary relief from caregiving tasks. Such care could include in-home assistance, a short nursing home stay or adult day care.
Social worker
A social worker offers residents and their families therapy, support services and planning for discharge. Social workers may also teach and counsel staff members.
Speech-language pathologist
A speech-language pathologist tests, diagnoses and treats people with speech and swallowing problems.
Staff-resident ratio
The staff-resident ratio compares the number of staff members to the number of residents they care for.
Survey
The state health department takes an unannounced survey of each nursing home about once a year. This survey helps make sure a facility is giving good care. A nursing home must participate to keep its license. Each facility has to post its latest survey results. These required surveys differ from the surveys of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) that a nursing home may request (see Accredited facility).
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