Glossery of Terms

Glossary of Senior Housing Terms

The terms below can help you learn about commonly used terms and the different senior housing and care choices available.

Accreditation: A seal of approval given by an autonomous governing body to a community or service provider. To become accredited, the community or provider must meet specific requirements set by the accreditation entity and is then generally required to undergo a thorough review process by a team of evaluators to ensure certain standards of quality. The accrediting organizations are independent, not government agencies or regulatory bodies. Some examples of accreditation bodies for the senior housing and care industry include CARF (Commission on Accreditation of Rehabilitation Facilities), CCAC (Continuing Care Accreditation Commission), and JCAHO (Joint Commission on Accreditation of Healthcare Organizations).

Activities of Daily Living (ADLs): Bathing, eating, grooming, dressing, toileting and other day-to-day activities.

ADA (Americans with Disabilities Act): Passed by Congress in 1980, this law establishes a clear and comprehensive prohibition of discrimination on the basis of disability. Administrator: In most cases, a licensed professional who undertakes the duty of managing the day-to-day operations of a care facility such as a nursing home or assisted living facility.

Adult Day Care: Structured programs with stimulating social activities and health-related and rehabilitation services for the elderly who are physically or emotionally disabled and need a protective environment. The participant is usually brought to the care facility in the morning and leaves in the evening.

Advantage List: List of health service providers that agree to give particular insurance company policyholders a preset discount. (from LTCInsurance)

Aging in Place: A concept that advocates allowing a resident to choose to remain in his/her living environment regardless of the physical and or mental decline that may occur with the aging process of aging.

Alzheimer's Care Center: A treatment center that specializes in providing care for those with Alzheimer's disease with more of the care geared towards supervision of the patient in a safe and controlled environment. (from LTCInsurance)Alzheimer's: A progressive, neurodegenerative disease characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer's disease is the most common cause of dementia. (from the Alzheimer's Association)Ambulatory: The ability to walk freely & independently, not bedridden or hospitalized. Assessment: An evaluation, usually performed by a physician, of a person's mental, emotional, and social capabilities. (from AA)

Assisted Living: a special combination of housing, personalized supportive services and health care designed to meet the needs -- both scheduled and unscheduled -- of those who need help with activities of daily living. Services provided in Assisted Living residences usually include:
Three meals a day served in a common dining area
Housekeeping services
Transportation
Assistance with eating, bathing, dressing, toileting and walking
Access to health and medical services
24-hour security and staff availability
Emergency call systems for each resident's unit
Health promotion and exercise programs
Medication management
Personal laundry services
Social and recreational activities(from ALFA)

Caregiver: The primary person in charge of caring for an individual with Alzheimer's disease, usually a family member or a designated health care professional. (from AA)

Case management: A term used to describe formal services planned by care professionals. (from AA)

Charge Nurse: An RN or LPN who is responsible for the supervision of a unit within a nursing facility. The charge nurse schedules and supervises the nursing staff and provides care to facility residents.

Congregate Housing: Is similar to independent living except that it usually provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing. (from ALFA)

Continuing Care Retirement Community (CCRC): Is a community that offers several levels of assistance, including independent living, assisted living and nursing home care. It is different from other housing and care facilities for seniors because it usually provides a written agreement or long-term contract between the resident (frequently lasting the term of the resident's lifetime) and the community which offers a continuum of housing, services and health care system, commonly all on one campus or site. (from ALFA)

Continuum of Care: Care services available to assist individuals throughout the course of a disease. This may include Independent Living, Assisted Living, Nursing Care, Home Health, Home Care, and Home and Community Based Services.

Convalescent Home: See Nursing Home. Dementia: The loss of intellectual functions (such as thinking, remembering, and reasoning) of sufficient severity to interfere with a person's daily functioning. Dementia is not a disease itself but rather a group of symptoms that may accompany certain diseases or conditions. Symptoms may also include changes in personality, mood, and behavior. Dementia is irreversible when caused by disease or injury but may be reversible when caused by drugs, alcohol, hormone or vitamin imbalances, or depression. (from Alzheimer's Assoc.)

Developmental Disability (DD): Affliction characterized by chronic physical and mental disabilities, which may include: cerebral palsy, retardation, thyroid problems, seizures, and quadriplegia.

Director of Nursing (DON): A DON oversees all nursing staff in a nursing home, and is responsible for formulating nursing policies and monitoring the quality of care delivered, as well as the facility's compliance with federal and state regulations pertaining to nursing care.

Financial Counseling Programs: Help seniors with managing their finances, bills, and completing Medicaid, Medicare or insurance forms. (from LTCInsurance)

HIPAA (The Health Insurance Portability and Accountability Act of 1996): This act became a law on January 1, 1997. The act states the requirements that a long term care policy must follow in order that the premiums paid may be deducted as medical expenses and benefits not paid be considered as taxable income. (from LTCINSURANCE)

HMO: A Health Maintenance Organization (HMO) is an organized system for providing comprehensive health care in a specific geographic area to a voluntarily enrolled group of members.

Home Health Care: Provision of medical and nursing services in the individual's home by a licensed provider.

Hospice Care: Philosophy and approach to providing comfort and care at life's end rather than heroic lifesaving measures (from AA), it can include medical, counseling, and social services. Most hospice care is furnished in-home, while specialized hospices or hospitals also provide this service.

Independent Living: Is a residential living setting for elderly or senior adults that may or may not provide hospitality or supportive services. Under this living arrangement, the senior adult leads an independent lifestyle that requires minimal or no extra assistance. Generally referred to as elderly housing in the government-subsidized environment, independent living also includes rental assisted or market rate apartments or cottages where residents usually have complete choice in whether to participate in a facility's services or programs. (from ALFA) See Senior Apartments.

Instrumental Activities of Daily Living (IADLs): Secondary level of activities (different from ADLs, such as eating, dressing, and bathing) important to daily living, such as cooking, writing, and driving. (from AA)

Kitchenette: Each facility may have its own definition of a kitchenette, but generally one includes a sink, cabinet space, and a mini-refrigerator, maybe a microwave. In contrast, a full kitchen would usually have a burner unit, sink, cabinets, full-size refrigerator, and possibly a microwave or stove.

Licensed Practical Nurse (LPN): LPNs are trained to administer technical nursing procedures as well as provide a range of health care services, such as administration of medication and changing of dressings. One year of post high school education and passage of a state-licensing exam is required.

Life Care Community: A Continuing Care Retirement Community (CCRC) that offers an insurance type contract and provides all levels of care. It often includes payment for acute care and physician's visits. Little or no change is made in the monthly fee, regardless of the level of medical care required by the resident, except for cost of living increases.

Living Will: A written document, which states the wishes of an individual in advance concerning the use of life saving devices and procedures in the event that the person is terminally ill or has suffered an injury and is no longer competent. (from LTCInsurance)

Long-Term Care: Care given in the form of medical and support services to persons who have lost some or all of their capacity to function due to an illness or disability. (from LTCInsurance)

Long-term Care Insurance: The insurance which pays for a succession of care giving services for the elderly or chronically ill. This care may be provided in a facility (nursing home, mental hospital, etc.) or in the individual's home with a nurse or aide. (from LTCInsurance)

Managed Care: Can best be described as the partnership of insurance and a health care delivery system. The basic goal of managed care is to coordinate all health care services received to maximize benefits and minimize costs. Managed care plans use their own network of health care providers and a system of prior approval from a primary care doctor in order to achieve this goal. Providers include: specialists, hospitals, skilled nursing facilities, therapists, and home health care agencies.

Medicaid: Public assistance funded through the state to individuals unable to pay for health care. Medicaid can be accessed only when all prior assets and funds are depleted. There are income eligibility criteria that must be met to qualify for Medicaid. Medicaid accounts for about 52 percent of the nation's care costs, and is the source of payment for almost 70 percent of residents in nursing homes. Medicaid can reimburse Nursing Facilities for the long-term care of qualifying seniors, and in some states, Medicaid pays for Assisted Living care through Medicaid waivers. (from LTCInsurance)

Medicare: A federal health insurance program for people age 65 and older and for individuals with disabilities. (from AA) The Social Security Administration regardless of income administers Medicare. It also provides for hospital and nursing facility care (Part A) and physician services, therapies, and home health care (Part B).

Medical Director: The medical director coordinates with an individual's personal physician to ensure that the facility delivers the care that is prescribed. In some instances, the medical director may be a resident's primary physician. A staff medical director assumes overall responsibility for the formulation and implementation of all policies related to medical care.

Medications Management / Medication Administration: Formalized procedure with a written set of rules for the management of self-administered medicine, as in an assisted living setting. A program may include management of the timing and dosage for residents, and could include coordination with a resident's personal physician. The resident must take the medication him or herself. For instance, the facility can remind the resident that she needs to give herself the medicine injection, but the facility cannot perform the actual injection itself.

Medigap Insurance: Private health insurance that is used to pay costs not covered by Medicare, such as deductibles and co-insurance (from LTCInsurance)

National Association of Insurance Commissioners (NAIC): A national organization made up of state officials who are in charge of regulating insurance. They have considerable influence and strive to promote national uniformity in insurance regulations. (from LTCInsurance)

Non-Ambulatory: Inability to walk independently, usually bedridden or hospitalized.

Not-for-Profit: Status of ownership and/or operation characterized by government by community-based boards of trustees who are all volunteers. Board members donate their time and talents to ensure that a not-for-profit organization's approach to caring for older people responds to local needs. Not-for-profit homes and services turn any surplus income back into improving or expanding services for their clients or residents. Many not-for-profit organizations are often associated with religious denominations and fraternal groups. Not-for-profits may also interact with Congress and federal agencies to further causes that serve the elderly.

Nurse Assistant: Nurse assistants work under the supervision of a Registered Nurse or Licensed Practical Nurse. A Nurse Assistant provides the most personal care to residents, including bathing, dressing, and toileting. Must be trained, tested, and certified to provide care in nursing facilities that participate in the Medicare and Medicaid programs.

Nursing Home: Provides 24-hour skilled care for the more acute patients. Patients generally rely on assistance for most or all daily living activities (such as bathing, dressing and toileting). (from ALFA) One step below hospital acute care. Regular medical supervision and rehabilitation therapy are mandated to be available, and nursing homes are eligible to participate in the Medicaid program. These facilities are State Licensed. Also referred to as Nursing Facility or Convalescent Home. See also Skilled Nursing Facility.

Occupational Therapy: A creative activity prescribed for its effect in promoting recovery or rehabilitation. This is done to help individuals relearn activities of daily living and is generally administered by a licensed therapist.

Physical Therapy: The treatment of disease or injury, by physical and mechanical means (as massage, regulated exercise, water, light, heat, and electricity.) Physical therapists plan and administer prescribed physical therapy treatment programs for residents to help restore their function and strength.

Quality care: Term used to describe care and services that allow recipients to attain and maintain their highest level of mental, physical, and psychological function, in a dignified and caring way.

Real Estate: These housing options offer home ownership opportunities for adults 55 years of age and older, or sometimes 62 years and older. Some communities offer rental programs and rent-to-own options. The types of residences you may find are: Single Family Homes, Cottages and Patio Homes, Condos and Townhouses, Manufactured Homes, Gold Communities and Gated Communities.

Registered Nurse (RN): Graduate trained nurse who has both passed a state board examination and is licensed by a state agency to practice nursing. A minimum of two years of college is required in addition to passage of the state exams. The RN plans for resident care by assessing resident needs, developing and monitoring care plans in conjunction with physicians, as well as executing highly technical, skilled nursing treatments.

Rehabilitation: Therapeutic care for persons requiring intensive physical, occupational, or speech therapy in order to restore to the patient to a former capacity.

Residential Care: See Assisted Living. Respite Care: Services that provide people with temporary relief from tasks associated with care giving (e.g., in-home assistance, short nursing home stays, adult day care). (from AA)

Senior Apartment: Age-restricted multiunit housing for older adults who are able to care for themselves. Usually no additional services such as meals or transportation are provided. Similar to Independent Living.

Senior Citizen Policies: Insurance policies for those over the age of 65. In many cases these policies are in combination with coverage provided by the government under the Medicare Program. (from LTCInsurance)

Support group: Facilitated gathering of caregivers, family, friends, or others affected by a disease or condition for the purpose of discussing issues related to the disease. (from AA)

see www.uselderguide.com for more information

Califorina Elderly Stats

California is projected to be one of the fastest growing States in the nation in total population. In 1990, California comprised 12 percent of the nation's population and is expected to have 14 percent of the nation's population by 2020 (an increase of 15.7 million people). In California, the elderly population is expected to grow more than twice as fast as the total population and this growth will vary by region. The maps show the percentage increases for the elderly (age 60 and over) and the oldest old (age 85 and over) populations from 1990 to 2020 for all 58 counties in California. The numbers encircled refer to Planning and Service Areas (PSA). Within each PSA is an Area Agency on Aging responsible for planning and administering services for seniors.
Percentage Increase of the Elderly Population: 1990 to 2020
The elderly age group will have an overall increase of 112 percent during the period from 1990 to 2020. More than half the counties will have over a 100 percent increase in this age group. Eleven of these counties will have growth rates of over 150 percent. These counties are located throughout the central and southern areas of the State. The influence of the 60 and over age group on California is expected to emerge most strongly between 2000 to 2020. see www.uselderguide.com for more info.

How is a Board and Care Home different from Assisted Living Facilities or a Nursing Home?

With the proliferation of housing-with-services in recent decades, many types of assisted living facilities have opened, providing a wide range of services. So long as a person does not need daily services of medical professionals, an assisted living facility may be available that helps with most every aspect of personal care such as dressing, grooming, eating, toileting and getting around. In the days when most seniors had to go to a nursing home if they needed such comprehensive custodial care, the Board and Care homes provided minimal assistance. The larger facilities were often called “retirement homes,” and required that the senior be capable of getting to the dining hall for meals, and be independent in most activities. The staff might monitor the resident’s medications to be sure they were taken on time in the right dosages. Housekeeping and laundry were commonly provided by the staff. The typical large Board and Care home offered little else in the way of personal assistance. The smaller 2-6 bed facilities often did a lot more for the residents, such as assistance with dressing, toileting and getting around. Many of these had special licenses qualifying them to perform those extra personal services. www.uselderguide.com for more information.

Nowadays, even though Board and Care is just one type of assisted living, it is a very important type. Because of their history, Board and Care facilities are subject to state licensing laws, so can be held to recognized standards of care, and if there are problems such as inadequate care, the facility can be reported to the government body that regulates it. In addition, government funding sometimes can cover the cost of living in a Board and Care (www.hendomhome.com), for people receiving public assistance payments (SSI)

It’s important to remember that “mom and pop” Board and Cares, and other types of assisted living facilities, are not always closely regulated. Because of this, standards of care are not uniform, and services vary greatly from one facility to the next. If you are looking for an assisted living arrangement, it’s important to ask about each facility’s certifications and licenses, then check their validity. A government-backed licensing program is likely to be more specific in standards of care than a commercial company who does certification. Even with licensing, though, government agencies may only infrequently monitor facilities, so it’s important to drop in unannounced to confirm that conditions are safe and sanitary, that promised services are being provided, and that no elder abuse or neglect is occurring.A Board and Care Home differs from a Nursing Home in that it has very limited, if any, onsite medical care. A Nursing Home is for people who require daily supervision and care provided by medical professionals such as registered nurses and certified nurse assistants, under the supervision of licensed physicians.

Cost of Senior Care

The cost of senior housing depends a lot on the range of services you want or need. At the high end are Continuing Care Retirement Communities (CCRCs) that provide all options from independent living to nursing home care. Purchasing a living space can cost from $20,000 to way over $100,000 in many areas; then there’s a monthly fee from $1000 to $4000, which is lowest while you function independently and highest if you need nursing home care.
In the mid-range there are the board & care homes which provide communal meals and some personal care. They go by different names in various places such as “residential care facility” or “personal care home.” They may be converted single-family houses with 2 to 6 residents, or larger apartment complexes. As an example of costs, the monthly rates in California range from $850 to $4000.
At the low-cost end, there is some subsidized senior housing--sometimes called congregate housing, HUD housing or Section 8 Housing--where you pay part of the rent and government funding covers the rest. Your rent is based on the ability to pay—usually a percentage of your income. Unfortunately, many of these programs have long waiting lists and you must have limited income and assets to qualify.
For most types of senior housing, like housing in general, the prices continue to rise over time.
for more help contact www.uselderguide.com , www.californiaseniorguide.com, www.hendonhome.com.

About US

http://www.uselderguide.com/ is a free referral service for families choosing an assisted living facility. We have been helping the senior community and their families find housing options since 1993.Selecting eldercare for a loved one is a difficult choice, US Elder Guide has experienced consultants to help sort through the many care options available today. These options include assisted living communities, Alzheimer's care, board and care homes, nursing homes, respite care, retirement communities, homecare and hospice care. This personalized service is offered at no charge to consumers.During your initial conversation with one of our consultants we will review your loved ones:

» Physical needs
» Social needs
» Desired location
» Mental status
» Finances

Addressing these issues will help our advisors refer you the best matched facility. Your advisor will then review all the available choices and refer your loved one to the most highly qualified residences. Your advisor will be available to you through the duration the entire decision-making process, providing information and assistance so you can make a confident decision in finding elder care. http://www.uselderguide.com/aboutus.html

Tips when searching for a care home

Tips to help you find the right home for your loved one.

Tip #1: Cleanliness is next to godliness - Is the community fresh and clean? Look past the furnishings and into corners, baseboards, and windows. Ask how often housekeeping is provided in the apartment or room. What services does maintenance provide? What is their response time?
Tip #2: Smells - Odors may indicate lack of cleanliness or a temporary problem that was caused by a recent incident. If you find odors in a concentrated area of the tour this may indicate a single incident. Odors throughout the community are likely to indicate a problem. Ask the manager what they believe to be the problem before proceeding.
Tip #3: Activities - Ask to watch activities. Are they well attended? Does the staff seem to be enjoying the activity as well? View the community event calendar. Do they match your loved one's interests? Look for small and large group activities, trips or outings. Inquire about religious services if this is important.
Tip #4: Care takers - Staff attitude and friendliness are of the utmost importance. Observe the staff interacting with current residents. Do they listen and make eye contact? If you feel welcomed while you tour, so will your loved one. Make sure to get a good understanding of the staffing pattern. How many people are truly involved in his/her care? Introduction to the management team will help you understand the goals of the property. Is the manager willing and available to meet with you? Do you have confidence in his/her management style and experience?
Tip #5: Outdoors & Fresh Air - Everyone wants to go outside on beautiful spring days. Investigate the outdoor areas for the residents. Does it feel safe and secure? Find out if the staff uses the same area for breaks. Do they host activities such as gardening in these areas?
Tip #6: Food - The dining room experience is very important to seniors. Discuss entree choices and ask about dining hours and procedures. Bring your loved one in for a meal to taste the food and meet some of the residents. Discuss what happens if a resident cannot make it to the dining room for a meal. Don't forget to ask about the laundry service. Who does the laundry and what is the cost? Ask about laundry procedures.
Tip #7: Security - Safety and security features are very important for seniors. Are the bathrooms accessible and do they have grab bars in convenient locations? How does a resident contact staff if they have an emergency in their room or apartment? What other safety features are available in the apartment and throughout the community? Ask about the staffing pattern to understand who will be on-site to assist the resident. How may licensed nurses or staff members are available? What are the staffing patterns at night versus in the daytime? How are medications managed?
Tip #8: Care Levels - As you tour, ask lots of questions on personal care. Look at current residents. Are they clean-shaven with well-groomed hair and nails? Discuss bathing options and your loved one’s preferences. Are the residents dressed appropriately? Are the staff treating residents with respect and a smile?
Tip #9: Check Out times - No senior likes to move a lot. Ask about specific move-out criteria. Under what circumstances is a resident asked to move? What type of notice is given by them or by you? In many cases, a 30-day notice may be required.
Tip #10: Gut Feeling - As you're touring, can you imagine you or your loved one living there and being comfortable? Did you feel at ease while touring? Was the staff friendly and inviting? The property doesn’t have to be the most beautiful to be the best place for them to live comfortably! Follow your instincts and your heart.
http://www.uselderguide.com/ for more help.

Assisted Living Right Choice

When searching for care for your elderly loved one the choice is usually a difficult one - Assisted living facility, residential care home, Nursing homes, large facility, small facility - the choices are limitless. Utilizing a reputable referral agency helps take the guess work out finding the right care. www.uselderguide.com had a thorough listing of senior care facilities throughout the US. Also try www.californiaseniorguilde.com they specialize in assisted living in Los Angeles, San Diego and Orange County. Their are also specialized homes I found www.hendonhomes.com they specialize in Japanese senior care and seniors with Japanese heritage with Japanese television programing, Japanese newspapers, food from Japan and Japanese staff. If you are looking for specific care for you elderly loved one try one of these sites I'm sure you'll find the staff knowledgeable and willing to help with whatever your needs are.