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Glossary of Terminology in the Care for the Elderly

Long Term Care - Residential Care - Home Care - Caregivers - Day Care - Assisted Living Facilities


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Glossary of Terminology

This is a short Glossary with an explanation of the terminology used in the Care for the Elderly. We tried to include the most common terms, but it is by no means complete. If you feel, we have left out an important term, please send us an e-mail with the term and an explanation and, if it is relevant, we will see that it is included.


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The first thing you have to understand is that CARE FOR THE ELDERLY, its regulations and oversight is STATE BUSINESS. The Federal Government has some influence through the FDA and the Department of Social Services, but the primary regulatory Authority is the State.

This is a general glossary. Some States use variations of the terminology shown, so it is a essential that you look at the social services website of your state to get the exact details for the area you live in or where you consider placing a charge. Licensure regulations change on almost a daily basis, and you should be aware that some information on this site may no longer be accurate. Check with local Social Services to get the most up to date information

In-Home Caregivers and Companions
(For more details, if available, click on the type of care or facility)

Type of Care or Facility Definition
Care provided by member of Family Completely unregulated. Usually the most cost effective way to provide care. If the care provided is on a voluntary basis, then there is no need to report income to the IRS. However, if you "employ" a member of the family and remunerate that member with some kind of hourly or fixed wage, then you have to "keep books" and that member has to report the income to the IRS.
The Day Care Companion Assistance, in-house monitoring, supervision and help to an individual in maintaining a safe living environment when the person does not want to or is no longer able to do this alone. You have to make payroll deductions and report earnings of the employee to the IRS.
The Homemaker Companion A Homemaker Companion Service is required when total home management is desired. The person cared for is able to look physically after themselves, but may no longer be willing or able to manage his/her household on his/her own. The same employment reporting regulations apply as above.
Personal Care and Homemaker Companion This service is required when total home management is needed and when the client is no longer able to look physically after him- or herself. Overnight supervision might be provided by relatives or in-laws. The same employment reporting regulations apply as above.
Live-in Companion This service provides an almost permanent 24 hour a day presence by the companion. It is an ideal solutions when close around the clock supervision, monitoring and companionship is required or wanted. It is a true and cost effective alternative to a care home. You should be aware that a cleaning service for heavy cleaning will be required. The same employment reporting regulations apply as above.
Live in Caregiver This service provides a round the clock supervision and monitoring of the client and involves total home management when the client is no longer able to look physically after him- or herself. It includes overnight monitoring and supervision. In addition to the caregiver who will perform light to medium household duties, a cleaning service for heavy cleaning will be required.The same employment reporting regulations apply as above.
Home Health Agency Some States operate a Home Health Agency which is either a state-owned and operated agency (often part of social services), or a private nonprofit organization, or a proprietary organization which provides skilled home health care to the public. This is usually initiated by a physician and is provided in the place of residence of the person receiving the care. This care includes at least skilled nursing and other services (depending on the State) which may be physical therapy, speech therapy, occupational therapy, medical social services, and home health aides. Services may include intravenous therapy, respiratory/inhalation therapy, electrocardiogram and hospice services.

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Institutional Care-Homes and Facilities

Type of Care or Facility Definition
Adult Day Health Care An Adult Day Care is a group program designed to meet the individual needs of functionally impaired adults, which is both structured and comprehensive, and which provides a variety of health, social, and related support services in a protective setting.
Adult Family (or Residential) Care Homes Some States allow the operation of an Adult Home. The conditions vary from State to State. An Adult Home is operated for the purpose of providing long-term residential care, room, board, housekeeping, personal care and supervision to five or more adults unrelated to the operator. Adult Homes may be operated by a natural person, a partnership, a not-for-profit corporation, a public corporation or a non-publicly traded business corporation.
Nursing Home/Facility A Nursing Home may be a private home, institution, building, residence or other place, serving two or more persons who are not related to the operator, whether operated for profit or not. Nursing Homes include those places which undertake to provide maintenance, personal care, or nursing for persons who because of age, illness or physical infirmity, are unable to properly care for themselves. These facilities provide (depending on the State) skilled nursing care, intermediate care, mentally disordered care, developmentally disabled care, sub-acute care, hospice inpatient services, and other routine services. Also included are consultation and evaluation services.
Hospice or Palliative Care Homes Hospice provide medically directed program in setting that is often a continuum of home, outpatient, and homelike inpatient care for the terminally ill patient and, sometimes, his/her family. It employs an interdisciplinary team to assist in providing palliative and supportive care to meet the special needs arising out of the physical, emotional, spiritual, social, and economic stresses which are experienced during the final stages of illness and during dying and bereavement.


Assisted Living and Similar Facilities

Type of Care or Facility Definition
Personal Care Home,
Residential Care Facilities or
Residences for Adults -
An Adult Residential Care Home/Facility provides room, board and personal services, for compensation, to two but not more than eight residents (this varies from State to State) in a congregate living and dining setting and is in a home that is designed as any other private dwelling in the neighborhood. In other words it is a residential house rather than an institutional building. The housing arrangements are chosen voluntarily by the resident, the resident's guardian, or other responsible person. The majority of the residents are 60 years of age or older needing varying levels of care and supervision. These are provided as agreed to at time of admission or as determined necessary at subsequent times of reappraisal.
Assisted Living Facility These facilities provide housing, food services and personal services for elderly or disabled adults who require supervision or assistance with the activities of daily living. Assisted Living facilities may provide apartment living (multi room facilities) for an individual, where the residents have a choice of, for instance, taking their meals in a restaurant type facility or individually in their apartments. Top rated facilities also provide leisure activities such as theater, music, golf, aerobics etc.
Continuing Care Retirement Community (a form of an Assisted Living Community) These are housing, care and residential complexes restricted to seniors. The facilities usually include independent living units (apartments or cottages), social activities, meals, supportive assistance and personal care all on a campus-like facility. Nursing Home care is also included and may be provided on or off-campus. The Community's health-related and nursing care are licensed and regulated by the respective State Health Department Some States have strict reviews of the community's financial status and pricing structure. Others are more lax about it. As a general rule, the better the State supervision and control, the better the facilities.

Other Terms Explained

Term Definition
Living Will or Advance Health Directive A LIVING WILL, sometimes called will to live, advance health directive, or advance health care directive, is a specific type of power of attorney or health care proxy or advance directive. It is a legal instrument that usually is witnessed or notarized.

These documents state:

  • That the principal is appointing an individual to direct their health care decisions should the principal be unable to do so (e.g. called "power of attorney for health care"), or
  • Specific directives as to the course of treatment that is to be taken by caregivers, or, in particular, in some cases forbidding treatment and sometimes also food and water, should the principal be unable to give informed consent ("individual health care instruction") due to incapacity.

In the USA, most states recognize living wills or the designation of a health care proxy. However, a "report card" issued by the Robert Wood Johnson Foundation in 2002 concluded that only seven states deserved an "A" for meeting the standards of the model Uniform Rights of the Terminally Ill Act. Surveys show that one-third of Americans say they've had to make decisions about end-of-life care for a loved one.



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