Definitions

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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

AARP (American Association of Retired Persons) A non-profit organization engaged in activities such as education, lobbying, research, etc., for the benefit of the senior population.

Activities of Daily Living (ADL) Everyday activities people do independently - eat, bathe, dress, move from bed to chair, use the toilet, maintain bladder and bowel continence - used to measure the ability to function.

Acute Care Care for rapidly developing illness or injury with pronounced symptoms and finite in length. Medical care required for short period of time to cure a certain illness and/or condition.

ADL (Activities of Daily Living) Everyday activities people do independently - eat, bathe, dress, move from bed to chair, use the toilet, maintain bladder and bowel continence - used to measure the ability to function.

Adult Day Care Day care services outside the home, focused primarily on social and custodial care. Social, recreational and/or rehabilitative services provided for persons who benefit from daytime supervision. An alternative between care in the home or an institution. Refers to health support and rehabilitation services provided in the community to people who are unable to care for themselves independently during the day but are able to live at home at night.

Adult Day Health Care More skilled level of care than Adult Day Care, including physical rehabilitation therapy and some nursing and nutrition. Both Adult Day Care and Adult Day Health Care have individually designed programs to meet the needs of adults, some of whom may be physically, mentally or functionally impaired. Many also offer specialized programs for Alzheimer's care.

Adult Foster Care A live-in arrangement where one adult lives with and provides care and/or services to an unrelated individual or family member. Such arrangements may be certified by the state or managed independently.

Ageism Prejudice against people because of their age.

Aging in Place When an older individual continues to live at home or within the community, outside of an institutional environment.

ALF (Assisted Living Facility) Provides a combination of housing, personalized support service and health care. These residential facilities provide care for individuals who cannot live independently, but who do not yet require 24 hour Skilled Nursing care. A non-medical institution providing room, board, laundry, some forms of personal care and usually recreational services. Licensed by state departments of social services, these facilities exist under several names including Domicilliary Care Facility, Sheltered House, Board and Care Home, Community-based Care Facility, Residential Care Facility, etc., assisted living care in a residential setting, usually in a home with a capacity of no more than 6 beds. Also known as Residential Board and Care, Congregate Living Health Facility (CLHF) and Residential Care Facility for the Elderly (RCFE).

Alternate Facility A licensed residence other than a skilled nursing facility where care services are delivered (i.e. hospice, assisted living, Alzheimer's or Christian Science care facility setting.

Alternative Plan of Care Benefit Payment for a special arrangement of services specifically designed to allow the person to reside in a setting other than a nursing facility (i.e. services to provide assistance and capital improvements such as ramps, grab bars and/or durable medical equipment).

Alzheimer's Disease A form of organic dementia resulting in premature mental deterioration, first described in 1906 by German neurologist, Alois Alzheimer.

Alzheimer's Care Some Alzheimer's and Dementia care can be provided by Homecare - Medical Nursing Agencies. Often, care for the senior with Alzheimer's or Dementia is provided through a dedicated Alzheimer's/Dementia facility, or within a separate area of Assisted Living or Skilled Nursing Facilities.

Alzheimer's Units Special living units within skilled nursing facilities or assisted living facilities specifically providing care and services for those with Alzheimer's disease.

American Association of Retired Persons (AARP) A non-profit organization engaged in activities such as education, lobbying, research, etc., for the benefit of the senior population.

Aphasia Loss of the ability to use or understand language.

Assessment A determination of physical and/or mental status by a health professional based on established medical guidelines.

Asset Protection Willful legal planning to achieve protection from Medicaid "spend-down" requirements, typically provided by irreversible trusts.

Assisted Living Facility (ALF) Provides a combination of housing, personalized support service and health care. These residential facilities provide care for individuals who cannot live independently, but who do not yet require 24 hour Skilled Nursing care. A non-medical institution providing room, board, laundry, some forms of personal care and usually recreational services. Licensed by state departments of social services, these facilities exist under several names including Domicilliary Care Facility, Sheltered House, Board and Care Home, Community-based Care Facility, Residential Care Facility, etc., assisted living care in a residential setting, usually in a home with a capacity of no more than 6 beds. Also known as Residential Board and Care, Congregate Living Health Facility (CLHF) and Residential Care Facility for the Elderly (RCFE).

B

Bankruptcy An event we try to avoid by utilizing the insurance mechanism.

Bed Reservation Benefit Pays the cost of reserving a place in a care facility should you be temporarily absent from a facility during a covered stay. Some policies only pay for bed reservation if the absence is due to hospitalization.

Benefit Period The maximum time, usually in days, that a policy will pay the daily benefit. The average stay in a skilled nursing facility is 2.8 years, so many people choose either a 3 year plan (1095 days) or a 4 year plan (1465 days) to cover the average stay plus a little time to spare. Others feel safest with an unlimited benefit period.

C

Capital Improvements Permanent physical adaptations to a residence which enables an individual to remain and function in that environment.

Care Coordinator A health care professional whose training includes managing and arranging for long term care services. This person can be a doctor, nurse, social worker or other similarly trained and licensed professional.

Care Management Services provided by a professional, typically a nurse or social worker, to access, coordinate and monitor the overall medical, personal and social services needed by an individual requiring long term care.

Caregiver - Primary The key person (usually a relative) overseeing and providing care for an incapacitated person.

Caregiver(s) - Secondary Relatives or others who assist part-time in giving care.

Catastrophic Illness Illness resulting in sudden temporary or permanent change or significant disruption to a person's normal lifestyle.

Chronic Care Care for an sick person with an illness continuing over a protracted period of time or recurring frequently. Chronic conditions often begin inconspicuously and symptoms are less pronounced than acute conditions.

CLHF (Congregate Living Health Facility) Provides a combination of housing, personalized support service and health care. These residential facilities provide care for individuals who cannot live independently, but who do not yet require 24 hour Skilled Nursing care. A non-medical institution providing room, board, laundry, some forms of personal care and usually recreational services. Licensed by state departments of social services, these facilities exist under several names including Domiciliary Care Facility, Sheltered House, Board and Care Home, Community-based Care Facility, Residential Care Facility, etc., assisted living care in a residential setting, usually in a home with a capacity of no more than 6 beds. Also known as Residential Board and Care, Assisted Living Facility (ALF) and Residential Care Facility for the Elderly (RCFE).

Congregate Living Facilities providing independent living apartments for seniors in good health who want independence and companionship. Also known as Senior Community, Independent Living and Retirement Homes.

Congregate Living Health Facility (CLHF) Provides a combination of housing, personalized support service and health care. These residential facilities provide care for individuals who cannot live independently, but who do not yet require 24 hour Skilled Nursing care. A non-medical institution providing room, board, laundry, some forms of personal care and usually recreational services. Licensed by state departments of social services, these facilities exist under several names including Domiciliary Care Facility, Sheltered House, Board and Care Home, Community-based Care Facility, Residential Care Facility, etc., assisted living care in a residential setting, usually in a home with a capacity of no more than 6 beds. Also known as Residential Board and Care, Assisted Living Facility (ALF) and Residential Care Facility for the Elderly (RCFE).

Cognitive Impairment Refers to loss or deterioration of mental capacity in people suffering from various conditions including Alzheimer's disease.

Cognitive Reinstatement A provision to continue a policy which has lapsed (providing that back premiums are paid) when the cause of the lapse was due to cognitive impairment.

Continuing Care Retirement Community A residential community providing a variety of living arrangements and services from independent living apartments to ALF and SNF care.

Convalescent Home These live-in facilities provide physician prescribed medical treatment to those who are unable to care for themselves. These nursing care homes focus on patients who have health problems requiring convalescent and/or restorative services. Some patients require short-term physical rehabilitation while recovering from surgery; others in the skilled nursing facility may require long-term nursing and medical supervision. Also known as Nursing Home and Skilled Nursing Facility (SNF).

Custodial Care Services that can be given safely and reasonably by a non-medical person, designed mainly to assist with ADLs, including bathing, eating, dressing and other routine activities.

D

Daily Benefit Amount A specified, maximum daily dollar amount payable on a covered period of care. Policies offer a range of choices in ten-dollar increments. Your choice should take into account the local costs of care, how much you could pay for care out of your own resources (without dipping into savings) and how much money or care you could count on from your family.

Dementia Care Some Alzheimer's and Dementia care can be provided by Homecare - Medical Nursing Agencies. Often, care for the senior with Alzheimer's or Dementia is available in a dedicated Alzheimer's/Dementia facility, or within a separate area of Assisted Living or Skilled Nursing Facilities.

E

Elimination Period A deductible. A specified time period of covered care where no benefits are payable. Ideally, you should select the longest period you could sustain care costs using your available, expendable assets.

H

Home Health Care Refers to a wide range of services, from skilled care and physical therapy to personal care delivered at home or in a residential setting.

Homemaker Services Assistance given in managing and maintaining household activities that allows you to remain safely in your home when you can not manage those activities on your own. May include meal preparation, laundry, cleaning, chores, etc.

Hospice Hospice is a type of palliative care given during the final stages of a terminal illness. Known more commonly as just Hospice, this service promotes a patient's comfort by focusing on the physical and emotional causes of any pain and suffering. Also known as end-of-life care, Hospice is designed to keep pain and suffering to a minimum, not to cure the illness, as the patient's doctor has determined that the patient is terminal and can no longer benefit from regular medical treatment. Hospice care can be provided in the patient's residence, in a singular Hospice facility, or within either an Assisted Living or a Skilled Nursing Facility. All Hospice Agencies are Medicare certified.

I

Independent Living Facilities providing independent living apartments for seniors in good health who want independence and companionship. Also known as Retirement Homes, Senior Community and Congregate Living.

Inflation Protection Increases the daily benefit amount on an annual basis. If elected, increases benefits in order to protect against the effects of inflation. Most common is the Compound 5% Inflation Rider which increases the daily benefit amount each year by 5% of the previous years daily benefit amount. The compound effect really begins to take off around the 15th year, so if you are younger when you buy, this seems to be the best choice. If you are well into retirement, it's a toss-up between paying for the extra protection or simply starting out with a higher daily benefit at the beginning. Under age 70, choose always compound. Over 70 consider a 5% simple option.

Intermediate Nursing Care Assistance needed for stable conditions that require daily, but not 24-hour, nursing supervision. Such care is ordered by a physician and supervised by registered nurses. It is less specialized than skilled nursing care, often involves more personal care, and is generally needed for a long period of time.

L

Living Will and Advance Directives Living wills and other advance directives describe your preferences regarding end of life care. Because unexpected situations can happen at any age, all adults need advance directives.

Long Term Care (LTC) Also called custodial care. Assistance, expected to be provided over a long period of time, to people with chronic health conditions and/or physical disabilities who are unable to care for themselves without the help of another person.

Long Term Care Insurance (LTCI) Insurance available through private insurance companies as a means for individuals to protect themselves against the high costs of long-term care.

LTC (Long Term Care) Also called custodial care. Assistance, expected to be provided over a long period of time, to people with chronic health conditions and/or physical disabilities who are unable to care for themselves without the help of another person.

LTCI (Long Term Care Insurance) Insurance available through private insurance companies as a means for individuals to protect themselves against the high costs of long-term care.

M

Medicaid A means-tested program supported by federal, state, and local funds and administered by each state to provide health care for eligible low-income individuals.

Medicare A federal government insurance program to assist those age 65 and over and the disabled with medical and hospital expenses. Medicare covers only skilled care in a skilled nursing facility and limited skilled nursing care at home. It does not provide benefits for personal or custodial care. Medicare requires co-payments and deductibles.

Medicare Supplement or "Medigap" Policies are private insurance policies that supplement Medicare benefits by covering co-payments and deductibles for medical and hospital expenses. These policies do not provide coverage for personal or custodial care.

Medical Power of Attorney A Medical Power of Attorney is a legal instrument that allows you to select the person that you want to make healthcare decisions for you if and when you become unable to make them for yourself. The person you choose is representative for the purposes of healthcare decision making.

N

Non forfeiture Benefit This benefit returns some of the investment if the coverage is eventually lapsed or dropped. It usually takes the form of a paid-up coverage with reduced benefits. Sometimes this benefit is offered in the form of a "return of premium" which returns all or some of your premium payments after a period of time or upon death. The extra cost can add from 10 - 100% to the premium cost depending upon your specifications.

Nursing Home These live-in facilities provide physician prescribed medical treatment to those who are unable to care for themselves. They provide room and board and a planned, continuous medical treatment program, including 24-hour-per-day skilled nursing care, personal care, and custodial care. Nursing care homes focus on patients who have health problems requiring convalescent and/or restorative services. Some patients require short-term physical rehabilitation while recovering from surgery; others in the skilled nursing facility may require long-term nursing and medical supervision. Also known as Skilled Nursing Facility (SNF) and Convalescent Home.

P

Palliative Care Care given during the final stages of a terminal illness. Known more commonly as just Hospice, this service promotes a patient's comfort by focusing on the physical and emotional causes of any pain and suffering. Also known as end-of-life care, Hospice is designed to keep pain and suffering to a minimum, not to cure the illness, as the patient's doctor has determined that the patient is terminal and can no longer benefit from regular medical treatment. Hospice care can be provided in the patient's residence, in a singular Hospice facility, or within either an Assisted Living or a Skilled Nursing Facility. All Hospice Agencies are Medicare certified.

Personal Care Refers to assistance provided by another person to help with walking, bathing, eating, and other routine daily tasks. It is provided by aides who are not medical professionals but are trained to help with these tasks.

Pre-Existing Conditions Medical conditions that existed prior to the effective date of the policy. Some policies may exclude claims stemming from a condition that falls under this definition for a specified period of time.

Primary Caregiver The key person (usually a relative) overseeing and providing care for an incapacitated person.

R

RCFE (Residential Care Facility for the Elderly) Provides a combination of housing, personalized support service and health care. These residential facilities provide care for individuals who cannot live independently, but who do not yet require 24 hour Skilled Nursing care. A non-medical institution providing room, board, laundry, some forms of personal care and usually recreational services. Licensed by state departments of social services, these facilities exist under several names including Domiciliary Care Facility, Sheltered House, Board and Care Home, Community-based Care Facility, Residential Care Facility, etc., assisted living care in a residential setting, usually in a home with a capacity of no more than 6 beds. Also known as Congregate Living Health Facility (CLHF), Residential Board and Care and Assisted Living Facility (ALF).

Residential Board and Care Provides a combination of housing, personalized support service and health care. These residential facilities provide care for individuals who cannot live independently, but who do not yet require 24 hour Skilled Nursing care. A non-medical institution providing room, board, laundry, some forms of personal care and usually recreational services. Licensed by state departments of social services, these facilities exist under several names including Domiciliary Care Facility, Sheltered House, Board and Care Home, Community-based Care Facility, Residential Care Facility, etc., assisted living care in a residential setting, usually in a home with a capacity of no more than 6 beds. Also known as Assisted Living Facility (ALF), Congregate Living Health Facility (CLHF) and Residential Care Facility for the Elderly (RCFE).

Residential Care Facility for the Elderly (RCFE) Provides a combination of housing, personalized support service and health care. These residential facilities provide care for individuals who cannot live independently, but who do not yet require 24 hour Skilled Nursing care. A non-medical institution providing room, board, laundry, some forms of personal care and usually recreational services. Licensed by state departments of social services, these facilities exist under several names including Domiciliary Care Facility, Sheltered House, Board and Care Home, Community-based Care Facility, Residential Care Facility, etc., assisted living care in a residential setting, usually in a home with a capacity of no more than 6 beds. Also known as Congregate Living Health Facility (CLHF), Residential Board and Care and Assisted Living Facility (ALF).

Respite Care Is nursing home or home care that temporarily replaces the existing level of support received from an informal, non paid caregiver for the purpose of providing care and supervision to the patient while relieving the caregiver.

Retirement Homes Facilities providing independent living apartments for seniors in good health who want independence and companionship. Also known as Independent Living, Senior Community and Congregate Living.

S

Secondary Caregiver(s) Relatives or others who assist part-time in giving care.

Senior Community Facilities providing independent living apartments for seniors in good health who want independence and companionship. Also known as Independent Living, Retirement Homes and Congregate Living.

Skilled Nursing Care Nursing and rehabilitative care provided by or under the direction of skilled medical personnel - available 24-hours a day & ordered by a physician under a treatment plan. Can be either in a facility setting or at-home. Note: Medicare and Medicaid both have their own definitions of "skilled nursing care" which do not necessarily match those found in LTC policies.

Skilled Nursing Facility (SNF) These state licensed live-in institutional setting facilities provide physician prescribed medical treatment to those who are unable to care for themselves. These nursing care homes focus on patients who have health problems requiring convalescent and/or restorative services. Some patients require short-term physical rehabilitation while recovering from surgery; others in the skilled nursing facility may require long-term nursing and medical supervision. Also known as Nursing Home and Convalescent Home.

SNF (Skilled Nursing Facility) These live-in facilities provide physician prescribed medical treatment to those who are unable to care for themselves. These nursing care homes focus on patients who have health problems requiring convalescent and/or restorative services. Some patients require short-term physical rehabilitation while recovering from surgery; others in the skilled nursing facility may require long-term nursing and medical supervision. Also known as Nursing Home and Convalescent Home.

Spend-down Depleting almost all assets to meet eligibility requirements for Medicaid.

T

Third-Party Notification Gives you the option of having the "premium overdue" notice sent to a third party as a precaution to insure that the policy does not unintentionally lapse.

W

Waiver of Premium A provision which allows you to stop paying premiums once you are in a period of covered care. Usually applies to only to a facility stay, although some policies do waive premiums for approved home health care as well. Date when premium stoppage begins varies with each company.

 
     
 
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