Glossary of Home Care Terms

C

Care Manager

A health care professional, typically a nurse or social worker, who arranges, monitors or coordinates long-term care services. Also referred to as a care coordinator or case manager.

Certified Nursing Assistant (CNA)

CNAs are trained and certified to help nurses by providing nonmedical assistance to patients, such as help with eating, cleaning and dressing.

Chronic Illness

A physical or mental disability that continues or recurs frequently over a long period of time; often it is associated with disability.

Cognitive Impairment

Deterioration of intellectual ability, such as disorientation as to people, places or time; impairment of short-term or long-term memory; and/or impairment of one’s ability to reason that has progressed to the extent that a person requires substantial supervision by another person. Cognitive impairment includes Alzheimer’s disease and senile dementia. The existence of cognitive impairment is determined by clinical evidence and standardized tests that reliably measure the person’s impairment. For more information, click on Senile Dementia symptoms.

Continuum of Care

A comprehensive system of long-term care services and support systems in the community, as well as in institutions. The continuum includes 1) community support services such as senior centers; 2) in-home care, such as home-delivered meals, homemaker services, home health services, shopping assistance, personal care, chore services and friendly visiting; 3) community-based services such as adult day care; 4) non-institutional housing arrangements such as congregate housing, shared housing, and board and care homes; and 5) nursing homes and subacute and acute facilities if necessary.

CPR

Cardiopulmonary resuscitation.

Cueing

Directing or supervising the actions of someone with cognitive impairment (for example, showing them how to eat, reminding them which medications to take at the appropriate times, giving visual or verbal reminders for dressing or toileting, etc.).

Custodial Care

Help and supervision with daily living activities—dressing, eating, personal hygiene and similar functions.

D

Depression

An underdiagnosed condition among seniors. Symptoms include a persistent sad, anxious or “empty” mood; loss of interest or pleasure in activities once enjoyed; and difficulty sleeping. With proper medical care, depression is reversible.

Diastolic Pressure

Blood pressure reading when the heart is resting between beats; the second number in a blood pressure reading. See Systolic Pressure.

Dietician

One qualified by training and education in establishing dietary procedures and planning menus for regular and special diets.

Director of Nursing

A registered nurse (RN) who oversees the nursing department, including nursing supervisors, licensed practical nurses, nurse’s aides and orderlies. A director of nursing typically writes job descriptions, hires and fires members of the nursing staff, and writes and executes procedures and policies for a nursing practice.

Discharge Planner

A social worker or other health care professional who assists hospital patients and their families in transitioning from the hospital to another level of care such as rehabilitation in a skilled nursing facility, home health care in the patient’s home or long-term care in a nursing home.

Diuretics

A class of drugs given to help the body rid itself of excess fluid; they are often used on older persons with heart disease.

Durable Medical Equipment

Medical equipment that is ordered by a doctor for use in the home. These items, such as walkers, wheelchairs and hospital beds, must be reusable. Durable medical equipment is paid for under Medicare, subject to a 20% coinsurance of the Medicare-approved amount.

E

Edema

Collection of fluids in tissues that results in swelling.

Emergency Monitoring System (Personal Emergency Response System)

An electronic device, usually worn as a pendant or bracelet, which can be activated at the touch of a button in an emergency situation. When the alarm is activated, it sends a signal to a 24-hour emergency response center, where an operator attempts to establish two-way contact with the client and dispatch appropriate assistance. Emergency monitoring services are usually private pay and are rarely covered by Medicare/Medicaid.

F

Functional Impairment

Requiring assistance with one or more personal care services including, but not limited to, bathing, dressing and undressing, meal preparation and clean-up, grooming and toileting.

G

Gatekeeper

A term sometimes used to refer to HMO primary care physicians or nurse practitioners because of their responsibility for referring members to specialists or other services.

Geriatric Care Manager (Aging Life Care Professional)

A professional Geriatric Care Manager has been educated in various fields of human services — social work, psychology, nursing, gerontology — and trained to assess, plan, coordinate, monitor and provide services for the elderly and their families. Advocacy for older adults is a primary function of the care manager.

Geriatric Social Worker

A licensed professional who assists the elderly and their families in understanding and coping with the social, emotional and psychological aspects of aging.

Geriatrician

A medical doctor with special education and training in the diagnosis, treatment and prevention of disabilities in older people.

Geri-Chair

A wheelchair that cannot be self-propelled and has a high back, a foot ledge and a removable dining tray.

Gerontologist

A professional who specializes in the mental and behavioral characteristics of aging.

Grab Bar

Bars or railings placed around tubs, showers and toilets to be used to steady oneself.

H

Homebound

Unable to leave home or cannot leave home without considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for nonmedical reasons, such as a trip to the barber.

Home Health Aide

A person who provides personal care including bathing, dressing and grooming, and some household services.

L

Licensed Health Care Practitioner

A physician (as defined by the Social Security Act) or a registered professional nurse, licensed social worker or any other health care worker who meets the requirements of the U.S. Treasury Department.

Licensed Practical Nurse (LPN)

One who has completed one or two years in a school of nursing or vocational training school. LPNs are in charge of nursing in the absence of a registered nurse (RN). LPNs often give medications and perform treatments. They are licensed by the state in which they work.

M

Maslow’s Triangle

or hierarchy of needs is a theory of human motivation. Maslow’s hierarchy of needs, is represented as a pyramid with the more basic needs, such as Adl’s and IADL’s at the bottom.

Medical Director

A physician who formulates and directs policy for medical care in a nursing home.

Medication Management

Formalized procedure for the management of self-administered medicine and may include written rules regarding timing, dosage and coordination with a resident’s personal physician.

N

Non-Ambulatory

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

O

Occupational Therapist

A person trained to conduct therapy to maintain, restore or teach skills to improve manual dexterity and hand-eye coordination.

P

Parkinson’s Disease (PD)

PD is a progressive disorder of the central nervous system which affects more than one million Americans. Individuals with PD lack a substance called dopamine, which is important in the central nervous system’s control of muscle activity. PD is often characterized by tremors, stiffness in limbs and joints, speech impediments and difficulty in initiating physical movement. Late in the course of the disease, some individuals develop demineia and eventually Alzheimer’s disease. Medications such as levodopa, which prevents degeneration of dopamine, are used to improve diminished motor symptoms in PD patients but do not correct the mental changes that it causes.

Patient Care Plan

A plan formulated by a registered nurse in conjunction with a physician for the ongoing care and rehabilitation of a nursing home resident to their optimum potential.

Personal Emergency Response System

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.

Physical Therapist

A licensed professional who treats impaired motion or disease through exercise, massage, hydrotherapy or mechanical devices to improve physical mobility.

Physician Assistant

A person who performs a number of tasks that were traditionally performed by the physician (i.e., taking medical histories or making routine examinations). Training for physician assistants usually includes a specialized two-year program. Physician assistants always work under the supervision of a physician.

Plan of Care

The written plan that describes the services and care you need for your health problem. Your plan of care must be prepared or approved by your doctor.

Primary Caregiver

The person, usually the spouse or adult child, who takes on the primary day-to-day responsibility of caring for the physical, psychological and social needs of another person.

Primary Care Physician (PCP)

The doctor who is consulted first when a health problem occurs and on whom the patient relies for advice, referrals and ongoing care.

PRN

An abbreviation used to indicate that a medication is given or treatment performed only as the need arises.

Provider

A properly licensed doctor, health care professional, hospital or other health care facility, including a home health agency, that provides health care or related social services.

Psychotropic Medications

Drugs used in the treatment and control of mental illness.

R

Registered Nurse (RN)

A graduate nurse who has completed a minimum of two years of education at an accredited school of nursing. RNs are licensed by the state in which they work.

Rehabilitation Therapy

Exercises and/or treatments designed to help patients regain lung function.

Respite Care

Temporary caregiving services provided when the primary caregiver needs time away from caregiving. Respite care is provided in-home or at an alternative location for a short stay.

Restraint

A device used to prevent a person from falling out of a chair (e.g., a belt around the waist tied to a wheelchair or a jacket with straps tied to a wheelchair). A jacket restraint could be used to prevent a person from crawling over the side rails of a bed. Wrist restraints are used under unusual circumstances. Restraints should be used as protection for the resident only when other means are not reasonable.

S

Speech Therapist

A rehabilitation professional who provides therapy to overcome speech and communication problems, such as speech difficulties following a stroke. A speech therapist may also provide assistance for managing swallowing problems.

Subacute Care

Typically following a stay in a hospital, this is maintenance care for serious medical conditions that are not urgent or life-threatening. Hospitals typically do not provide subacute care on an ongoing basis. Subacute care may include long-term ventilator care or other procedures provided on a routine basis either at home or by trained staff at a skilled nursing facility.

Support Group

Temporary caregiving services provided when the primary caregiver needs time away from caregiving. Respite care is provided in-home or at an alternative location for a short stay.

T

Transfer

To move a resident (or loved one) from one place to another—from the bed to a wheelchair or from assisted living to skilled care.

Transitional Care

Type of care designed for those who are being discharged from an acute care situation, such as a hospital stay, but are not quite ready to return to their home. Short term in nature, this care may be specialized for specific conditions and also includes rehabilitative services.

V

Visiting Nurse (Private Duty Nurse)

A visiting nurse service provides registered nurses to administer health care to seniors in their own homes. Visiting nurse agencies may provide a wide range of services, both medical and nonmedical. Visiting nurses evaluate and manage their patients’ care at home, working with their physicians to ensure that all medical needs are being met. Visiting nurse services allow seniors to remain in their homes, even when they become ill or physically disabled. Most visiting nurse services are covered by third-party insurance, including Medicaid, Medicare, private insurance and HMOs.

Vital Signs

Temperature, pulse, respiration and blood pressure.

Visiting Physician (House Calls)

Visiting physician services recall the “old-fashioned” tradition of doctors’ house calls. For many seniors who are ill or who have severe physical limitations, visiting a doctor’s office can be extremely difficult. A visiting physician service may be the best solution for these patients. Visiting physicians can provide a broad range of medical care, from routine exams to more comprehensive treatment in the patient’s home. Visiting physicians are usually accompanied by a medical assistant or nurse, as well as portable diagnostic equipment. Visiting physicians work closely with other caregivers to monitor and manage all aspects of the patient’s medical care.

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