common terms & descriptions
is someone who works to help another person with activities of daily living. Personal care aides usually work with home care agencies that provide non-medical, personal care services in people’s private homes.
is health care or supportive care provided by a professional caregiver in the individual home where the patient or client is living, as opposed to care provided in group accommodations like clinics or nursing homes. Homecare is also known as domiciliary care, social care or in-home care.
provide vital support for the elderly and individuals with disabilities, which allow them to stay in their homes as a cost-effective alternative to receiving care in a nursing home facility. There are several jobs for home care aides, including home health aides and personal care aides.
Home Health Aides are employed by home health agencies that bring medical care into people’s homes. This care is typically paid for by Medicare or Medicaid are usually certified by Medicahelp patients in a variety of ways, which may include taking their vital signs or giving them medicine under a nurse’s direction.
can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But caregiving may also be stressful and sometimes even overwhelming. You may be "on call" for 24 hours a day. You may also be working outside the home and taking care of children. So, you need to make sure that you are not ignoring your own needs. You have to take care of your own physical and mental health as well. ** Because when you feel better, you can take better care of your loved one. It will also be easier to focus on the rewards of caregiving.
A nurse, social worker, or other healthcare professional who plans and coordinates services for an individual’s care. This person usually works for an agency or care setting. (Also see Geriatric Care Manager.) Source: Pioneer Network ©2011
A detailed written plan that describes what is needed for an individual’s care and provided by a range of health professionals, including nurses, therapists, social workers, nursing or personal assistants. For those living at home, a good care plan should also list the caregiving activities that family members are able to do, need help learning how to do, and will be doing. “I” Care Plans are written in the first person, as if the person receiving care wrote it her- or himself, and express the desires of the individual for her or his care. Care plans can describe the risks that an individual is prepared to take in exercising his or her autonomous self-determination and choice. Creating the care plan should involve an interdisciplinary team of the care recipient, caregivers, including the nursing assistant, as well as the family as appropriate. Source: Pioneer Network ©2011
Assistance for families in assessing the needs of older adults and making arrangements for services to help the older adult remain as independent as possible. Centers for Medicare & Medicaid Services (CMS): With a budget of approximately $650 billion and serving approximately 90 million beneficiaries, the Centers for Medicare & Medicaid Services (CMS) plays a key role in the overall direction of the healthcare system. With regard to long-term care, CMS is responsible for regulating and paying nursing homes, home health agencies, and hospices for the care of Medicare and Medicaid (in conjunction with the states) beneficiaries. Source: Pioneer Network ©2011
A person trained and certified to assist individuals with non-clinical tasks such as eating, walking, and personal care. (See definitions for Personal Care and ADLs.) This person may be called a “direct care worker” (DCW). In a hospital or nursing home the person may be called a nursing assistant, a personal care assistant, or an aide. Creating Home: A Guide to Better Care Options for an Aging America Citizen Advocacy Group (CAG): A CAG is a state or regional nonprofit organization dedicated to improving the quality of long-term care. Members of a CAG may include long-term care recipients, their families and friends, citizen advocates, long-term care ombudsmen, and organizations subscribing to the CAG’s purpose. Source: Pioneer Network ©2011
These are registered nurses with specialized education and training beyond the basic registered nurse level. Some are called clinical nurse specialists, and some are called nurse practitioners. (See Nurse Practitioner.) Source: Pioneer Network ©2011
A professional providing medical, nursing, and other healthcare related services. Source: Pioneer Network ©2011
A person trained to provide basic health care tasks for older adults and persons who are disabled, in their home. Tasks include personal care, light house cleaning, cooking, grocery shopping, laundry and transportation. Tasks may also include taking vital signs (such as heart rate and blood pressure) or app Source: Pioneer Network ©2011
responsible for managing the individualized patient care by promoting and restoring patients' health through the nursing process; collaborating with physicians and multidisciplinary team members; providing physical and psychological support to patients, friends, and families
plans and manages patient care according to each patient’s needs. Interviews patients and records their medical history and physical condition. Obtains patients and records their medical history and physical conditions.
is one who receives care; an individual with a medical condition or who requires support with activities of daily living and is in a relationship with a caregiver, such as a doctor, nurse, friend, or family member, who provides treatment, assistance, or comfort -National Alliance for Caregiving & AARP.
- Home and community-based medically complex nursing care means skilled nursing services provided in the home and community to an eligible individual, inclusive of the pediatric and adult population, who requires daily ongoing medical care, including skillful observations and monitoring, clinical judgments, and interventions to correct or ameliorate the individual’s overall status, well-being and quality of life. These services are –
- Provided by a registered nurse, licensed practical nurse, or licensed vocational nurse;
- Under the direction of the individual’s physician;
- Defined by the highest scope of nursing licensure with regard to safety, medical necessity, and level of care; and
- Home and community-based medically complex nursing care includes –
- Intensive skilled nursing care that covers an individual’s medically necessary care, for up to 24-hour-a-day, for individuals with disability, physical illness, or chronic condition, as defined by the individual’s physician.
- Beyond what is authorized under home health care services paragraph (7) of section 1905(a) of the SSA (42 U.S.C. 1396d(a)).
- Ability for the individual to remain in their home and community rather than a hospital or a skilled nursing facility.
- Such other services specified by the Secretary of Health and Human Services.
- Home and community-based medically complex nursing care eligible individual means –
- An individual with complex medical conditions that may-
- require skilled nursing interventions; or
- be dependent on medical technology.
- Have conditions that require ongoing nursing assessment, clinical judgement and interventions.
- Reasonable likelihood that the individual’s life will be compromised or threatened without such care.
- Other medically necessary conditions as defined by the Secretary of Health and Human Services.
- An individual with complex medical conditions that may-
- Home and community-based medically complex nursing care shall be provided to an eligible individual in any setting in which normal life activities take place outside of the home. (Source: Bayada)
An individual working in a nursing home or assisted living community that provides “hands on” help with activities of daily living (ADLs) to residents. (See Certified Nursing Assistant.). Pioneer Network ©2011
A nurse, social worker, or other professional who coordinates a patient’s transition (move) from one care setting to the next, such as from hospital to nursing home or to one’s own home with home health care and other services. (See “What Level of Care Should I Be Looking For?” Pioneer Network ©2011
is currently a unique hybrid, multiple-payer system, but with elements of single payer (i.e., Medicare, although beneficiaries also contribute through premiums), publicly subsidized private payers (e.g., employer-sponsored health insurance), socialized medicine (e.g., Department of Veterans Affairs, in which government is both the payer and the employer), and self-pay (i.e., out of pocket).
are two separate, government-run programs. They are operated and funded by different parts of the government and primarily serve different groups. If someone is eligible for both Medicare and Medicaid (dually eligible), you can have both. They will work together to provide them with health coverage and lower your costs. Also know that while Medicare and Medicaid are both health insurance programs administered by the government, there are differences in covered services and cost-sharing
- Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income.
Medicaid: is a state and federal program that provides health coverage if you have a very low income.
Private pay, or “out of pocket” is usually the way people pay for personal or non-medical in-home care because this is not covered under Medicare. However in recent years, many Medicare Advantage plans (managed Medicare) offer their members home care, which the plans call “in-home support.
criteria if the individual meets the income eligibility for Medicaid, is usually paid for means an individual or their family that pays for the care they are receiving. Private pay, also known as paying “out-of-pocket” is one of the most widely accepted forms of payment in the home care space.
Veterans are eligible to receive several different in-home services including skilled home health, homemaker, palliative and respite care. Individuals will be assessed and the number of hours will be determined on their needs.
Long Term Services and Supports (LTSS) This terms is used to describe a myriad of services including in-home services, nursing homes, assisted living, adult day servicest.
Unlike traditional health insurance, long-term care insurance is designed to cover long-term services and supports, including personal and custodial care in a variety of settings such as your home, a community organization, or other facility.
Daily functions such as getting dressed, eating, taking a shower or bath, going to the bathroom, getting into a bed or chair, or walking from place to place. The amount of help a person needs with ADLs is often used as a measure to determine whether he or she meets the requirements for long-term care services in a nursing home as well as government subsidized home, and community-based services. (Also see Instrumental Activities of Daily Living.) Source: Pioneer Network ©2011
Medical care for health problems that are new, quickly get worse, or result from a recent accident. Acute care has recovery as its primary goal, typically requires the services of a physician, physician assistant, nurse practitioner, nurse, or other skilled professional, and is usually short-term. It is usually provided in a doctor’s office, a clinic, or a hospital. Adult Day Services: Community-based programs that provide meals and structured activities for people with cognitive or functional impairments, as well as adults needing social interaction and a place to go when their family caregivers are at work. (See also Respite.) Source: Pioneer Network ©2011
AAAs coordinates and offer services that help older adults remain in their home, if that is their preference. Services might include Meals-on-Wheels, homemaker assistance, and whatever else it may take to enable the individual to stay in his or her own home. By making a range of options available, AAAs make it possible for older individuals to choose home and community-based services and a living arrangement that suits them best. (See Eldercare Locator.) Source: Pioneer Network ©2011
A state regulated residential long-term care option that may have different names depending on the state. Assisted living is a facility that provides or coordinates oversight and services to meet residents’ individualized, scheduled needs, based on the residents’ assessment and service plans, and their unscheduled needs as they arise. There are more than 26 designations that states use to refer to what is commonly known as “assisted living.” There is no single uniform definition of assisted living, and there are no federal regulations for assisted living. In many states, most assisted living is private pay. Be sure to check with your state about any waiver programs that might be available through Medicaid to pay for the care provided in assisted living.
A housing option that offers a range of services and levels of care. Residents may move first into an independent living unit, a private apartment or a house on the CCRC campus. The CCRC provides social and housing-related services and might have an assisted living residence and a nursing home, often called the health care center, on the campus. If and when residents can no longer live independently in their apartment or house, they move into assisted living (unless it is provided in their apartment or house) or the nursing home.
A person with a background in nursing, social work, psychology, gerontology or other human services field, who has knowledge about the needs of and services available for older adults. A geriatric care manager coordinates (plans) and monitors (watches over) a person’s care. He or she also keeps in contact with family members about the person’s needs and how their loved one is doing. Most geriatric care managers are privately paid and usually not covered by private insurance. Some long-term care insurance companies use care managers to assess the individual’s need for services and arrange for the needed services.
A medical doctor with special training in the diagnosis, treatment, and prevention of illness and disabilities in older adults. Source: Pioneer Network ©2011