Long-Term Care Glossary

Activities of Daily Living (ADL): A term for tasks such as bathing, dressing, transferring, walking, eating, using the toilet and grooming. “Instrumental Activities of Daily Living” include use of the telephone, shopping, meal preparation, housework, laundry, taking medications and managing money.

Acute Care: Hospital service within a limited time frame.

Adult Day Care: A temporary daytime placement provided for people who need supervision.

Alzheimer’s Disease: The most common form of dementia. It is progressive and irreversible. The person will demonstrate a gradual impairment of memory, thinking, recall, judgment, communication, perception and insight.

Ambulatory: Ability to walk.

Ambulatory with assistance: Mobilizing with a cane, walker or wheelchair.

Ancillary Service: Extra services which are not included in the basic rate of a facility.

Anti-Anxiety Medications: A tranquilizing drug which has a calming or soothing effect.

Anti-Depressant Medication: A drug that stabilizes mood.

Anti-Psychotic Medication: A more powerful group of tranquilizing drugs.

Assisted Living Facility (ALF): Also known as Residential Assisted Living Facility (RALF). Housing for individuals who need some assistance with activities of daily living. There is 24- hour- a-day staff to assist with resident needs and some medical care.

Bariatric: The care of and special equipment needs of the severely obese patient.

Bowel and Bladder Training: A specific program to retrain the bowel and bladder functions with the goal of minimizing or eliminating the symptoms.

Conservatorship: A court proceeding in Idaho whereby someone seeks appointment as conservator to handle an incapacitated person’s estate or financial affairs.

Continent: Ability to control urine and bowel elimination.

Creutzfeldt-Jacob Disease: A rapidly progressing (a few months to a year), fatal dementia. Symptoms include cognitive decline, personality and behavior changes and problems with coordination.

Custodial Care: Long term care of someone who is stabilized medically. Does not require skilled nursing or rehabilitation.

Decubitis Ulcer: Also known as pressure sore or bedsore. A skin sore or ulcer, typically caused from sitting or laying in one position too long.

Dementia: This term refers to loss of intellectual function. Alzheimer’s disease is the most prevalent dementia.

Dementia with Lewy Body: Also known as Lewy Body Dementia, Lewy Body Disease, Diffuse Lewy Body Disease, Cortical Lewy Body Disease, Lewy Body Variant of Alzheimer’s and Parkinson’s disease with dementia. Deposits of abnormal proteins called “Lewy bodies” disrupt brain function. It is noted for visual hallucinations, fluctuating cognition, stiffness of movement and lack of facial expression.

Dietician: A professional who is trained in planning menus and special diets.

Disorientation: A loss of bearings with respect to person, place and time. Loss of sense of familiarity.

Do Not Resuscitate (DNR): A physician order indicating that in the event the heart and or breathing stops, no intervention should be started by staff.

Durable Medical Equipment (DME): Equipment used for repeated medical purpose. Common examples are wheelchairs, walkers and oxygen equipment.

Durable Power of Attorney or Financial Power of Attorney: A estate planning document that allows the principal to appoint an agent to act for the principal with regard to financial matters specified in the power of attorney document. The financial power of attorney may be immediately effective (granting the agent immediate power to act) or springing, meaning that the agent’s authority does not “spring” into existence until proof of incapacity of the principal is established.

Durable Power of Attorney for Health Care or Health Care Power of Attorney: A document that appoints someone as the authorized agent (attorney-in-fact or proxy) for health care decisions. Appointing someone provides that person with the authority to consider the medical circumstances and interpret wishes accordingly.

Frontotemporal Dementia: A disorder that affects the frontal and temporal lobes of the brain. It progresses faster than Alzheimer’s. It is associated with personality changes, loss of judgment and inappropriate social skills. Emotions might be complete apathy or excessive excitement. Pick’s Disease is one example of Frontotemporal Dementia.
Global Deterioration Scale: Also known as the GDS or the Reisberg Scale. Established in 1982, this scale tiers the progression of Alzheimer’s disease. It divides the disease into seven stages of diminishing ability.
Home Care: Non-medical assistance in the home. Services generally include: assistance with bathing, dressing, grooming, transfers, meal preparation, light housekeeping and laundry.

Home Health Care: Skilled medical assistance in the home. Services include Physical Therapy, Occupational Therapy, Speech Therapy, Respiratory Therapy, Nursing, Social Work, Nutritional Counseling and Home Health Aide.

Hospice: A medically directed program for patients and families facing terminal care. Hospice focuses on comfort, not cure. A Hospice team includes a Physician, Nurse, Social Worker, Chaplain and volunteers who are dedicated to helping people die with dignity.

Huntington’s disease: Inheritance of a single gene causes this brain disorder. Characterized by mood swings, muscle twitches troubles with balance and trouble with memory.

Incapacitated: A finding of legal incapacity requires a court proceeding in connection with a guardianship or conservatorship petition. Determination of incapacity includes proof of a disabling condition or cognitive impairment.
Living Will: A document that allows you to give advance direction if you cannot speak for yourself as to how you would like to be treated at the very end of your life. The key issue the Living Will addresses is whether you would like your life to be artificially prolonged if two doctors certify that you are terminal and your death is imminent.

Long-Term Care: An assortment of services that help people with health and personal needs over a duration of time. It might be in a nursing home, an assisted living facility or at home. Most long-term care is considered custodial care.

Medicaid: A federal program that is administered by the Department of Health and Welfare in Idaho that will pay for skilled nursing care, assisted living care (as long as the ALF accepts Medicaid) and for some in-home care (under the Home & Community Based Services program).

Medicare: A medical plan that is managed by the Federal Government. It covers certain medical services in hospitals as well as other settings. Services are covered under Medicare Part A and or Medicare Part B. The recipient has to pay a deductible as well as a co-payment. Many recipients also have a supplemental policy to pay for costs not covered by Medicare.

Mini-Mental Status Exam: The MMSE is a commonly used quick tool to assess cognitive function. It indicates decline in orientation, comprehension, attention, calculation, recall and language.

Mixed Dementia: Indicates that Alzheimer’s disease and vascular dementia occur at the same time. Researchers recommend diagnosis of mixed dementia when a person demonstrates dementia symptoms and cardiovascular disease that slowly progresses.

Multi-Infarct Dementia: One type of vascular dementia. Infarct means damaged area and generally refers to the damage caused by a transient ischaemic attack (TIA or small stroke). The brain damage caused by lots of these small strokes can build up, resulting in the symptoms of dementia.

Nasal Gastric Tube (NG tube): A tube which runs from the nose to the stomach. It is a method of administering medications and nutrition directly into the GI tract.

Normal Pressure Hydrocephalus: When the fluid surrounding the brain and spinal cord does not drain right, this disorder can occur. Individuals experience cognitive decline, delay in response, difficulty walking and bladder incontinence. A possible treatment is placement of a tube, or shunt, to drain fluid from the brain.

Occupational Therapist (OT): This therapist assists in developing skills for “the job of living”. Treatment helps to improved ability to perform activities of daily living (ADL’s). An OT recommends adaptive equipment and teaches ways of dealing with physical and cognitive limitations.

Ombudsman for the Elderly: The federal Older Americans Act requires every state to operate a long-term care ombudsman program. The ombudsman is responsible for advocating on behalf of residents of nursing homes, assisted-living facilities and other long-term care facilities. The ombudsman provides information about options and rights and can resolve complaints.

Osteoarthritis: A degenerative joint disease. It is a non-inflammatory, slowly progressing disorder.

Osteoporosis: An age related condition in which bones are weakened, making them susceptible to fracture.

Physical Therapist: This therapy is concerned with maximizing the potential of movement. The focus may be rehabilitation or prevention of injury.

Pick’s Disease: This is a frontotemporal dementia (meaning it occurs in the frontal and temporal lobes of the brain). What distinguish Pick’s from Alzheimer’s disease are the very early changes in personality and behavior. Other Alzheimer’s like symptoms include changes in speech pattern, impaired cognition, compulsive behavior and abrupt mood changes.

Power of Attorney: See “D” above for Durable Powers of Attorney governing financial and health care decision-making.

PRN: A medical abbreviation meaning “as needed”.

Psychotropic Medication: Medications that treat and control behavior associated with dementia or mental illness.

Resident Rights: Federally mandated rights for every resident in a long-term care setting.

Respite: Implies a temporary break in providing care.

Restraint: An example of a physical restraint is a “seatbelt restraint” or a “lap-buddy”. A chemical restraint implies a medication sedation which exceeds the helpful effect of the drug.

Skilled Nursing Facility (SNF): Commonly referred to as a “nursing home”. This is a level of care for patients who require daily involvement from nursing or rehabilitation staff.

Social Worker (Medical): This professional provides the support needed to cope with chronic, acute or terminal illness. They counsel patients, advise family caregivers and coordinate health related services

Subacute Care: Skilled, medical care that is not provided in the acute hospital setting. Skilled Nursing Facilities can offer subacute level of care. This level indicates that a patient requires an RN or skilled therapy services.

Transient Ischaemic Attack (TIA): TIAs are commonly known as “small strokes” or “baby strokes.” It is a temporary interruption of the blood supply in the brain. The symptoms might be speech slurring and weakness on one side of the body. The symptoms commonly clear within 24 hours.
Urinary Tract Infection (UTI): An infection in the urinary tract.
Vascular Dementia: Caused by problems with the supply of blood to the brain. This is generally recognized as the second most common type of dementia. It is sometimes known as “post stroke dementia.” Brain changes occur in steps (abrupt and noticeable), instead of the slow decline that is seen in Alzheimer’s. This person may have a history of heart attack, stroke, hardening of the arteries or high cholesterol.
Wernicke-Korsakoff Syndrome: Also known as Korsakoff psychosis or alcoholic encephalopathy. A loss of brain function because of vitamin B1, or thiamine, loss. This is typically from malnutrition common in those with alcoholism. The syndrome can also be associated with AIDS and some cancers.