Glossary of Terms

Active 55—a resident in the household must be at least 55 years of age. Amenities might include a clubhouse, a golf course, walking trails, hobby centers, computer labs, and other recreational spaces. These communities usually do not provide for assistance with increased care or any health-related services. Outdoor maintenance is normally included in a monthly homeowner’s association or condominium fee.

Activities of daily living (ADLs)—are routine activities that people tend to do every day without needing assistance. There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence.

Alzheimer’s disease—is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out simple tasks

Assisted living—communities aimed at helping residents remain as self-sufficient as possible with the assurance of assistance when needed. A combination of housing, meals, personal care and support, social activities, transportation and 24-hour supervision is usually provided.

Blue Zones—certain places around the world identified as having high concentrations of centenarians, or people living 100 years or more. The concept grew out of demographic work done by Gianni Pes and Michel Poulain who identified Sardinia's Nuoro province as the region with the highest concentration of male centenarians in the world. Author and Blue Zones founder Dan Buettner identified longevity hotspots in Okinawa (Japan); Sardinia (Italy); Nicoya (Costa Rica); Icaria (Greece); and among Seventh-day Adventists in Loma Linda, California.

Centers for Medicare & Medicaid Services (CMS)—a federal agency within the U.S. Department of Health and Human Services that administers the Medicare program to age-qualified citizens and works in partnership with state governments to administer Medicaid.

Certified home health care—Is primarily engaged in providing skilled nursing services and other therapeutic services in your home; Has policies established by a group of professionals (associated with the agency or organization), including one or more physicians and one or more registered professional nurses, to govern the services which it provides.

Continuing care retirement community (CCRC) —retirement communities with accommodations for independent living, assisted living, and nursing home care, offering residents a continuum of care. A person can spend the rest of his life in a CCRC, moving between levels of care as needed. Most CCRC require payment of a large entrance fee.

Continuum of care—A comprehensive and integrated system of health care that includes a broad range of care levels meant to promote the health of an individual throughout the span of their lifetime. Services along the continuum include preventive health services, care management, acute care, post-acute care and long-term care.

Entrance fee—a one-time cost that you pay up front when you become a resident of a CCRC. The entrance fee is one of the most expensive costs associated with paying for a CCRC, because it prepays the cost of your healthcare services. In some communities, it also includes the purchase of real estate. Entrance fees may be fully or partially refundable. If they are, they are usually refunded to a resident’s estate once he or she has passed. In addition, the CCRC may require that the resident’s unit be re-sold (or re-occupied) before it is paid out.

Five-star rating—The Five-Star Quality Rating System is a tool to help consumers compare nursing homes more easily and help identify areas about which you may want to ask questions. Created by the Centers for Medicare & Medicaid Services (CMS) in 2008, the rating system uses information from Health Care Surveys (both standard and complaint), Quality Measures, and Staffing.

Geriatric Care Management—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.

Hospice—offers medical care towards maintaining or improving quality of life for someone whose disease is unlikely to be cured.  Each patient’s care plan is updated as needed to address the physical, emotional and spiritual pain that often accompanies terminal illness. Hospice also offers support for caregiver(s) during the illness and grief support after the death.  Hospice is available to the patient and family when curative measures have been exhausted and life prognosis is six months or less.

Independent living communities—cater to seniors who are very independent with few medical problems. Residents live in fully equipped private apartments. A variety of apartment sizes are available from studios to large two bedrooms. Dining services are offered along with housekeeping, maintenance, transportation and numerous social outings and activities to choose from for entertainment.

Instrumental activities of daily living (IADLs) —are the skills needed to successfully live independently. These skills are usually learned during the teenage years and include the following: Managing finances, handling transportation (driving or navigating public transit), shopping, preparing meals, using the telephone and other communication devices, managing medications, housework and basic home maintenance.

Level of Care Fee—not all assisted living residents require the same level of assistance. Most assisted living communities use a tiered pricing model with bundled services. For instance, a resident needing very little assistance would be at the lowest tier or level and residents needing the most services would be at the highest level. Other pricing models include all-inclusive, a la carte, or fee-for-service basis.

Long-term care—is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. It is common for long-term care to provide custodial and non-skilled care, such as assistance with Activities of Daily Living.

Medicaid— Medicaid, called Medi-Cal in California, is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home care and personal care services.

Medicare— is a single-payer, national social insurance program, administered by the federal government. It provides health insurance for Americans aged 65 and older who have worked and paid into the system through a payroll tax. It also provides health insurance to younger people with some disabilities as well as younger people with end stage renal disease and amyotrophic lateral sclerosis.

Memory care— is a distinct form of long-term care designed to meet the specific needs of persons with Alzheimer's disease, dementia or other types of memory related problems.

Monthly Service Package—a monthly fee that includes a variety of services, amenities, and utilities such as heating, cooling, cable TV, and property taxes.

Move-in Fees—senior living communities typically charge a non-refundable administrative move-in fee, sometimes called a community fee, which must be paid prior to move-in. This fee covers everything from the pre-move-in assessment, to getting the new resident set up for services and renovating his or her apartment.

Occupational therapy— a form of therapy for those recuperating from physical or mental illness that encourages rehabilitation through the performance of activities required in daily life.

Personal moving consultant—A professional who can help coordinate all aspects of the moving process, including downsizing, packing, space planning, and connections to reliable real estate agents.

Physical therapy— the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.

Post-acute care— includes rehabilitation or palliative services that patients receive after, or in some cases instead of, a stay in an acute care hospital. Depending on the intensity of care the patient requires, treatment may include a stay in a SNF, ongoing outpatient therapy, or care provided at home.

Rehabilitation—is a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease such as stroke or hip fracture to as normal a condition as possible. There are multiple places where rehabilitation can take place including hospitals, skilled nursing facilities, assisted living communities and home.

Respite care—a short-term stay at a senior community, usually an assisted living or memory care community. Whether it's for a few hours a week to run errands or a weekend getaway, or a few weeks to take a vacation, respite care offers caregivers a temporary rest from caregiving, while the person continues to receive care in a safe environment.

Second person fee—The Monthly Service Package is based on single occupancy per apartment, so most communities charge a second-person fee for couples sharing living space to cover the cost of the spouse's meals, laundry, utilities, transportation, and access to amenities.

Skilled nursing care—Round-the-clock care for individuals who suffer from chronic health conditions too complex to be treated at home or in assisted living.

Skilled nursing facility—oftentimes referred to as a SNF or nursing home, they are normally the highest level of care for older adults outside of a hospital. They are residential facilities where a licensed nurse is always on the premises and residents can receive skilled nursing services 24 hours a day. 

Speech therapy—Speech and language therapy provides treatment, support and care for older adults, who have difficulties with communication, or with eating, drinking and swallowing.