Advanced Directives - A written statement of an individual's preferences and directions regarding health care. This document protects a person’s rights even if he becomes mentally or physically unable to choose or communicate his wishes.

Assisted Living Facility - A senior housing facility, usually consisting of individual apartments, that offers 24-hour onsite staff, congregate dining and planned activities. Nursing services are available for an additional fee.

Caregiver – the person, usually a family member or friend, who is responsible for the physical, psychological, emotional and social needs of an elder. While some organizations use the term to refer to persons who are hired to perform supportive tasks for elders in their homes, Sheltering Arms Senior Services uses the term assistant instead.

Care Plan - As provided by Sheltering Arms Senior Services, this document is formulated by a professional counselor and provides a detailed outline of the physical, psychological, emotional and social needs of an elder, and the services and/or interventions required to meet those needs.

Case Management – Service provided to elders and families by professional Sheltering Arms staff that includes assessment, development of care plans, assistance with applying for or arranging needed services, and on-going monitoring for emerging needs. This service is for seniors who want to remain living in their own homes, but need outside assistance to do so.

Certified Nurse Aide (CNA) – An assistant who has taken special training, passed proficiency testing and received certification by the state, entitling the aide to work in a facility or a private home. A CNA provides personal care such as assistance with ambulation, bathing, dressing and feeding, and may take vital signs, such as blood pressure, under nursing delegation. CNA’s are also required to have CPR training.

Companion Services – Includes monitoring conditions in and around the home, reading mail and books, writing letters, preparing a light meal, and assisting with light housekeeping tasks.

Continuum of Care – A comprehensive set of services ranging from preventive services to acute care to long term and rehabilitative services. By delivering continuity of care, it is possible to focus on prevention and early intervention for those who have been identified as high risk, and also provides easy transition from service to service as needs change.

Custodial Care - Nonskilled, personal care, such as help with activities of daily living (ADLs) like bathing, dressing, eating, getting in and out of bed or chair, moving around, and toileting. It may also include care that most people do themselves, such as using eye drops. Medicare does not pay for custodial care.

Dementia - Chronic, usually progressive deterioration of intellectual capacity associated with the widespread loss of nerve cells and the shrinkage of brain tissue. Signs include changes in memory, personality, and behavior, and make carrying out normal daily activities difficult. Though it is not part of the normal aging process and can affect persons of any age, this condition is most commonly seen in the elderly.

Durable Medical Equipment (DME)
As defined by Medicare, equipment which is primarily and customarily used to serve a medical purpose, can withstand repeated use, is generally not useful to a person in the absence of an illness or injury, and is appropriate for use in the home, such as crutches, walkers, oxygen therapy equipment, and wheelchairs.

Geriatric Care Management – As provided by Sheltering Arms Senior Services, this service includes an in-home assessment of the elder’s needs, a home safety evaluation, the development of a detailed care plan, monitoring of care services, assistance with legal and financial issues, educational materials, and family counseling and support.

Homebound - Used to describe people with physical or cognitive limitations that restrict their ability to leave their home, so much so that they cannot travel independently, nor use most modes of public or private transportation.

Home Health Aide – Assistant trained to perform Personal Care, usually placed when there is a medical need which requires a nurse to come into the home, otherwise a Personal Care Assistant is used. Also known as a Certified Nurse Aide (CNA), home health aides can take vital signs under nursing delegation.

Home Management Assistant – Person hired to provide home management services in the senior’s home, such as light housecleaning, cleaning kitchen and bathroom, changing linens, laundering and ironing, grocery shopping and running errands, and preparing nutritious meals.

Home Management Service – Includes light housecleaning, cleaning kitchen and bathroom, changing linens, laundering and ironing, grocery shopping and running errands, and preparing nutritious meals. Some agencies call this service Homemaker Service.

Instrumental Activities Of Daily Living (IADL’s) - Activities related to independent living, such as preparing meals, managing finances, driving, shopping for groceries or personal items, performing light or heavy housework, and using a telephone.

Long Term Care - The broad spectrum of medical and support services provided to persons who have lost some or all capacity to function on their own due to a chronic illness or condition, and who are expected to need such services over a prolonged period of time. Long term care can consist of adult day care, care in assisted living or skilled nursing facilities, or care in the home by family members or employed help.

Medicaid – Financing provided by state and federal governments to address medical and long term care needs of low income individuals.

Medicare – A federal health insurance program which helps defray many of the medical expenses of Americans over the age of 65.

Medigap - Health insurance plan that fills the gaps in Medicare plan coverage.

Money Management – Sheltering Arms Geriatric Care Management service which provides checkbook balancing, bill paying, and the management of medical paperwork.

Palliative Care - The care of patients with a terminal illness, not with the intent of trying to cure them, but to relieve their symptoms. Palliative care consists of relief of pain and nausea, as well as psychological, social and spiritual support services.

Personal Care –  “Hands-on” services such feeding, bathing and dressing, oral hygiene and grooming, range of motion exercises, assistance with toileting, transferring in and out of chair and bed, and medication reminders, provided by Certified Nurse Aide (CNA) or Personal Care Assistant.

Personal Care Assistant – Performs “hands-on” duties such feeding, bathing and dressing, oral hygiene and grooming, range of motion exercises, assistance with toileting, transferring in and out of chair and bed, and medication reminders. Does not perform any nursing delegated tasks, such as checking blood pressure.

Private Duty Nursing – Medical care provided by registered nurses (RN’s) or licensed vocational nurses (LVN’s) in the home, requires doctor’s orders. Also known as skilled nursing.

Quality of Care - A measure of the degree to which delivered health care services meet established professional standards and judgments of value by the consumer. Quality may also be seen as the degree to which actions taken or not taken maximize the probability of beneficial health outcomes and minimize risk and other adverse outcomes.

Rehabilitative Care - The care of patients with the intent of curing their disease or improving their condition. For example, physical therapy after hip replacement surgery to resume walking, etc.

Respite services, In-Home – Short-term, temporary care services provided in the home which offer relief to a family caregiver, such as Home Management Services and Personal Care Services.

Skilled Nursing - Medical care provided by registered nurses (RN’s) or licensed vocational nurses (LVN’s) in the home, requires doctor’s orders.