Twenty-four hours a day, seven days a week.

Term indicating that the building requires a pass key, fob or magnet card to open entrance doors; however, there is likely no one staffed at the entry after business hours.

Communities that are age restrictive such that one or all residents within a home, town home, apartment, condo or living unit must be 55 or older. Some communities require that all residents living there be 55+

Pus which has accumulated in a cavity formed as the result of an infection - typically caused by bacteria or parasites. This is the body's defensive reaction to attempt to prevent the spread of infection to other parts of the body.

Can be verbal, mental or physical. MUST be reported to DSHS at 800-562-6277

Cash money that can be accessed from a life insurance policy before death occurs

The practice of physicians and health care providers of accepting the exact reimbursement rate paid for by Medicare. Providers are not allowed to charge the consumer additional fees above and beyond the assignment amount

Defines a living situation which is free of barriers

A process which typically involves self-evaluation of a service, followed by an agency or association or peer review to determine if the business or agency is meeting quality standards as outlined by the agency which provides the certification

Placing blame on someone else

Typically means care within a hospital setting. The patient may be medically unstable or require monitoring by health care professionals or require therapies or treatments. Term is typically used for short-term illness after which point a person can recuperate and return to wellness.

A sickness which is chronic, likely debilitating in some manner.

Alzheimer's disease; note - only the Alzheimer's Association uses this term. The senior housing and health care industries note this disease as ALZ.

American with Disabilities Act of 1990 Civil rights law which prohibits discrimination based on disability.

Activities of Daily Living. A means of describing the functional status of a person. ADLs do not include cognitive (thinking/processing) abilities - this is a separate function. Basic ADLs: Bathing, feeding, going to the toilet, dressing, grooming, taking meds Mobility ADLs: Being able to get out of the house on their own and to travel, be able to walk and to get up out of and into a chair without assistance. Instrumental ADLs: Cooking, shopping, housework, transportation Cognitive: based on abilities to be aware of time/number, place, person and self (Note - most LTC policies are based on the BASIC ADLs and cognitive abilities)

Patented items which make a task easier for someone with a disability, illness or cognitive impairment

Department within the US Dept of Health & Human Services granting funds to state government agencies offering support programs to older adults. This agency is mandated by the Older Americans Act.

Checking someone in to a care setting or signing the paperwork to make a move into a senior community

Provide social interaction and activities for older adults and perhaps also for disabled individuals during daytime hours.

Similar to Adult Day Care only with a health care component such as medication monitoring, social services or perhaps also clinic services.

The umbrella term for a Will or Trust, DPOA or POA, Living Will, No code (Polst form) and other legal documents

A written document that states your wishes regarding how you would want medical decisions to be made should you lose the capacity to make the decisions for yourself. A health care advance directive may be comprised of a Living Will, a Durable Power of Attorney for Health Care or both

A person who looks after the well-being and fair treatment of another individual.

The process of ensuring that another person's rights and preferences are known and followed.

A group which typically has a specific, common interest such as religion, ethnicity, sexuality or other tie

Typically apartment-style housing which has been built under tax-favored status. Residents must likely be age 55+ or have a disability. There are likely maximum allowable incomes or financial parameters for admission.

Adult Family Home (also known as Adult Care Home, Residential Care Home, Board & Care or Adult Foster Care Home)

The concept of remaining in the same physical location when additional services are required or requested.

Behaving in an abnormally forceful or belligerent way either verbally, physically or by simply being physically present when it is not appropriate to be in someone else's physical space.

also known as

Assisted Living (becoming a broadly used term, but generally means assistance with ADLs, regardless of where that service is provided.

presents itself VERY much like Alzheimer's disease in that a person is forgetful and can become quite frail.

Within a long-term care policy, an insurance company may state that they will consider paying coverage for any other type of care not specifically noted in the policy. For instance, if a person does need help with a specific number of ADLs and the policy only lists skilled nursing and assisted living coverage; if there is an "alternative plan of care clause," the insurance company may be open to paying for care in an Adult Care Home.

Healing or treating disease through chiropractic, acupuncture, homeopathy, herbal treatments and faith healing. The phrase "Complementary and alternative medicine" together typically relates to a combination of Western and Eastern practices.

A form of dementia that is both progressive and degenerative, which affects brain functions, causes the loss of short-term memory and reasoning ability, the ability to care for oneself and deterioration of speech and communication skills. Alzheimer's is not currently curable but there are medications that can retard the degeneration rate for many people

Ability to walk, get around. Apnea (see sleep apnea)

Used as a synonym for the word "stroke," because many stroke patients lose consciousness during the acute stage of vascular compromise. This word also is used to describe loss of consciousness.

Within senior housing and care communities, these may be therapies, beauty shop, outings or even medical supplies or services

Fees assessed for ancillary services

The most common disorder of the blood. A deficiency of red blood cells and/or hemoglobin.

A blood clot to the brain

Similar to a savings account or CD at a bank, only this account is held with an insurance company. There are MANY different types of annuities within these broad types:

a guaranteed interest rate

paying out a monthly, immediate income

Return may vary as it is tied to stocks, bonds or index funds

follows guidelines to qualify for COPES/Medicaid

No remaining value to pass on via will to trust, a guaranteed monthly payment is made as long as the person is alive, based on the contractual agreement (these are becoming scarce) Anti-depressants- Medications which help an individual feel better about their life or that may have a calming effect on a person

Nervousness or anticipation that causes stress and affects behavior.

A nationwide network of programs, State and local, that can assist older people with planning their life-long needs. Some of the services are: adult day care, counseling, information about and referral for in-home services, legal services, nutrition and meals, personal care, respite care, skilled nursing care/therapy, and transportation.

a language disturbance caused by brain atrophy, stroke or AD. Causes impairment in a person's ability to speak, write or even comprehend

Adult Protective Services - agency that responds the same day to any report of abuse or neglect (they may or may not include the police)

Advanced Registered Nurse Practitioner - very similar to a general physician, typically practicing family practice-type medicine, but some specialize in Geriatric Care.

Choking on liquid, phlegm or food.

To review a person's health history and to document that individual's current health & mental status, psychosocial needs and service preference needs.

Used to describe walkers, canes, even devices that attach to shoes. Something used to help with ambulation.

(as it relates to muscles or the brain) - Relaxing or death of cells, withering

Lipid-laden plaques which obstruct the arteries

Hearing things which are not actually present or occurring

A practice of unscrupulous providers who attract older adults and their families by offering low rates for the month or several months and then increase the rate significantly ($1000 - $3000/month) once the older adults is settled in.

Services provided to obese or morbidly obese individuals

Washing a person while the caregiver is standing outside of the tub or while the patient is lying in bed

Reserving space in a nursing home or assisted living community even though the resident is not yet living there. There may or may not be a fee involved in a bed hold.

A fee paid to the state per licensed bed or licensed apartment

Bars which are intended to keep a person from rolling out of bed or to be able to elevate oneself while lying in bed. These are now considered a form of restraint and are not allowed in senior care settings. They may be used in the hospital setting.

The actions a person takes as a result of their personality or other influence. This term is typically used when a person's actions are outside the norm of society.

A person who is loud, perhaps yelling and not thinking about what they are saying. The person is typically angry and acting in a way that is upsetting to other people in contact with the person.

An individual who is to receive personal or real property; can also mean a person who receives a benefit.

Boarding Home (a.k.a. Assisted Living community)

Two times a day

A psychiatric condition defined by periods of extreme mood. Moods can be depressive (unhappy/down) or manic (elevated mood, high energy or unusual thought patterns). A significant variant of bipolar disorder is designated as bipolar II. (The usual form of bipolar disorder is referred to as bipolar I.) Bipolar II is a syndrome in which the affected person has repeated depressive episodes punctuated by what is called hypomania (mini-highs). These euphoric states in bipolar II do not fully meet the criteria for the complete manic episodes that occur in bipolar I.

A disease which can be spread by contamination of blood. Most common examples are HIV, Hepatitis B and C.

What Adult Family Homes are called in California (they are also called Residential Care Homes in California)

In the state of Washington, this is a type of licensure required by a senior living complex in order to provide assisted living services.

Some senior communities were constructed based on tax-favored bonds. In order to qualify and to continue qualifying for such tax-favored funding, a community must maintain a certain level of "lower income" residents

Condition of the digestive system where a person finds it difficult to have a bowel movement.

A blockage of the intestines and is considered a medical emergency requiring surgery.

Inflammation of the medium-size airways in the lungs.

Blood pressure

A diet of only bananas, rice, unsweetened applesauce and toast (or pasta or potatoes)

Bachelor of Science in Nursing

A person walks through a line and chooses food from a food bar. The person may be asked to also to clear their table and to return their dishes to a specific area

A physician who specializes in care of the heart

A professional who provides consulting services to an older adult to help make decisions, to advocate for them and to ensure proper care and treatments are received. This person also documents current status of a person and attempts to project future needs. This person may also recommend or suggest additional services, care or treatments.

A written document which defines a resident's specific needs; and then outlines a means for meeting those specific needs. The care plan also makes note of any particular, possible concerns which require a higher level of monitoring.

Number of clients a professional or paraprofessional is handling at the time

Synonymous with Care Manager.

An opaqueness that develops in the lens of the eye or in its envelope, causing myopia (distant objects appear blurred). Causes a person to not be able to see blue colors. Can lead to blindness if not treated.

A tube placed into the body cavity, duct or vessel. This word is used in many ways. Catheters allow drainage of infection. They can also allow fluids or access (central venous catheter - also known as a central line - placed into a large vein in the neck, chest or groin for easier access to give intravenous drugs or fluids) or surgical instruments into the body. Also very common term used to describe a tube for directing out urine or feces from the body

a latex sheath placed over the penis

inserted through the urethra of the penis into the bladder

a surgically-created connection between the bladder and the skin

Continuing Care Retirement Community. A complex or campus offering independent living, assisted living and skilled nursing care; and perhaps dementia care as well.

Occupancy rate, number of occupied beds or apartments in relation to the number of total licensed beds or apartments. This number is typically stated numerically by the number of beds or apartments which are occupied; or as a percentage.

A catheter placed into a large vein in the neck, chest or groin when a health care provider needs access for more intensive cardiovascular monitoring, for assessment of fluid status and for increased access for intravenous drugs and fluids.

Physician's orders stating a person requires care services

State approval that a service may be provided by a business or agency. For instance, a nursing home provider must apply for a certificate of need in order to increase the number of beds in a skilled nursing facility. In the state of Washington, there has been a long-time moratorium placed on granting new certificates of need. This document is also required in many states to open a home health care agency or perhaps even an Assisted Living (ALs do not require a C of O in the state of WA)

Certified Financial Planner

Not related to personal care. These are tasks which are considered to be errands or homemaker duties. They do not involve actually touching an individual.

Medical care which addresses preexisting or long term illness (this is the opposite of acute care, which addresses short term or severe illness of a brief period. The most common chronic medical conditions in the elderly are: Asthma, Emphysema, Chronic Bronchitis Cirrhosis of the Liver Congestive Heart Disease Depression Hypertension

Coronary Heart Failure

A flat, absorbent material placed on top of a chair or mattress to protect against moisture. Similar to an adult diaper which is not attached to a person, but rather lies flat on top of a surface.

Care Manager

Certified Nursing Assistance, Registered Nursing Assistant or Nursing Assistant Registered

An implanted hearing aid device for a person who is severely hard of hearing. Unlike a hearing ad, the implant doesn't amplify sound, but instead stimulates the auditory nerves inside the cochlea with electrical implants.

A relationship which is often viewed as unhealthy in that two people's personalities and beings are intertwined into one. This is viewed as unhealthy as the two people frequently have different needs and preferences, which causes unnecessary stress or conflict for the other person. This term is not to be confused with "dependence," which is used to describe a single individual's reliance upon something or someone else.

A syndrome causing memory loss or inability to process information or to react in a way that is considered to be socially normal Coinsurance -Under Medicare, it is the percentage or portion of the Medicare-approved amount that you the consumer have to pay after having met the deductible for Part A and/or Part B. For other types of health insurance, it is usually a percentage of billed charges after you have met the deductible. For example, if you have paid the deductible and the insurance company pays 70 percent of the remaining amount of your claim, your coinsurance is 30 percent.

A surgical procedure which connects part of the colon onto the anterior abdominal wall, leaving the patient with and opening in the abdomen, called a stoma. With a colostomy, feces leave the patient's body through the stoma and collects in a pouch attached to the patient's abdomen.

An amount a person must pay out of their own pocket before insurance begins covering a service or product.

Chronic Obstructive Pulmonary Disease. Characterized by limitation of airflow in the airway. COPD is the umbrella term for chronic bronchitis and emphysema.

Having to do with mental status and abilities.

Anger or frustration in a person with memory loss which causes anxiousness. Typically manifested in speaking angrily, hitting, biting. In many cases a person who is combative can be helped by removing stimulation and approaching them in a caring and nurturing manner.

The presence of two or more conditions or diseases in the same individual

The act of entertaining or simply being with another person, typically for a fee.

When the state receives a call from a Mandatory Reporter or a call regarding suspected abuse, neglect, exploitation or violation of resident rights or states codes and laws, a person hired by the state (Registered Nurse or Masters of Social Work) is dispatched to review the circumstances and to write a report, or suggest a plan of action.

Congestive Heart Failure

A term used to describe Assisted Living in some states in the US.

A court order that property or a person be subject to the control of another person, entity or agency.

Used to describe a senior living situation or a senior service which offers independent living through skilled care. This term is also used to describe the entire senior housing and care industry.

Nursing home

A gradual recovery of health after illness (today we hear the word recuperate more frequently)

Therapies and treatments which have been clinically proven to be effective. (Note - as "alternative medicines and treatments" become accepted and proven, they then become known as "conventional health care."

A program offered within the Medicaid (entitlement program) which provides financial assistance within assisted living, adult care homes and in-home care.

Community Relations

A handle of a door which is rectangular and typically spans the width of the door. Used to open a door, and is oftentimes alarmed.

Rare and incurable degenerative neurological disorder that is fatal.

A chronic inflammatory disease of the intestines. It primarily causes ulcerations (breaks in the lining) of the small and large intestines, but can affect the digestive system anywhere from the mouth to the anus.

Community Services Office. An office assisting and processing Medicaid/COPES applications.

Community Services Rep - a Marketer or Admissions person

Directing, prompting or supervising someone with cognitive impairment; demonstrating how to eat, medication reminders, prompting with visual or verbal cues so as to accomplish dressing or toileting

Term used to describe non-medical care, very light care; synonymous with monitoring.

Cardio Vascular Accident = a stroke

A person with dementia or reaction to medication, disease or infection may be awake during the night and sleep during the day.

Director of Community Relations - a Marketer or Admissions person

sometimes also noted as DDD; A person who has not matured in a way that is normal for their age - typically as it relates to mental capacity and ability to process ideas or to retain information or memories; may also involve the inability to complete activities of daily living without guidance or assistance.

Removal of dead, damaged or infected tissue.

Lack of water in the body.

A false belief. In psychiatric terms, the term relates to a mental illness.

The broad term used to describe a lessening of an individual's ability to think, process information or respond to stimulus; a person who is not able to interact with society in a normal fashion due to memory loss, brain damage, illness or health condition.

A person's unwillingness or inability to recognize the reality of a situation or matter.

A state operated, federally and state funded program to assess, monitor and distribute financial assistance to needy or medically needy individuals who do not have the financial means to pay for services; also the regulatory agency who issues licenses to extend personal care to older adults. This agency also monitors the performance of senior care providers to ensure residents rights, laws and the business' policies and procedures are being followed.

A mental status which causes a person to feel tired, without energy and perhaps without interest in interacting or completing tasks.

The process of decreasing and then removing a chemical substance (drug or alcohol) from a person. This term is also sometimes used as it relates to nutrition when an individual's diet is being changed with the intent of providing improved nutritional status.

A metabolic disorder of hyperglycemia (high blood sugar) Type 1 = autoimmune destruction of the pancreatic beta cells with produce insulin Type 2 = Gestational diabetes, which involves insulin resistance Both forms of diabetes are chronic conditions, yet treatments exist to prolong life

To define a disease or condition by its outward signs and symptoms or to analyze the underlying physiological or biochemical causes of a disease or condition.

Renal replacement therapy which acts as a replacement for a lost kidney due to renal failure or missing kidney.

Can be a vitamin, mineral, herb, botanical (excluding tobacco), an amino acid or an extract. Intended to give the body something it needs or is lacking. Can cause drug interactions and other problems for other adults.

The use of a finger to activate the sphincter muscle in order to have a bowel movement. Common need of people with muscular disorders.

Umbrella term used to describe the legal documents outlining a person's wishes and intents. Typically describes a Living Will and a DNR (Do not resuscitate). DNRs are now more readily called a POLST form.

A social worker or health care professional who helps patients and their families who are leaving a hospital environment to transition to another level of care: rehabilitation in a Skilled Nursing Facility (SNF), home health care provided in the patient's home, or long-term care in a SNF. Disease course

long lasting and likely deteriorates

long lasting but relapses frequently

affected again by something which affected them in the past

a state of absence of a disease or disappearance of a chronic disease Discharge (as it relates to leaving an acute or senior care setting) - The point at which an older adult is released from the acute or rehabilitative environment to return home or to a different (lower level) care setting.

The body attempting to eliminate infection from the body by encapsulating it and sending liquids to an open area of the body to flush out infection.

A thought disorder used to describe a pattern of unusual language that is thought to reflect mental illness.

Durable Medical Equipment; Durable Medical Equipment (DME) - Medical equipment required by a doctor's order to be used in the home. These are reusable items, such as hospital beds, walkers, and wheelchairs; paid for under Medicare, subject to a 20% coinsurance of the Medicare-approved amount

Do not resuscitate. This document has been replaced by a POLST form, but the senior housing and health care industries still call the POLST form a "DNR"

Director of Nursing Services

rather than Doctor

Director of Nursing

Durable Power of Attorney; Document giving someone else the legal right to make decisions on your behalf (as long as they are in line with the decisions you would typically make on your own) and to transact business. There are Powers of Attorney that are also limited to: Health Care Financial Durable Power of Attorney includes both Must have provision for HIPPA to be a useful document

Changing a bandage on a wound or incision. This is considered a skilled task; however it can be delegated through nurse delegation.

Removing an elderly person from all medications to remove all traces of the medication from their system. Frequent practice within Geropsych programs

A situation where a substance affects how the drug affects the body. Interactions can be due to conflicting drugs, drug and food interactions as well as drugs and herbal interactions.

An individual who qualifies for both Medicare as well as Medicaid

Executive Director

Retention of water causing swelling, particularly in the extremities (legs / arms) -causes stress on the heart

Tested frequently in the elderly via blood or urine sample. Muscles, body functions and neurons are activated

for instance, muscle contraction is dependent upon the presence of calcium, sodium and potassium. Without these ions, muscle weakness or severe muscle contractions can occur. Other ions frequently discussed in the elderly are: magnesium, chloride, phosphate and hydrogen carbonate.

A number of days before a benefit begins (a term used primarily in the insurance industry)

A term most frequently seen within dementia care, where a person leaves a building or home without the caregiver's permission or recognition the person is leaving.

Vomit

Inflammation of the brain caused by viral or bacterial infection. As the brain pushes against the skull, death can result.

Providing positive support and reinforcement to helps a person behave in a certain way or to take a certain action. Frequently used in regards to the act of enticing a person to take part in a social activity or in completing a task such as eating food or drinking liquids.

Looking inside the human body with an instrument called an endoscope

Liquid supplements to provide a patient with nutrition, glucose, fiber or other food supplements (the most commonly used product is Ensure)

The term is an umbrella term to denote that federal or state funds are being used to help pay or offset the cost of care, health care or nutrition services. Financial assistance to financially and medically needy individuals. Term is also used to describe Veteran's benefits when a Veteran requires care services, regardless of financial status.

Emergency room

The act of the State placing a lien on an individual's assets in order to recover all or some of the money paid out in entitlements.

Person named to be in charge of an estate

A person who cunningly attempts to elope by looking for opportunities to get outside or to leave a home or building.

Behavior of feeling compelled to leave a building or house. Some AD patients feel they must be elsewhere - such as at work or they may relive a traumatic experience such as thinking a family member has been injured, and feeling they need to be of help to that person.

The act of using something in an unjust, cruel or selfish manner for one's one benefit.

Lacking interest in living, inclusive of eating, drinking and perhaps even responding to stimulus or interaction.

Prohibits discrimination in housing as it relates to race, religion, national origin sex, handicap and family status. Title VIII of the Act is also known as the Fair Housing Act.

Actions taken to monitor or help a person avoid losing their balance. This term is also used for someone who has fallen quite a bit or is at risk for fall, with the intent to more diligently monitor the person in the event that an addition fall occurs.

A person who is unstable on their feet, has an unsteady gait (means of walking), stutter steps (prevalent in stroke and Parkinson's patients)

Disagreement, discord or acting out of family members who are in disagreement or who are not able to communicate well with each other. Frequently, such disagreements cause a division of family members, and creates stress or poor communication within a family unit.

A time to speak about a person's needs, gather input for the older adult and their support system and for the caregivers or management staff to give feedback and concern regarding a person's care, health, spiritual and mental condition.

A means of charging a person based on time it takes to complete a task or service. Time may be calculated in increments of 5 minutes, 15 minutes, half hour or hour.

Also known as "rate schedule." Document which outlines monthly base rates, service fee rates and perhaps ancillary (additional) fees.

The highest level of real property ownership, where an individual or corporation holds full title and rights to real property.

The highest standard of care imposed by law. The expectation is to be highly loyal to the person to whom they owe the duty. Also means that a person providing a service cannot place their own, personal interests before the duty at hand.

Within Boarding Homes/Assisted Living, the situation where a license can move from apartment to apartment without specifying an apartment number. For instance, a senior living community may be comprised of 100 living units, 30 of which are licensed as a Boarding Home. With a floating license, the community need not specify in advance which of the 30 living units will offer care services; instead, the community may offer care in any of the 100 living units (up to 30 people).

A certificate obtained by attending a classroom or online training regarding food safety and sanitation. A requirement of anyone who serves food.

Not medically stable or lacking in energy and strength. Also used to describe a person who is susceptible to illness or is not functioning well in regards to being independent with activities of daily living.

Used to describe the muscular reaction which occurs in individuals (particularly with Parkinson's disease) where the muscles contract and brain signals are not sent to the muscles to change. Frequently causes a person to become rigid and can lead to falls.

Occurs when a person does not recognize the need to visit the toilet.

The manner in which someone walks

A belt placed around a patient's waist to allow the caregiver an easier means to be able to assist the person to transfer or to steady them while walking.

Crystalline bodies formed within the body from normal or abnormal bile components.

Gastro Esophageal Reflux Disease - mucosal damage produced by the abnormal intrusion of gastric liquids into the esophagus

A physician specializing in the elderly, especially those who are frail and have complex medical and social problems.

Electronic and computerized gadgets which are intended to enhance the quality of life or reduce the amount of human interaction required to monitor and record an older person's safety and well-being. Such devices are cameras to monitor, automatic weighing scales on a bed to monitor weight gain or loss, sensors on commodes to record use of the toilet, automatic pill dispensers which not only dispense, but also alert and record

A physician or ARNP specializing in the care of older adults

An outpatient or inpatient hospital program which helps define and treat mental disorders and mental illness such as depression, anxiety, delusions, memory loss, episodic outbursts, etc. Having to do with the mental well-being of older adults

A transfer tax imposed on the value of certain gifts.

The act of giving money to other individuals or to charity.

A disease of the optic nerve which involves loss damage to the nerve and as a result, visual impairment. Can cause blindness

General Manager

A short-term, court appointed person who oversees either the financial and medical or only one aspect of a frail or mentally incapacitated individual before a permanent Guardianship/Conservatorship can be initiated.

Rare type of investment which is tied to the insurance industry, which gives specific and definable income to a person for their lifetime.

A legally appointed person who has authority to care for the personal and property interests of another individual (called a ward). This term is used interchangeably with the word "Conservatorship"

History & Physical

It's estimated that 10% of the population have such sensory experiences. Seeing, hearing, smelling, tasting, touching things that aren't in reality present. A hallucination can also affect balance.

Care that requires that a person touch another person

Term used to describe legal documents of a Living Will and Power of Attorney.

Relating to blood - a protein which makes up 97% of the red cell's dry content and 35% of the total content (including water). Hemoglobin transports oxygen from the lungs to the rest of the body where it releases the oxygen load.

Implies viral infection and likely injury to the liver - can be self limiting, healing on its own or progressive. Acute hepatitis is when it lasts less than 6 months, chronic hepatitis is when it persists longer. A = infectious jaundice contracted through contaminated food, treatable B = not common in elderly unless they are getting blood transfusions C = contracted through contact with blood, serious precautions taken when caring for someone with HepC - particularly if receiving insulin. Not yet treatable, but science is close to resolving Drug-induced and alcohol induced hepatitis is becoming more prevalent in the elderly

Health Insurance Portability Act, enacted in 1996. Requires that a person give written approval before private or health care information may be shared with other people or other agencies.

An annual or time-specific check-up of major organ functions, health status and review of wellness, illness or disease. This check-up results in a written document outlining the status of a person's health and noting any specific areas of concern.

Health Maintenance Organization. An insurance company which accepts the risk of providing preventative and acute care in return for a monthly premium.

The act of collecting items, typically viewed as a mental disorder as a result of mental instability.

Part of the Aging and Disability Services Administration, an agency within the Department of Health and Social Services (DSHS). At the local level, HCS staff help adults who need care services but may need state funds Medicaid to help pay for them.

Services that are rendered to individuals living in their own homes, but can also describe services provided to individuals in a senior living situation, when such service is rendered by someone else other than the owner/operator of the senior living community

Not able to leave the home, except for doctor or medical appointments

Household services provided by another individual because you are unable to accomplish them; laundry, light cleaning, meal preparation, shopping and transportation assistance. Homemaker Service providers cannot provide personal or hands-on care in most states.

Services provided which are typically hands-on services. These services may be offered in a private home setting, or may be offered by an outside agency within a senior living setting. This service requires a license to provide.

Services which typically include a higher level of care, monitoring and therapies. This license requires a higher level of documentation, procedures and policies and a higher level of regulation.

Allowing another individual to live in a home or apartment, regardless of whether money or services are exchanged.

Care and services for someone (and their family) who is not expected to live for more than six months and who has an illness or disease which is viewed by medical professionals as "untreatable." Hospice services can be offered in any living setting. There is one resident hospice on the Eastside, which specializes is pain management and supportive living for individuals who are in the dying process. Hospice services can be deleted at any time or can be extended for another six month period of time, contingent on the physician's diagnosis and orders.

Referring to the DSHS phone line for Mandatory Reporters

This is actually the brand name of a type of lift - there are actually many types of lifts. Proper name is mechanical lift. Device that allows one person to transfer another person, even if the resident is quite heavy.

Fearful of water or taking a shower or bath

A situation created by a lower than normal amount of sugar (glucose) in the blood stream. Patient reaction varies from feeling queasy to coma or even permanent brain damage. Seem frequently in people with diabetes. Can be readily treated by ingesting glucose or foods digestible to become glucose.

Low blood pressure. Older adults frequently pass out and can fall if they stand up and experience a sudden drop in blood pressure.

Irritable bowel syndrome (affects 22% of the population) - gas, bloating, indigestion, constipation, diarrhea, flatulence, passage of mucous in the stool, cramping-abdominal pain

Intermediate Care Facility

Intensive Care Unit

Independent living; senior housing type that typically denotes that the resident requires no personal care services.

A stoma (opening) constructed by bringing the end of the small intestine (the ileum) out onto the surface of the skin, where waste passes out and in collected in an external bag.

a distorted sensory perception which is an interpretation of the brain. Not considered mental illness, but rather an incorrect assumption.

Stool that is stuck in the bower as a result of severe constipation.

The incapacity of an individual to participate in legal proceedings.

Lack of control over bladder or bowel, or lack of recognition of the urge or need to urinate or defecate; or unawareness that urine has flowed out of the body or that a bowel movement has occurred.

A type of long-term care insurance

A written document stating whether a person or legal entity has given permission for medical or financial information to be shared with other medical or housing & care professionals.

Inability to sleep

Tasks in addition to activities of daily living, that you are required to be able to perform in order to live independently (that is, without assistance or substantial supervision from another person); bill paying, grocery shopping, laundry, light housekeeping, meal preparation, medication management, using the telephone. Most long-term care insurance policies will not pay benefits for the loss of ability to perform IADLs

Dying without a legal will.

Placing liquid substances directly into a vein. Treatments can be intermittent or constant. If constant, then the term intravenous drip applies.

A legal document that once established will not come to an end until the terms of the trust have been fulfilled .

Inadequate flow of blood to part of the body caused by constriction or blockage of the blood vessels. This word is also used to describe a lack of oxygen to the tissue.

Intravenous. Can be for hydration, pain meds, wound treatment, antibiotics or other medications. Not readily accepted in ALZ communities, as residents pull them out too easily. SNFs are not always enthusiastic about admitting Medicare or Medicaid residents requiring IV treatment as it is costly to the organization.

Aggregations of dissolved calcium oxalate crystals in the urine which form inside the kidneys or ureters.

Refers to a small area which is typically part of another living space, such as a living or dining area. Likely does not have a stove, but may have burners, a microwave, sink and cupboards.

Inability to fully digest milk products, causing digestive and elimination discomfort and irritation in the person who has the intolerance. Caused by the body's inability to product the enzyme lactase

Behavior of some AD patients, placing clothing on top of clothing or placing undergarments on top of regular clothing; or wearing multiple watches or jewelry

Every community views levels of care differently. Belief that people fit somewhat into categories of care ranging from being independent to full (also called "heavy care" or "full care")

10-15% of dementias are of this type (60-75% are from Alzheimer's or vascular dementia). This is an overlapping of Alzheimer's & Parkinson's Disease

Term used to define the type of application and approval required to operate a service or business.

A recorded document which gives public notification that an individual or business has placed a "hold" on assets which may currently not be liquid or available to cover the debt or payment due.

Term used to describe two different things. One use of the term is based on the concept that a person can obtain

Mechanical and electric devices intended to keep body functions, nutrition and hydration continuing.

Typically relates to an on-site resident manager or care giver that actually lives in the home.

Legal document that outlines medical and treatment preferences

Typically an ALZ community that has barriers in place to deter people from leaving the building. (There is NO such thing as a purely locked facility due to fire codes)

The act of being of support to an older adult when living in a different city, state or country. Assistance is most often offered by phone or via the Internet, but may include the help of a hired case or care manager, other family members or friends of the older adult

Services rendered over an extended period of time to someone needing assistance with normal activities of daily living; types of services are rehabilitation, skilled nursing, and palliative care (hands-on care), inclusive of supervision and a wide array of personal care and social services. Training may also be included to help older people adjust to or overcome many of the limitations that often come with aging. Long-term care can be provided at home, in a community, or in various types of facilities, including nursing homes and assisted living facilities. Regardless of where it is provided, most long-term care is custodial care, the type of care that is not paid for by Medicare.

An insurance policy that helps pay for a portion of long-term medical and non-medical care, like help with ADLs. Generally, Medicare will not pay for long-term care. This type of insurance may help with long-term care that may be needed at some point in the future.

Federally-funded programs that are nationwide and run independently of care communities, which provide problem resolution between residents and assisted living facilities, nursing homes and other residential care facilities.

Income which is determined by the state to be at a specific level which does not allow the person to live at a specific standard of living (not to be confused with poverty level, as a person with low income may be able to live without financial assistance).

An income determined by the state to allow perhaps some financial assistance or inclusion in one or more free or low-cost benefits, but not at a level of requiring full financial support. May be considered to be at a level of being self-sufficient unless care needs are involved; in which case the state may offer assistance / entitlements.

Licensed Practical Nurse (in some states = LVN)

Long term care

A policy an individual purchases to cover the cost of care in a care setting, or to cover perhaps in-home care, in the event that assistance with a defined number of Activities of Daily Living or mental impairment exists.

where the inner lining (the macula area of the retina) begins thinning and in some cases, it bleeds.

For seniors, there are specific insurance programs which are alternatives to standard Medicare. In lieu of standard Medicare, the participant pays a lower or zero premium to the HMO to receive health care benefits. In return for paying a lower premium, the senior is then enrolled in a specific care program and must see only certain providers. The Insurance Company then makes the decision as to which treatments, procedures and therapies are offered.

A person working with older adults is considered to be fully responsible for reporting any suspected abuse, neglect, exploitation, violation of resident rights or violation of state codes and laws. The Mandatory Reporter line for Washington state is 800-562-6078.

A severe medical condition characterized by extremely elevated mood, energy and unusual thought patterns. Rapid speech Racing thoughts Decreased need for sleep Hyper-sexuality Euphoria Grandiosity Irritability Increased interest in goal-directed activities

A person who experiences periods of elation and periods of depression.

Used to describe early stages of any memory impairment. Researchers believe that this is likely an early manifestation of Alzheimer's Disease

Part of the US federally mandated process for clinical assessment of all residents in Medicare, Medicaid or licensed nursing homes. This process provides a comprehensive assessment of a person's functional capabilities and helps staff identify potential health problems

Local agencies providing low cost, hot, nourishing meals to the elderly and disabled, allowing frail, homebound people to remain in their own homes.

Food which has been blended or processed to aid in chewing and/or swallowing

An electric or non-electric tool used to lift or to move a person who is unable to assist in getting up out of bed or cannot move from one place to another.

California's Medicaid program.

Like an insurance program for older adults or for individuals who have end stage renal failure. The person must pay a monthly premium for this benefit.

Hospital insurance and insurance for up to 100 days of skilled nursing care

Medical insurance which helps pay for some services and products not covered by Medicare Park A. Part B services are generally covered on an outpatient basis.

Also called Medicare Advantage Plans. An option given to consumers to purchase health insurance plans in lieu of standard Medicare Part A & B coverage. Some plans may even include Medicare Part D. These are HMO-type plans and are Managed Care plans.

Prescription drug plans.

Also known as an "HMO" or Managed Care. A provider who accepts zero premium or a lower premium and then receives a monthly fee from the purveyor managing the Medicare program to provide all care-related and acute care to an individual.

An insurance policy which covers the co-pays or items which may not be covered by standard Medicare. There are numerous types of policies (Plans A through J) which offer varying levels of coverage.

An entitlement program intended for people who require care services and who meet certain financial criteria.

see Lien

A person who can become very quickly medically unstable and require frequent trip to the Emergency Room. An individual who is medically fragile typically requires a high level of monitoring.

that which is reasonable and appropriate based on clinical evidence and testing. Medicare uses this term to define goods and services they will cover for diagnosis or treatment of illness, injury or to cover the improvement of functionality of a body part.

a private health insurance plan available to purchase to cover the "gaps" between what Medicare will and won't cover. Medigap polices are STANDARDIZED, which means that each company offers the very same coverage based on plans A to J, the only difference is coverage is premium/cost as well as service.

A person may not be able to retain short-term memories such as (what did I just say, or what did I just eat). An individual can also lose long-term memories.

May be used to describe either the mental stability (level of calmness versus anxiety) or it may be used to describe an individual's outlook on life. This term is also used to define an individual's mental well-being as it relates to mental disorders or diseases which cause memory loss, delusions, confusion, etc.

(pronounced "Mersa") Methicillin-resident staphylococcus aureus. A bacterium that has developed a resistance to penicillin. Known as a "hospital-associated infection," as it is contracted most frequently while in the hospital or in a nursing home.

Mental Health Professionals. Professionals called in when someone is at risk of harming themselves or other people

A series of short questions which allows a health care professional to measure the current mental status of an individual. This exam may be used to compare improvements or decline in a person's cognitive abilities. This exam is being replaced by other, more recently designed exams.

A restriction placed on the development of a particular new service. For instance, in the state of Washington, there is a moratorium placed on the issuance of new Skilled Nursing Facility licenses.

An area of the home with a separate entrance and likely a full kitchen and bathroom.

Masters of Social Work

Causes approx. 20% of dementia cases - small, almost imperceptible strokes

A situation where a person has gone through several personal losses; whether they be loss of own mental or physical abilities or losses of friends or family or losses of physical possessions. The current belief is that these losses accrue and have a multiplying effect on an individual, likely causing depression.

Typically caused from lack of proper care of a wound site, Death of cells and living tissue.

Avoidance of person or avoiding meeting a person's physical or care needs.

A physician specializing in the kidneys.

A physician specializing in the nervous system

Tingling sensation in limbs, thought to be caused by nerve damage. Frequently seen in individuals with Diabetes.

A legal document stating that a person does not want certain resuscitation methods performed. This form has been replaced by a new form called a POLST form; however, many health care providers still call this a "No code" or "DNR," which stands for Do Not Resuscitate.

Spinal fluid build-up in the brain

A business or agency which operates with less emphasis on profit. Not-for-profits still may be seeking to build a "reserve," which is really the very same thing as "profit," only the intent is to place this reserve back into the agency or service at a later date in time. (not to be confused with "free" or "government provided entitlement")

Act of training and monitoring a paraprofessional to complete a task which has, historically, only been completed by a nurse. Example = inserting eye drops into the eyes of an elderly person.

A residential facility licensed by the state that provides room, meals, help with ADLs, recreation, and nursing care to the chronically ill or those unable to take care of their needs; may also be called a Long Term Care Facility. If certified by Medicare, it is also called a Skilled Nursing Facility

Oxygen

A rehabilitation professional who instructs people on how to compensate and overcome functional limitations that are a result of injury, illness or disability. OT's teach skills and techniques needed to perform ADLs and help maximize the person's independence.

A state-paid or volunteer that seeks to protect the rights of residents.

Cancer specialist or surgeon

A means for allowing a person with memory loss to be as independent as possible. The caregiver gives one direction at a time to help the patient work through a process such as brushing one's own teeth. Oriented x3, x2, x1 = (It's too bad the phrase isn't x4, because it overlooks an important issue. The last thing to go (in regards to memory) for most people is "self." X3 = can still do pretty well with time/numbers, knows where they are and other people X2 = not doing well with time and numbers X1 = not doing well with time and number and frequently doesn't know where they are or think they are somewhere else

(a.k.a. Degenerative Arthritis). Low grade inflammation resulting in paint in the joints. This pain is caused by wearing of the cartilage which typically acts as a cushion inside joints.

a disease of the bone which reduces the bone mineral density. Bones become more susceptible to fracture

A stoma, which is an opening which has been surgically created to connect part of the body cavity to the outside environment.

Over the counter, medications not requiring a prescription

Amount of money a person must pay before insurance or another provider begins paying all or a portion of an expense.

Primarily caused by gallstones or alcohol consumption; although it can also be a side effect of medication. Severe upper abdominal pain radiating through the back. Causes nausea and vomiting.

A fear or anxiety concerning one's own well-being or safety, which is viewed by society as irrational or excessive. (see psychosis)

A person who is non-licensed

an alternative mode of transportation that doesn't follow a fixed route.

has an apostrophe (it's ok not to write the word "Disease" after it)

That portion of the applicant's income that must be paid to the housing/care facility from their personal income.

defining the person, entity, business or agency responsible for paying an invoice or bill

A stream of money paid out by a company after a person retires

Term used in two ways in our industry. This can mean "daily rate," for instance, a per diem can denote the amount of money an employee can spend on a daily basis for expenses. This term is also used to explain temporary or occasional work a health care worker offers to a provider. For instance, a Social Worker may work "per diem work," which means that he/she is asked to work only when there are patients to serve, and he/she only receives pay based on the exact amount of hours worked.

A number of days that a person must wait before benefits or an entitlement begins

Common among both ALZ patients as well as stroke victims - the act of repeating words or concepts over and over, retelling the same story Phobias (at least the ones you'll likely hear about as they're prevalent): Fear of going outdoors Fear of elevators Fear of people Fear of dying Fear of choking Fear of heights Fear of cats or dogs Fear of medications Fear of not being close enough to a bathroom Fear of dying Fear of falling

the belief that other people are watching them and judging them constantly. In milder cases, people don't want to be seen eating or drinking in front of other people - causes humiliation

Progressive, degenerative neurological disease similar to ALZ.

The act of shredding paper and rolling it into small balls or rubbing or twisting clothing to create small balls. AD patients can also practice this behavior by rubbing their skin repeatedly or by rubbing the carpet.

Liquid has entered the lungs

The act of holding food or medications in the cheeks - primarily a behavior from someone who has loss of cognitive abilities - forgetting how to swallow, but can also be a behavior of someone who has failure to thrive; or is paranoid and does not want to swallow medications.

A system used by senior care providers to assess fees for services.

A document available only through a Health Care Professional. This document outlines what revival or hydration methods a person prefers in the end stages of life, or due to an accident, illness or disease.

Prospective Payment System - refers to DRGs (Diagnosis-related Groups). These classify hospital cases into one of approximately 500 groups. Medicare uses DRGs and further classifies DRGs into MDCs (Major Diagnostic Categories).

A short questionnaire or series of questions which allows an Admissions person or nurse to determine if the provider wishes to offer admission to a patient. The person completing the screening may be asking two different types of questions. One type is to determine that the provider can meet the care needs of the individual. The other type of questions involves determining if the patient is a good "risk" for the provider. Particularly when Medicare is involved and the provider is receiving a daily lump sum of money to cover all the care and medical needs (including medication and therapies), the intake person must fully understand if the provider will have an opportunity to gain a profit, break even, or sustain a loss by admitting that individual.

What a medical professional views as the primary or most obvious issue(s) Pressure sores – (aka bed sores) are an injury to the skin and underlying tissue. They can range from mild reddening of the skin to severe tissue damage – and sometimes infection – that extends into muscle and bone. (See Stage 1, 2, 3 or Wounds)

A doctor who has been asked to oversee the care of an individual

Protects personal and private information, requiring a person give authorization IN WRITING before sharing the information with any other agency or person

Typically means one-on-one care or care for a couple in their private home setting or more personalized care from a caregiver to a single person or couple within a retirement or assisted living setting. The term is used for both professionals (Nurses) as well as paraprofessionals (non-licensed individuals)

Capable of paying for services or goods out of personal funds

Pharmacological term meaning "as needed"

The process by which an executor (if there is a legal will), or a court-appointed administrator (if the descendent was intestate), manages and distributes a decedent's property to heirs or beneficiaries

Delaying or putting something off until a later date in time

Artificial limb or mechanism, intended to be a replacement for a actual body part

(a.k.a. Depends, which is brand name) Pads or full briefs to catch urine and feces and to draw moisture away from the skin.

Someone who offers lodging and/or care Provider tax (a.k.a. "bed tax") - An annual state tax which applies to licensed facilities and communities

A short-term memory loss issue that may be easily misdiagnosed and treated as dementia such as: dehydration, UTI, drug interaction

Word used to describe a mental state in which a person loses contact with reality and may not be able to function socially.

sensory perception - can be visual, auditory, olfactory, gustatory, tactile or proprioceptive (sense of balance and position in space)

a false belief

a form of mental disorder, long-lasting rigid patterns of thought and actions which causes significant distress or impairment to personal, social and occupational situations

Development in and interaction within a social environment. Can also be used to describe the internal processes that occur within an individual.

Lack of development or decline in one's personal belief in oneself, which can present in physical, emotional or cognitive ways

A chemical substance which acts primarily upon the central nervous system and alters brain function. Can temporarily change perception, mood, consciousness and even behavior.

Physical Therapy - service intended to develop, maintain or restore maximum movement and functional ability of a person. An addition goal is to minimize or eliminate pain.

Relating to the lungs or breathing.

The human body has two major areas of blood vessels that distribute from, and return blood to, the left and right heart. The portion of the circulation that distributes the blood from the left side of the heart, throughout the body, is referred to as the systemic circulation. The portion of the circulation that distributes the blood from the right side of the heart, to the lungs, is referred to as the pulmonary (lung) circulation. The left ventricle of the heart pumps oxygenated blood from the lungs into the systemic circulation. When a doctor or a nurse measures the blood pressure on a person's arm, he/she is measuring the pressures in the systemic circulation. When these pressures are abnormally high, the person is diagnosed as having high blood pressure (hypertension). The right ventricle pumps venous blood returning from the body into the arteries of the lungs to receive oxygen. The pressures in the lung arteries (pulmonary arteries) are normally significantly lower than the pressures in the systemic circulation. When pressure in the pulmonary circulation becomes abnormally elevated, it is referred to as pulmonary hypertension.

Belief that a person should enjoy their surrounding and should find joy or peace in life, free of pain and anxiety. Many people believe that this quality of life also includes having a connection to other people.

Residential Care Facility

Revised Code of Washington

Modifications to a living unit which allow someone with disabilities to function independently or as independently as possible

A quite recent belief and concept (and Law!) that an older adult may opt to not take medication, accept a treatment, eat food, take water, or refuse services such as bathing, getting dressed, etc. (Highly protected by the Residents Rights BUT in direct conflict with the WACS & RCWs, which require attention to these issues

Regulations - meaning WACs, RCWs, Labor Laws, Fire Codes

Word used to describe someone recuperating and likely getting some type of therapy to become more independent. This term is also used to describe the process of stopping the misuse or abuse of prescription or recreational drugs or alcohol.

Amount covered or repaid to someone or to an agency or business based on a specific formula

Taking time to talk about the past or to talk about things that have happened in a person's life

Condition in which the kidneys fail to function properly.

Having and holding something against somebody

A generic term for a housing facility that provides care services to its residents; examples are group homes, specialized apartment complexes or other institutions. The term can be used to refer to a wide range of residential care options including assisted living facilities, boarding homes and skilled nursing facilities.

A document intended to give protection to older or vulnerable adults

Tangible or intangible things which add value or that are needed by a person or company

Assistance with breathing or relearning to breathe, or expanding the capacity of a person to take in oxygen

Short-term stay, ranging from a couple of days to likely no more than six months

Food service where a wait person comes to the table and takes an order and brings the food to the table. The server also picks up the dishes when a person is finished eating.

Items place around or on a person to decrease the ability of the person to move or to stand up

A loan available to people age 62+ used to access equity in a home. Can be taken in a lump sum or in multiple payments. The obligation to repay the loan is deferred until the owner dies.

Creation of a fictitious entity which then owns assets.

Considered to be chronic, this is an inflammatory autoimmune disorder which causes the body to attack the joints. Disabling and painful due to joint destruction.

Registered Investment Advisor, license required to charge a fee to give financial advice.

An additional statement placed within or at the end of an insurance document which either gives clarity or perhaps an additional benefit to the insured person

Retirement Living (Typically reflects very little services other than a meal/meals and housekeeping) Most commonly written as IL, which stands for Independent Living

Registered Nurse (can be a 2 or 4 year degree)

The act of an adult child becoming the parent's support system.

A person who is in a situation where they are providing help or support to one or more parents and is also caring for one or more children

A psychiatric diagnosis describing a mental disorder. Characterized by impairment of perception or reality with significant social dysfunction.

A motorized wheelchair that looks more like a motorcycle than a chair

Low income housing for disabled or elderly

Extremely common cause of death in the elderly. Symptoms of sepsis are often related to an infection. The immunological response that causes sepsis is a systemic inflammatory response in the body, causing coagulation of pathways. This causes dysfunction of the circulatory system, organ dysfunction and eventually death.

Community-based programs providing an array of services like social activities, nutrition, and educational and recreational opportunities for older adults.

Senior Information and Assistance

A person who touches himself/herself in public, exposes him/herself or says things which are considered to be something a person should not say to someone they don't know intimately. May also denote actions a person takes outwardly, attempting to touch or make sexual advances towards another person

Protecting from

Herpes zoster. Painful blisters prevalent in people age 60+. Early symptoms include headache, sensitivity to light and flu-like symptoms without fever; may involve itching, tingling or extreme pain in the area of the rash. Not contagious, except when in the blister-phase. Once the rash develops crusting, the disease is no longer contagious.

Two children (likely adult children) act in a way that is unsupportive and competitive in nature. When two people disagree strongly and have a history of not getting along, decisions and actions are typically not made in a favorable light

Daily nursing and rehabilitative care that can only be performed by skilled medical personnel or under the supervision of skilled medical personnel. This type of care is typically needed 24 hours a day, requires a physician’s order, and must follow a specified care plan. This type of care is usually rendered in a skilled nursing facility but may also be received it other types of facilities.

Term used to describe the condition of the skin - is it dry, is skin hanging from the muscle, are there sores or wounds?

Pauses in breathing during sleep. The phrase means "without breath." Can cause blood oxygen desaturation as well as neurological arousal (waking up abruptly).

Skilled Nursing Facility (a.k.a. Nursing Home, Transitional Care, Rehab, Nursing Care)

A program for individuals age 62+ (or disabled) to draw money from funds they have placed in the Government's care during their working years

Interacting with other individuals

profession of assisting with diagnosis and rehabilitation of communication, swallowing.

A period of time that a person is using their money to pay for services or goods before they quality for entitlement

Concerning matters of belief in something greater than life, afterlife or the supernatural

Supplemental Security Income. This is "Medicare for disabled individuals"

To bring to a point where there is little or no change Stage 1, 2 or 3 wounds – Describing pressure sores (See Pressure Sores) Stage 1 – Sores are not open wounds; skin may be painful but there are no breaks or tears Stage 2 – Skin breaks open, wears away or forms an ulcer, which is usually tender and painful. The sore expands into deeper layers of the skin. It can look like an abrasion, blister or shallow crater Stage 3 – Sore extends into the tissue beneath the skin, forming a small crater, Fat may show in the sore but not muscle, tendon or bone Stage 4 – The pressure sore is very deep, reaching into muscle and bone and causing extensive damage, Possible damage to deeper tissues, tendons and joints may occur. Stages of cancer – The term ‘stage of cancer’ means the stage the cancer was at when it was first diagnosed. The stage is very important as it is a critical factor in deciding the best way to treat the cancer. Stage 0: ‘in situ’ – Cancer in the position where it started Stage 1: localized cancer – Cancer cells pass through the boundary to the tissue in which it started. This invasion is a serious step because in indicates that the growing cancer cells may threaten life Stages 2 and 3: regional spread – Commonly, at this point, a daughter cell invades through the lymph system which in turn gives the cancer the ability to spread in the local region Stage 4: distant spread – Once in the lymph system, the cancer may spread further to other more distant lymph nosed or into the blood stream thus spreading to other areas of the body.

A person is present to monitor when a resident is standing up or transferring, but likely does not touch the person unless they become unsteady

Persons who have poor circulation can have fluids which accumulate in the limbs, which causes swelling. Stasis Ulcer (a.k.a. bedsores)

medical term meaning "immediately."

because of a weakening of pelvic floor muscle, small amounts of urine can be released from coughing, laughing, sneezing, exercising or moving.

rapid loss of part of the brain function due to interruption in the blood supply to the brain

a symptom of a neurological disorder which causes shuffling or poor balance due to varied and random size of steps.

Housing which is government funded and offers a highly discounted monthly rent as a means of providing low or lower income individuals with housing

Agitation which occurs in people with dementia in the evening or early evening. Survey (as it relates to quality assurance or obtaining opinions) - A written instrument to collect feedback from participants or customers, or to solicit feedback from potential customers; Most frequently used when a business or agency wishes to understand consumer preferences or to determine satisfaction with a product or service.

An annual or recurring visit from regulatory agencies to determine if a community is following state laws, their own procedures and policies and is also supporting residents' rights. Survey also includes safety measurements such as review of evacuation plans, drills, food handler permits, etc.

A fee paid privately above and beyond what the resident (participation) and the state (Medicaid) pay the provider for care. Such a fee must be for something which is NOT covered already by Medicaid, or it is considered then Medicaid Fraud.

Three or more people who meet together to talk or give mutual support to one another. There may be a group leader, who is most often referred to as the Facilitator or Support Group Leader.

An effect some diseases or a stroke can have on a person in regards to being able to ingest liquids or solid foods.

One that affects a number of organs in the body as a whole

(not to be confused with a tax deduction) - Having the net effect of increasing net income

(not to be confused with a tax credit) - an expense incurred by a taxpayer what is subtracted from gross income and results in a lowering of taxable income

Tax has to be paid at a later date

Free of tax

A financial instrument which gives a financial tax benefit to the issuer or the holder of the instrument. For instance, in retirement living, some communities are built with tax-favored bonds. The community must offer back something specific to the community in order to receive this tax-favored benefit - for instance, a community may be required to offer a certain number of living units to individuals who earn a lower income (please note - this is not LOW income) annual earnings

A term used to describe retirement-type investments which grow tax free, until such time that the funds are accessed

A financial term which indicates that tax is not being assessed on an annual basis; however, when funds are taken out, they are taxed

Traumatic brain injury; may be from a work-related, auto accident or other unfortunate event which causes injury to the brain. Individuals with TBI may appear to have memory loss, may behave in the way a child would, and may be uninhibited by other people or themselves, thereby causing themselves to be at risk

Intended to be a short-term transition location for a patient within an acute care setting (hospital). An area of the hospital which is focused on therapy and treatments rather than emergency care

Assistive phone device for people who are deaf or are hard of hearing. The device transfers speech into written words. The device also allows the person to type on a keyboard and an electronic voice sends out a reply from the person using the device

Supportive foot coverings which are extremely tight, intended to reduce edema (collection of water in the limbs) and to assist in reducing pain experienced in the legs

A telephone call to check in on someone to be certain that they are doing well

Technology having to do with the telephone; for instance, in-home care uses this technology to have caregivers "clock in" when they arrive at a client's home by dialing a phone number and then entering a series of codes or information

a form of real estate ownership where two or more persons or entities have an undivided interest in an asset, where ownership shares are not required to be equal and where ownership interests can be inherited.

A disease or illness which cannot be treated to return a person to wellness

Dying with a legally valid will in place.

Substance placed into liquids to help individuals who easily aspirate (choke) on thin liquids

frequently called simply an "embolism" or blood clot

Mini-strokes

Ringing in the ears

A schedule intended to be of help to an individual who is incontinent. By taking an individual or by reminding an individual to visit the bathroom every two hours or on a specific routine, it is possible to manage incontinence more effectively

Nutrition given through the nose

Help getting from one place to another; whether it be from a bed to a chair, from one chair to another chair; from a wheelchair to a commode, etc. Transfer assistance is provided to people who have difficulty standing on their own, or who may easily pass out when standing up on their own. It is also provided to people who have compromised circulation or diseases which affect the muscles

A beam from floor to ceiling placed next to a bed or chair. This is an assistive device which allows a person to self-transfer (for instance, get out of bed on their own by using their arms rather than their legs)

The time it takes for a person to become accustomed to their new living environment and begin to develop new routines of familiarity

This phrase is typically used for skilled nursing care which is intended to be short-term and rehabilitative in nature. This care may be offered in a section of an acute setting (hospital); or within a skilled nursing facility. The patient is most often recuperating from surgery, illness or episode of a disease. The intent is to be discharged from this care setting within a few days or possibly up to several months

An assistive device used by a person who needs to hold on to something in order to sit up in bed or to be able to elevate oneself

A testing time to determine if something is going to work out

A legal document which places real, and perhaps personal, property in the name of a "non-existing" entity. For instance: The Trust of Mrs. James Smith. All property is still controlled by the person named in the trust document; however, the real and personal property are not owned in the actual name of Mrs. James Smith, but rather in the name of "The Trust of Mrs. James Smith."

Payment made unethically or made to avoid paying taxes

involuntary loss of urine without feeling the need to urinate

A physician specializing in the bladder

A stoma, which is an artificial opening into the urinary system.

Urinary tract infection (many people misspell this as "track") A bacterial infection that affects any part of the urinary tract. Most common type of bladder infection is called cystitis (an inflammation of the urinary bladder)

A process of looking at how certain medical services are requested and performed. This term is used to define how medical professionals are effectively using resources to resolve problems or to take preventative measures.

An entitlement program provided to individuals who have served in the US military at least one day during active duty time. This program is intended for individuals who require care services in a care setting. The benefit is not available for in-home care at this time

written as VD; refers to a group of syndromes caused by different mechanisms all resulting in lesions on the brain.

A strict type of diet where the person eats no meat, fish, eggs or any product from an animal

An electrical device which assists a person to breathe

A cash payout on a life insurance policy before a person dies

Blood pressure and pulse

To urinate.

Washington Administrative Code, also known as state administrative law.

This is a brand name of an alarm system designed to alert care givers when a person has crossed a path or opened a door or window

People who are confused walk about, not knowing what they are doing or what they are seeking

The person who does not require care, and is likely remaining in the home

A mental institution located in Tacoma. Where people go who have severe mental illness, psychosis or mania which cause them to be a threat to themselves or to other people.