Glossary of terms used within Assisted Living
Terms (M- R) used within Assisted Living
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Macular Degeneration - where the inner lining (the macula area of the retina) begins thinning and in some cases, it bleeds.
Managed care - 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.
Mandatory Reporter - 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.
Manic - A severe medical condition characterized by extremely elevated mood, energy and unusual thought patterns.
- Rapid speech
- Racing thoughts
- Decreased need for sleep
- Hypersexuality
- Euphoria
- Grandiosity
- Irritability
- Increased interest in goal-directed activities
Manic depressive (now called Bi-Polar Disease) - A person who experiences periods of elation and periods of depression.
MCI (Mild cognitive impairment) - Used to describe early stages of any memory impairment. Researchers believe that this is likely an early manifestation of Alzheimer's Disease
MDS (Minimum Data Set) - 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
Meals on Wheels - Local agencies providing low cost, hot, nourishing meals to the elderly and disabled, allowing frail, homebound people to remain in their own homes.
Mechanical soft - Food which has been blended or processed to aid in chewing and/or swallowing
Mechanical transfer devise - 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.
Medi-Cal - California's Medicaid program.
Medicare - 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.
Medicare Part A - Hospital insurance and insurance for up to 100 days of skilled nursing care
Medicare Part B - 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.
Medicare Part C - 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.
Medicare Part D - Prescription drug plans.
Medicare Replacement - 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.
Medicare Supplement - 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.
Medicaid - An entitlement program intended for people who require care services and who meet certain financial criteria.
Medicaid lien - see Lien
Medically fragile - 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.
Medically necessary - 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.
Medigap - 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.
Memory loss - 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.
Mental status - 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 like. 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.
MRSA (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.
MHP - Mental Health Professionals. Professionals called in when someone is at risk of harming themselves or other people
Mini Mental Exam - 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.
Moratorium - 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.
Mother-in-Law Apartment - An area of the home with a separate entrance and likely a full kitchen and bathroom.
MSW - Masters of Social Work
Multi-infarct dementia (a.k.a. Ministrokes or TIAs) - Causes approx. 20% of dementia cases - small, almost imperceptible strokes
Multiple loss - 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.
Necrosis - Typically caused from lack of proper care of a wound site, Death of cells and living tissue.
Neglect - Avoidance of person or avoiding meeting a person's physical or care needs.
Nephrologist - A physician specializing in the kidneys.
Neurologist - A physician specializing in the nervous system
Neuropathy - Tingling sensation in limbs, thought to be caused by nerve damage. Frequently seen in individuals with Diabetes.
No Code - 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.
Normal Pressure Hydrocephalus - Spinal fluid build up in the brain
Not-for-Profit - 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")
Nurse delegation - 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.
Nursing Home - 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
O2 - Oxygen
Occupational Therapist (a.k.a. OT) - 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.
Ombudsman - A state-paid or volunteer that seeks to protect the rights of residents.
Oncologist - Cancer specialist or surgeon
One step directions - 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
Osteoarthritis - (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.
Osteoporosis - a disease of the bone which reduces the bone mineral density. Bones become more susceptible to fracture
Ostomy - A stoma, which is an opening which has been surgically created to connect part of the body cavity to the outside environment.
OTC - Over the counter, medications not requiring a prescription
Out of Pocket - Amount of money a person must pay before insurance or another provider begins paying all or a portion of an expense.
Pancreatitis - 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.
Paranoia - A fear or anxiety concerning one's own well-being or safety, which is viewed by society as irrational or excessive. (see psychosis)
Paraprofessional - A person who is non-licensed
Paratransit - an alternative mode of transportation that doesn't follow a fixed route.
Parkinson's - has an apostrophe (it's ok not to write the word "Disease" after it)
Participation (as it relates to COPES) - That portion of the applicant's income that must be paid to the housing/care facility from their personal income.
Payor source - defining the person, entity, business or agency responsible for paying an invoice or bill
Pension - A stream of money paid out by a company after a person retires
Per Diem - 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.
Period of Ineligibility - A number of days that a person must wait before benefits or an entitlement begins
Perseverate - 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
- Social phobias - 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
Pick's Disease - Progressive, degenerative neurological disease similar to ALZ.
Pilling - 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.
Pneumonia - Liquid has entered the lungs
Pocketing - 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.
Points - A system used by senior care providers to assess fees for services.
Polst Form - 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.
PPS - 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).
Pre-admission screening - 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.
Presenting illness - What a medical professional views as the primary or most obvious issue(s)
Primary care physician - A doctor who has been asked to oversee the care of an individual
Privacy Act of 1974 - Protects personal and private information, requiring a person give authorization IN WRITING before sharing the information with any other agency or person
Private duty - 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)
Private Pay - Capable of paying for services or goods out of personal funds
PRN - Pharmacological term meaning "as needed"
Probate - 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
Procrastination - Delaying or putting something off until a later date in time
Prosthetic - Artificial limb or mechanism, intended to be a replacement for a actual body part
Protective undergarments - (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.
Provider - 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
Pseudodementia - A short-term memory loss issue that may be easily misdiagnosed and treated as dementia such as: dehydration, UTI, drug interaction
Psychosis - Word used to describe a mental state in which a person loses contact with reality and may not be able to function socially.
- Hallucinations - sensory perception - can be visual, auditory, olfactory, gustatory, tactile or proprioceptive (sense of balance and position in space)
- Delusions - a false belief
- Personality disorders - 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
Psychosocial - Development in and interaction within a social environment. Can also be used to describe the internal processes that occur within an individual.
Psychosocial dysfunction - Lack of development or decline in one's personal belief in oneself, which can present in physical, emotional or cognitive ways
Psychotropic medications (or drug) - A chemical substance which acts primarily upon the central nervous system and alters brain function. Can temporarily change perception, mood, consciousness and even behavior.
PT - 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.
Pulmonary - Relating to the lungs or breathing.
Pulmonary Hypertension - 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.
Quality of Life - 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.
RCF - Residential Care Facility
RCW - Revised Code of Washington
Reasonable accommodation - Modifications to a living unit which allow someone with disabilities to function independently or as independently as possible
Refused or Refusal - 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
Regs - Regulations - meaning WACs, RCWs, Labor Laws, Fire Codes
Rehab - 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.
Reimbursement rate - Amount covered or repaid to someone or to an agency or business based on a specific formula
Reminiscing - Taking time to talk about the past or to talk about things that have happened in a person's life
Renal failure - Condition in which the kidneys fail to function properly.
Resentment - Having and holding something against somebody
Residential Care Facility - 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.
Resident Rights - A document intended to give protection to older or vulnerable adults
Resources - Tangible or intangible things which add value or that are needed by a person or company
Respiratory therapy - Assistance with breathing or relearning to breathe, or expanding the capacity of a person to take in oxygen
Respite (a.k.a. Respite Care) - Short-term stay, ranging from a couple of days to likely no more than six months
Restaurant style dining - 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.
Restraints - Items place around or on a person to decrease the ability of the person to move or to stand up
Reverse Mortgage - 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.
Revocable Living Trust - Creation of a fictitious entity which then owns assets.
Rheumatoid Arthritis - 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.
RIA - Registered Investment Advisor, license required to charge a fee to give financial advice.
Rider - 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
RL - Retirement Living (Typically reflects very little services other than a meal/meals and housekeeping) Most commonly written as IL, which stands for Independent Living
RN - Registered Nurse (can be a 2 or 4 year degree)
Role Reversal - The act of an adult child becoming the parent's support system.
Copyright 2007 © All rights reserved, CHOICE Advisory Services, Inc.
Last update: 2007-12-06 18:45
Author: Support
Revision: 1.2
