ELDER CARE: Caring for California’s Aging Population : RESOURCE GUIDE: CARING FOR THE ELDERLY : Glossary

ACUTE CARE--Medical services provided by physicians, nurses and other health-care professionals for a person who has disease or ailment that requires immediate but short-term attention.

ADULT DAY CARE--Centers that provide recreation, rehabilitation or nursing care for adults who suffer from memory loss, depression and loneliness.

ATTENDANT CARE--Full-time aides who help with feeding, bathing and other basic services for disabled people.

BOARD-AND-CARE FACILITIES--Also known as residential-care facilities, these are living quarters for the elderly in private homes, hotels or apartments. They must be licensed by the state and do not provide nursing care.

CASE MANAGERS--Also known as care managers, these professional advisers help evaluate the changing social, psychological, financial and housing needs of the elderly. Often trained as social workers or nurses, case managers evaluate an elderly person’s situation and make recommendations for the purchase of equipment or the hiring of household workers. They also can find new living quarters and coordinate medical, legal and financial services. Fees vary enormously.

COMPANIONS--Non-medical personnel who are hired or volunteer to take care of an elderly person who can’t be left alone.

CONSERVATOR or GUARDIAN--A person, usually a friend or relative, appointed by the court to handle to the affairs of an elderly person when that person requests help or is deemed incapable of managing alone.

DAY HOSPITALS--A cross between mini-hospitals and clinics, these facilities--also called geriatrics centers--offer services for individuals with multiple illnesses who need detailed medical and psychological evaluations.

FEE-FOR-SERVICE CARE--The form of health care provided under so-called indemnity insurance plans. Consumers are allowed to go to the physician or hospital of choice and they must pay premiums and a deductible, usually the first $100 to $500 in medical bills each year. Patients must also co-pay or assume responsibility for part, typically 20%, of doctors and hospital charges.

HMO--Health maintenance organization, also known as a prepaid health plan or a prepaid group practice plan. Services range from office visits and medications to surgery. Patients may be limited in the number and types of procedures they can receive and may not always get to see the physician or specialist of choice.

HOME-HEALTH AIDES--Working under the supervision of a nurse, these trained medical assistants bathe, administer medications, give injections, change bandages. Such services, provided by public and private agencies, can be covered by insurance or Medicare if they are deemed medically necessary and ordered by a physician.

HOMEMAKERS--Individuals who provide in-home support services: household chores, light cleaning, laundry, shopping and food preparation. Homemakers placed through agencies are often experienced with the problems of the elderly, but care should be taken to check references and conduct interviews first.

HOSPICE CARE--Specially planned medical, social and psychological care provided at home, in hospitals or in special facilities for the terminally ill. The goal of hospice care is to make the patient as comfortable as possible.

IN-HOME SUPPORT SERVICES--Household chores, shopping and personal care, including bathing and dressing, are provided by private businesses and government agencies. Fees vary by location and type of services needed. Financial assistance for in-home care is provided for low-income individuals by government agencies and some private churches and foundations.

LIFELONG CARE COMMUNITIES--Some retirement complexes provide a variety of housing alternatives in one location, ranging from separate apartments for fully independent and mobile residents to full-service nursing care for the mentally or physically disabled. Fee structures vary but are normally high because care is available no matter what the need. Because the communities are so new, few government regulations exist.

MEDICAID/MEDI-CAL--The federal and state governments provide health insurance for people 65 and older and those who are disabled and have low incomes and few assets. Medi-Cal in California covers the costs of nursing homes for those who cannot afford to pay themselves.

MEDICARE--Part of the Social Security Act, this federal health insurance program pays part of the costs of acute hospital care for people 65 and older after the patient has paid a deductible and at least 20% of the hospital bill. Part B of the act requires the patient to pay monthly fees, similar to those in private insurance programs, in return for payment of some doctors’ fees by the plan. The plan covers little, if any, of the costs of nursing home care.

MEDI-GAP INSURANCE--Many people purchase supplemental insurance, known popularly as “medi-gap” coverage. Such insurance may help pay Medicare deductibles and co-payments and items not covered by Medicare, such as hearing aids, eyeglasses and prescription drugs. Consumers should note whether the supplemental policy has its own deductibles or exclusions, whether it will cover preexisting illnesses and whether it can be canceled if too many claims are made.

MEALS-ON-WHEELS--Home-delivered meals are provided by churches, synagogues and government agencies. The meals tend to be nourishing and well-balanced, and the costs are usually low.

NURSING HOMES--These facilities provide a wide range of care for the frail or ill. They are generally classified by the level of service they provide: skilled nursing facilities for special or complex medical problems, intermediate for minor nursing requirements and custodial for bathing, feeding or close supervision but few medical needs. Residency in a nursing home may be temporary or long-term. Although only about 5% of frail elderly Americans live in nursing homes, they consume the largest proportion of money spent on long-term care for the elderly.

OMBUDSMAN--Every licensed nursing home in California is required to post a telephone number of an independent investigator designated to ensure that the rights and dignity of their residents are respected.

PROTECTIVE SERVICES--Under the auspices of local governments, protective service workers investigate complaints of suspected abuse, neglect or danger among the elderly. Anyone who has been subject to neglect or abuse, or knows of a case of mistreatment, should contact an elder-abuse hot line.

RETIREMENT COMMUNITIES--Often located in warm climates, small towns or near universities, these apartment complexes offer security, companionship and recreation for senior citizens. Services and quality vary widely. People who are considering moving to such communities should consider whether the costs fit their budgets and whether the community would accommodate them or refund their investment should they become incapacitated.

RETIREMENT HOTELS--Similar to residential hotels, these facilities typically offer meals and living quarters on a day-by-day or week-by-week basis. Although they provide no nursing care, they often cater to special needs of the elderly.

RESPITE CARE--Adult children or other family care givers who need a break from duties can call private agencies or senior centers for temporary assistance in caring for an elderly person.

SENIOR CENTERS--Financed by government agencies and private donations, neighborhood centers offer a variety of services, ranging from lectures to counseling. A few offer medical care and counseling.

SUPPORT GROUPS--Sponsored by hospitals, senior centers, government agencies and private foundations, informal groups of people with common problems meet to share experiences and discuss coping strategies during difficult times. Support groups have been established both for those who need care and those who give care.

TELEPHONE REASSURANCE--Most senior centers provide daily telephone checks for the homebound. Calls are often placed by volunteers, who sometimes also make visits.