Please keep in mind that we have included this glossary for learning purposes, and do not necessarily endorse or recommend any of the programs or services below.

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

Accessibility - Use and design of a space that allows the greatest amount of use by a person with a disability (examples: easy reach appliance, turning spaces that would allow a wheelchair to maneuver easily).

Activities of Daily Living (ADL) - These are fairly standardized, universally accepted tasks, such as dressing, bathing and eating, which indicate a person's ability to manage independently or his/her need for assistance.  Inability to perform Activities of Daily Living can be measured objectively, thereby providing valuable guidance when decisions about care and living arrangements must be made.  For example, a person who cannot get out of a chair without assistance may need a specific intervention, such as physical therapy, or he/she may need 24-hour oversight in case of emergency, depending upon many other factors.

Adaptability - Use and design of space that addresses the problems of individual differences over a period of time.  Allows the space to be easily changed as needed (examples: widening an existing doorway, adding a stair lift to a staircase).

Adult Day Care - Community-based programs designed to meet the needs of adults with functional impairments.  Through a structured and comprehensive program, adult day care centers offer a variety of health, social and related support services in a supervised, protective setting during some portion of the day.

Advance Directives - These legal documents state your choices about medical treatment or name someone to make decisions about your medical treatment, if you become unable to speak for yourself. There are four types of advance directives recognized in Texas:

1. A Directive to Physicians and Family or Surrogates (Living Will)
2. A Medical Power of Attorney
3. A Mental Health Treatment Declaration
4. An Out-of-Hospital Do Not Resuscitate Order

Advocacy Assistance - Programs that seek to influence legislative or regulatory actions to benefit specific interest groups or achieve specific social, political or environmental goals. Advocacy programs may intercede on behalf of individuals or groups to ensure that they receive the benefits and services to which they are legally entitled and that rights guaranteed by law are protected and enforced.

Alzheimer's Disease - Alzheimer's disease (pronounced AHLZ-hi-merz) is one of several disorders that cause the gradual loss of brain cells.  The most common cause of dementia is Alzheimer's disease.  A common mistake is to use the terms dementia and Alzheimer's interchangeably. A person who has dementia does not always have Alzheimer's. See "dementia" for more information.

Area Agencies on Aging (AAA) - Established under the Older Americans Act (OAA) in 1973 to respond to the needs of Americans aged 60 and over in every local community.  AAAs in communities across the country plan, coordinate and offer services that help older adults.  By making a range of options available, AAAs make it possible for older individuals to choose the services and living arrangement that suit them best.  The designated AAA for the Houston Harris County area is Harris County Area Agency on Aging (http://www.houstontx.gov/health/Aging/).

Assisted Living Facilities - These facilities are ideal for the person that does not need round-the-clock nursing and medical care but does require more personal care and health services than independent living provides.  Service provided may include dispensing medication; assistance with bathing, dressing, and personal grooming.

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Caregiver - If you are helping a spouse, relative or friend with basic activities-like driving them to the doctor, shopping, cooking, paying bills, bathing, housekeeping, managing medications and even arranging for others to provide services-you are a caregiver.  Extended family and non-family (by traditional definitions only) caregivers are increasingly part of an older adult's care network when illness or injury makes one necessary.

Care Manager or Case Manager - These terms are often used interchangeably. They may mean something different under a health insurance plan or within a public agency, but all care/case managers determine what a person needs/wants and then try to find and put those things in place.  This is called the assessment and care plan process and may be ongoing, not just a one-time occurrence. Good care/case management respects the client's autonomy.  Hospital social workers, discharge planners, community or county social services staff, nurses and private practitioners all may perform some case/care management tasks.

Certified Aging-in-Place Specialist (CAPS) - The CAPS designation identifies professionals that have been trained to help retirees and older adults remain in their homes safely, independently, and comfortably, regardless of income or ability level, and continue to live in a familiar environment throughout the maturing years.

Continuing Care Retirement Communities (CCRCs) - CCRCs are retirement communities with more than one kind of housing and different levels of care.  Most CCRCs offer three basic levels of housing on an as-needed basis: fully independent living, assisted living (personal care services) and skilled nursing care.  The basic idea of a CCRC is that once an individual becomes a resident, he/she never has to move again because any housing type and personal care services he/she will probably ever need are provided within the single campus setting.

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Dementia - Dementia is not a specific disease. Instead, it is an umbrella term for several diseases and symptoms related to a decline in thinking skills. Dementia is a category. Alzheimer's disease is a type of dementia. Dementia is a loss of intellectual ability. Thinking, remembering, and reasoning are impaired.  When this happens, a person may not perform daily activities well. Dementia is a progressive illness. The brain and eventually other body systems are affected. We do not have all the answers for why some people are affected by dementia and others are not. The most common cause of dementia is Alzheimer's disease. Other causes of dementia are dementia with Lewy bodies, Alzheimer's disease with vascular dementia, Alzheimer's disease with Parkinson's disease, and frontal lobe dementias. Then there are the rarer dementias, which include dementia due to human immunodeficiency virus, Creutzfeldt-Jakob disease and Huntington's disease.

Directive to Physicians and Family or Surrogates (Living Will) - A living will is the common name for a "Directive to Physicians and Family or Surrogates."  It tells your doctor or other health care providers whether you want to withhold or withdraw life support if you are in a terminal condition or in an irreversible condition. A living will only deals with medical issues while you are still living. You do not need a lawyer to complete your Texas living will.

Discharge Planning - This service is usually performed by a social worker on staff in connection with a discharge of a patient from a hospital, nursing home or like institution. A smooth transition in moving from one level of care to another involves assessment by the social worker of the patient's level of need. The discharge planner also contacts home health agencies to assist the patient in connection with his/her home care.

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Elder Abuse and Neglect - Programs designed to assist and protect older persons who are either institutionalized or reside in the community and who might be subjected to or vulnerable to the infliction of physical pain, mental anguish, unreasonable confinement, exploitation or the willful deprivation of essential services to the degree that it harms, or threatens with harm to, their physical or emotional health. Adult protective services and institutional abuse reporting programs are mandatory in Texas.

Elder Care Experts - Trained to listen to your unique situation and suggest services to meet your needs, Elder Care Experts help older adults in Harris County get connected to local services. Dial 2-1-1 for free answers to your questions.

Elder Law Attorney -These are lawyers who specialize and are well-versed in the areas of law of particular interest to older adults. The Older Americans Act mandates that part of its funding be used to insure access to legal services for anyone age 60 and over, so no one need go unrepresented, particularly where loss or denial of benefits, eviction, mistreatment or inappropriate discharge from a facility are at issue. Call your local Area Agency on Aging to find out who provides elder legal assistance in your area.

Employee Assistance Programs (EAP) - Employee Assistance Programs are offered by some employers as non-financial benefits that come with the job. One possible option is eldercare counseling, a term for assistance with the responsibilities of caregiving for an older family member while you work. Typically, this includes referrals to service providers and some level of assessment service

Ethical Wills - Ethical wills are a way to share your values, blessings, life's lessons, hopes and dreams for the future, love, and forgiveness with your family, friends, and community.

Executor - An executor is a person or institution named in a Will to administer the estate.

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Financial Assistance - Programs that provide temporary or ongoing financial assistance for individuals facing an unexpected financial crisis and for eligible low-income individuals to ensure that they have a basic income or that they are able to meet emergency financial needs.

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Geriatric Assessment - Programs that evaluate the medical or psychosocial functioning of an elderly person to arrive at a diagnosis and identify possible treatment.

Guardian - There are generally two types of guardians; guardian of the person and a guardian of the estate. The guardian of the person is responsible for providing the incapacitated person with clothing, food, medical care and shelter. The guardian of the estate has the duty and power to manage incapacitated adult's financial affairs. One person can fill both positions.

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Health Centers/Clinics - Outpatient health care facilities that provide a broad range of diagnostic medical care and treatment services that may include examinations, immunizations, dental care, laboratory and radiology services and health education. Services are usually available on ability-to-pay basis and target low-income and indigent residents of the community. Services may be available through private, nonprofit organizations or county-operated outpatient facilities.

Home Care Services - Programs that make certain types of personal care available for elderly, disabled, ill or convalescent individuals in their homes. These services are designed to help enhance a person's quality of life as well as to prevent or postpone the need for higher levels of care. Services included are: chores' grocery delivery, hairdressing in the home, homemaker, pharmacy, and respite care.

Home Health Agencies - Companies that provide short-term skilled nursing or rehabilitative services to homebound persons following a decline in function or an acute illness. Medicare, Medicaid, Veteran's Administration or private insurance may cover these services. Medicare will pay 100 percent of the cost of services when the doctor orders skilled, intermittent nursing care or rehabilitation services. The program does not cover ongoing care. Medicare will also pay 100 percent when the doctor orders the services of a part-time home health aide in conjunction with those skilled services. The home health aide will assist with bathing and dressing of the patient and light housekeeping in the area the patient occupies. These nurses, therapists and aides remain in the patient's home only long enough to perform their specific tasks.

Hospice Care - The goal of hospice is to care for you and your family, not to cure your illness. Hospice is a special way of caring for people who are terminally ill, and for their families. This care includes physical care and counseling.

Hospitals - Facilities where patients receive medical care, screening, counseling, evaluation and treatment for illness, injury or disability. Hospitals may also provide non-medical hospital-based outpatient services, such as senior enrollment programs, social services and physician referrals.

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Incapacitated Person- An adult who, because of physical or mental conditioning, is unable to feed, clothe or shelter himself/herself, to care for his/her physical health, or to manage his/her financial affairs.

Income Security - Programs that provide public assistance and support for the eligible needy and ensure those retirees, older adults, disabled people and other eligible individuals receive the social insurance benefits to which they are entitled.

Incontinence - Continence is the ability to control bladder and bowel functions. A person who has lost this ability or has "accidents" may be considered "incontinent."

Information & Referral - Programs whose primary purpose is to maintain up-to-date information about human services in the community and to link people who need assistance with appropriate service providers.

Insurance Programs - Programs that issue policies by which a company agrees to pay a specified amount to the beneficiary upon the insured person's death or programs that indemnify or reimburse policy holders for all or a portion of the cost of hospital or medical care or lost income arising from an illness or injury.

Intestate (without a will) - When a person dies without a will, the law determines who the heirs are, and assets are disposed of according to whether they are community or separate property.

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Living Trust - A trust is an alternate way to hold title to your assets during your lifetime. In the event of your incapacity, a person designated by you would serve as the successor trustee and manage the assets for your benefit. Upon your death, the assets held in the trust would be distributed as you have specified and would not go through the probate court system. A living trust arrangement does not provide any income tax or estate tax advantage versus the planning that could be done by having a will.

Long Term Care - Long term care is not just nursing home care. It covers a variety of arrangements such as shared housing, retirement communities, assisted living and home health and personal care that is generally custodial in nature. Given the complexity and options, it is considered advisable to plan ahead and learn about available services and resources in your local area.

Long Term Care Insurance - This type of private insurance policy can help pay for many types of long-term care, including both skilled and non-skilled (custodial) care. Policies can vary; some may cover only nursing homes whereas others may include coverage for a range of service like adult day care, assisted living, medical equipment and informal home care.

Long Term Care Ombudsman - Ombudsman provides advocacy services to nursing home and assisted living residents in the metropolitan area. In Houston the program is administered by the UT Center on Aging at the School of Nursing.

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Mediation - Mediation is the use of a neutral third party to assist in resolving disputes. Elder Care Mediation involves a decision that involves a senior, anyone over the age of 50 years young. Mediation offers a legally binding opportunity for families to have a quality, productive conversation which is timely, inclusive, private, safe, and empowering. It can be among family members, between family members and a long term care facility, or with any combination of parties who need to make decisions and explore solutions. Elder care family mediation is an effective process for making life transition decisions prior to the onset of a crisis.

Medicaid - Medicaid is a health benefit program administered by the State for people with low incomes who meet other eligibility requirements. Both eligibility and benefits vary state to state and do not "transfer" from one state to another. Medicaid pays for nursing home stays for those people who have exhausted nearly all their assets and financial resources.

Medical Power of Attorney - A Medical Power of Attorney (formerly known as Durable Power of Attorney for Health Care) is a legal document which allows you to appoint another person to make health care decisions for you if you should become temporarily or permanently unable to make those decisions yourself.

Medicare - Medicare is a federal program for hospital and medical care tied to Social Security eligibility, for individuals age 65 and older and certain disabled persons, regardless of income. Medicare is a national program, which moves with you from state to state. Medicare does NOT pay for extended nursing home stays. Medicare part A covers hospital and short term skilled care, while part B covers physician services, therapies and home health care, and part D covers prescription medication and some medical supplies.

Medigap - is a term coined for privately purchased health insurance that fills in the "gaps" in Medicare coverage. You may purchase this through private health insurance policies to supplement Medicare coverage for hospital and doctor bills; it does not provide help with long term care costs.

Mental Health Treatment Declaration (MHTD) - This document allows you to tell your doctor and other health care providers about your preferences and instructions regarding your mental health care treatment, if you are no longer able to make these decisions yourself.

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Nursing Homes - A nursing home provides care to people who can not be cared for at home or in the community. Nursing homes usually provide 24-hour medical care as well as room, meals, activities, and some personal care. Care in a nursing home can be very expensive.

Nutrition Services - Programs that seek to meet the basic nutritional needs of the elderly or disabled by providing improved access to free or low-cost food, including home-delivered meals (Meals on Wheels), congregate meals, and food stamp coupons that can be exchanged for food in nearly all grocery stores.

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Palliative Care - Palliative care is an approach to health care that focuses on improving the quality of life for those with a terminal or life-limiting illness. Palliative care treats death and dying as a normal life process that intends to neither hasten nor postpone death, while respecting the patient's wishes. Palliative care offers a support system that emphasizes comfort and the reduction of suffering for both the patient and their family.

Personal Care Attendant - Personal care attendants (also called homemakers, caregivers, companions and home care aides) help people who are elderly, disabled, ill, and/or mentally disabled to live in their own homes or in residential care facilities instead of in health facilities or institutions.  They assist with personal care activities such as, bathing, dressing, toileting, transferring, and eating, and home-making activities such as preparing meals, doing light housecleaning, and shopping.

Personal Care Homes - Personal care homes see Assisted Living Facilities listed above.

Power of Attorney - A power of attorney lets you give someone the authority to act on your behalf. A Durable Power of Attorney is a written document that gives one or more persons the authority to make personal and financial decisions if you are no longer able to make decisions for yourself.

Prescription Programs - Programs that help individuals obtain prescription medications at reduced or no cost. Eligibility is usually based on need or income.

Primary Care Physician (PCP) - A physician, such as a general practitioner, chosen by an individual to serve as his or her health-care professional and is capable of handling a variety of health-related problems, of keeping a medical history and medical records on the individual, and of referring the person to specialists as needed.

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Representative Payee - A representative payee is an individual or organization that receives Social Security and/or SSI payments for someone who cannot manage or direct the management of his/her money. Payees should use the funds for the current and foreseeable needs of the beneficiary and save any remaining funds for the beneficiary's future use.

Respite Care - Temporary relief from the duties of caregiving that range from several hours to days. Care can be provided in-home or in an adult day center or in a residential care setting such as an assisted living facility or a nursing home.

Reverse Mortgage - A federally insured loan that allows homeowners aged 62 and over to convert the equity in their homes into cash, while they are living in their homes. Instead of making monthly payments to a lender, as with a regular first mortgage or home equity loan, a lender makes payments to you. While a reverse mortgage loan is outstanding, you continue to own the home and hold title to it. The loan comes due in full when you move out, die or sell your home.

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Senior Centers -The centers in area range from centers where there may be an activity room to large multi-purpose centers with fitness and computer centers. These centers provide services to older adults such as home delivered meals, hot noon meals, recreation, transportation, intake for employment programs, outreach, trip, education and other services to assist older adults to remain independent in their own homes.

Spirituality - Spirituality refers to having a personal belief system that provides meaning and purpose to one's life.

Support Groups - Groups of individuals who share a common problem or concern and who meet together on a voluntary basis for mutual support. Members of mutual support groups share their experiences, strengths and hopes and rely on one another for assistance in the group setting. Professionals or peers may facilitate groups.

Supportive Services - Programs that decrease the personal and social isolation of elderly or disabled individuals.

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Terminally Ill - An illness, disease or injury where recovery can no longer be reasonably expected. For purposes of Medicare-covered hospice care, a person with a terminal illness has a life expectancy of six months or less, as certified by a physician, if the illness runs a normal course.

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Universal Design - Those design features that make a home safe and comfortable for everyone, young or old, whether they have a disability or not and benefits everyone by accommodating limitations.

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Visitability - Provides for a minimum level of access based on the Americans Disability Act (ADA) initiatives that will allow a person using a wheelchair basic access to the ground floor of a home (examples: 32" clear doorways, first floor bed and bath with enough space for two to simultaneously use space).

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Wellness Programs - Programs designed to educate individuals or groups about the connection between good health habits and quality of life. These programs focus achieving health benefits through positive changes in physical, psychological or social areas of life.

Wills - Wills are written documents that state how your estate should be handled and by whom, after you are deceased. While the law does not require a lawyer to write a will, an attorney can help avoid needless expense due to improper planning. If a person dies without a will or trust, or has not transferred property in some other way, the state determines how the property is distributed.

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Adapted from the Age Wise glossary and frequently asked questions of the Area Agency on Aging, Atlanta Region.  Special thanks to Aging Atlanta, a Robert Wood Johnson Foundation's Community Partnership for Older Adults initiative.