AARP:
The American Association of Retired Persons: A non-profit organization engaged in activities such as education, lobbying, research, etc. for the benefit of the senior population.
Activities of Daily Living (ADLs):
Activities that people do independently everyday - eating, bathing, dressing, moving about (mobility), transferring (for instance, from a bed to a chair), using the toilet, and maintaining bladder and bowel continence - used to measure the ability to function.
Acute Care:
Care for illness or injury that develops rapidly, has pronounced symptoms and is finite in length. Medical care that is required for a short period of time to cure a certain illness and/or condition.
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Adult Day Care: Social,
recreational and/or rehabilitative services provided for persons who benefit from daytime supervision. An alternative between care in the home and in an institution. Refers to health support and rehabilitation services provided in the community to people who are unable to care for themselves independently during the day but are able to live at home at night.
Adult
Foster Care:
A live-in arrangement where one adult
lives with and is provided care and/or services by an unrelated
individual or family. Such arrangements may be certified by
the state or managed independently.
Ageism: Prejudice
against people because of their age.
Aging
in Place: When an older individual continues to live
at home or within the community, outside of an institutional
environment.
Alternate
Facility: A licensed residence other than a skilled
nursing facility where care services are delivered (i.e. hospice,
assisted living, Alzheimer's or Christian Science setting).
Alternate
Plan of Care Benefit: Payment for a special arrangement
of services specifically designed to allow the person to reside
in a setting other than a nursing facility (i.e. services to
provide assistance and capital improvements such as ramps,
grab bars and/or durable medical equipment).
Alzheimer's
Disease: A form of organic dementia resulting in
premature mental deterioration, first described in 1906 by
German neurologist, Alois Alzheimer.
Alzheimer's
Units: Special living units within skilled nursing
facilities or assisted living facilities specifically providing
care and services for those with Alzheimer's disease.
Aphasia: Loss
of the ability to use or understand language.
Assessment: A
determination of physical and/or mental status by a health professional
based on established medical guidelines.
Asset
Protection: Willful legal planning to achieve protection
from Medicaid ""spend-down" requirements, typically provided
by irreversible trusts - recently outlawed by Congress except
under specific conditions.
Assisted
Living Facility ( ALF):
A non-medical institution
providing room, board, laundry, some forms of personal care,
and usually recreational services. Licensed by state departments
of social services, these facilities exist under several names
including domiciliary care facility, sheltered house, board
and care home, community-based care facility, residential care
facility, etc.
Bankruptcy: An
event we are trying to avoid by utilizing the insurance mechanism.
Bed
Reservation Benefit: Pays the cost of reserving you
place in a care facility should you need to be hospitalized
during a covered stay.
Benefit
Period: The maximum time, usually in days, that a policy
will pay the daily benefit.The average stay in a skilled
nursing facility is 2.8 years, so many people choose either
a 3 year plan (1095 days) or 4 year plan (1465 days) to cover
the average stay plus a little time to spare. Others feel safest
with an unlimited benefit period.
Capital
Improvements: Permanent physical adaptations to a
residence which enables an individual to remain and function
in that environment.
Care
Coordinator: A health care professional whose training
includes managing and arranging for long term care services.
This person can be a doctor, nurse, social worker or other
similarly trained and, licensed professional.
Care
Management: Services provided by a professional,
typically a nurse or social worker, to assess, coordinate,
and monitor the overall medical, personal, and social services
needed by an individual requiring long-term care.
Caregiver
- Primary: The key person (usually a relative) overseeing
and providing the care for a person who is incapacitated.
Caregiver(s)
- Secondary: Relatives or others who assist part-time
in giving care.
Catastrophic
Illness: Illness resulting in sudden temporary or
permanent change or significant disruption to a person's normal
lifestyle.
Chronic
Care: Care for an illness continuing over a protracted
period of time or recurring frequently. Chronic conditions
often begin inconspicuously and symptoms are less pronounced
than acute conditions.
Cognitive
Impairment: Refers to the loss or deterioration of
mental capacity in people suffering from conditions such as
Alzheimer's disease.
Cognitive
Reinstatement: A provision to continue a policy
which has lapsed (providing that back premiums are paid) when
the cause of the lapse was due to cognitive impairment.
Continuing
Care Retirement Community:
A residential community providing
a variety of living arrangements and services from independent
living apartments to ALF and SNF care.
Custodial
Care:
Services that can be given safely and reasonably
by a non-medical person, designed mainly to assist with ADLs,
including bathing, eating, dressing and other routine activities.
Daily
Benefit Amount: A specified, maximum, daily, dollar
amount payable on a covered period of care. Policies offer
a range of choices in ten-dollar increments.Your choice
should take into account the local costs of care, how much
you could pay for care out of your own resources (without dipping
into savings), and how much money or care you could count on
from your family.
Elimination
Period:
A deductible. A specified time period of
covered care where no benefits are payable. Ideally, should
be selected as the longest period that you could sustain care
costs using your available, expendable assets.
Home
Health Care: Referst to a wide range of services, from
skilled care and physical therapy to personal care delivered
at home or in a residential setting.
Homemaker
Services: Assistance given in managing and maintaining
household activities that allows you to remain safely in your
home when you can not manage those activities on your own.
May include meal preparation, laundry, cleaning, chores, etc.
Inflation
Protection: Increases the daily benefit amount on
an annual basis. If elected, increases benefits in order to
protect against the effects of inflation. Most common is the
Compound 5% Inflation Rider which increases the daily benefit
amount each year by 5% of the previous years daily benefit
amount. The compound effect really begins to take off around
the 20th year, so if you are younger when you buy, this seems
to be the best choice. If you are in retirement, it's a toss-up
between paying for the extra protection or simply starting
out with a higher daily benefit at the beginning.
Intermediate
Nursing Care:
Assistance needed for stable conditions
that require daily, but not 24-hour, nursing supervision. Such
care is ordered by a physician and supervised by registered
nurses. It is less specialized than skilled nursing care, often
involves more personal care, and is generally needed for a
long period of time.
Long
Term Care (LTC):
Also called custodial care. Assistance,
expected to be provided over a long period of time, to people
with chronic health conditions and/or physical disabilities
who are unable to care for themselves without the help of
another person.
Long
Term Care Insurance (LTCI):
Insurance available through
private insurance companies as a means for individuals to protect
themselves against the high costs of long-term care. Medicaid
is a means-tested program supported by federal, state, and
local funds and administered by each state to provide health
care for eligible low-income individuals
Medicare: A
federal government insurance program to assist those age 65 and
over and the disabled with medical and hospital expenses. Medicare
covers only skilled care in a skilled nursing facility and limited
skilled nursing care at home.It does not provide benefits
for personal or custodial care. Medicare requires co-payments
and deductibles.
Medicare
Supplement or "Medigap":
Policies...are private insurance
policies that supplement Medicare benefits by covering co-payments
and deductibles for medical and hospital expenses. These policies
do not provide coverage for personal or custodial care.
Non
forfeiture Benefit: This benefit returns some of
the investment if the coverage is eventually lapsed or dropped.
It usually takes the form of a paid-up coverage with reduced
benefits. Sometimes this benefit is offered in the form of
a "return of premium" which returns all or some of your premium
payments after a period of time or upon death. The extra cost
can add from 10 - 100% to the premium cost depending upon your
specifications.
Nursing
Home: A facility that provides room and board and a planned,
continuous medical treatment program, including 24-hour-per-day
skilled nursing care, personal care, and custodial care.
Personal
Care: Refers to assistance provided by another person
to help with walking, bathing, eating, and other routine daily
tasks. It is provided by aides who are not medical professionals
but are trained to help with these tasks.
Pre-Existing
Conditions: Medical conditions that existed prior
to the effective date of the policy. Some policies may exclude
claims stemming from a condition that falls under this definition
for a specified period of time.
Respite
Care: Is nursing home or home care that temporarily
replaces the existing level of support received from an informal,
non paid caregiver for the purpose of providing care and supervision
to the patient while relieving the caregiver.
Skilled
Nursing Care: Nursing and rehabilitative care provided
by or under the direction of skilled medical personnel - available
24-hours a day & ordered by a physician under a treatment
plan. Can be either in a facility setting or at-home.Note:
Medicare and Medicaid both have their own definitions of "skilled
nursing care" which do not necessarily match those found in
LTC policies.
Skilled
Nursing Facility ((SNF): A state licensed institutional
setting which provides nursing and rehabilitative care provided
by or under the direction of skilled medical personnel - available
24-hours a day & ordered by a physician under a treatment
plan.
Spend-down: Depleting
almost all assets to meet eligibility requirements for Medicaid.
Third-Party
Notification: Gives you the option of having the "premium
overdue" notice sent to a third party as a precaution to insure
that the policy does not unintentionally lapse.
Waiver
of Premium: A provision which allows you to stop
paying premiums once you are in a period of covered care. Usually
applies to only to a facility stay, although some policies
do waive premiums for approved home health care as well. Date
when premium stoppage begins varies with each company. |
