Glossary and Definitions of Terms Used in NJ Elder Care

UNDERSTANDING DIFFERENT TYPES OF DEMENTIA

Dementia is not a single disease; it consists of various conditions that affect memory, cognition, and daily functioning.

Understanding the type of dementia you or a loved one has can help in providing better care and support.

A quick guide to some of the most common types of dementia:

ALZHEIMER’S DISEASE

The most common form of dementia, Alzheimer’s, is characterized by memory loss, confusion, and changes in behavior. It progresses gradually, affecting a person’s ability to perform daily tasks.

VASCULAR DEMENTIA

This type of dementia is caused by strokes or poor blood flow to the brain. Vascular dementia affects reasoning, judgment, and memory. Symptoms can present themselves suddenly or more slowly over time.

LEWY BODY DEMENTIA

This form of dementia is associated with elevated deposits of certain protein(s) in the brain. People with Lewy Body Dementia often experience hallucinations, movement issues, and fluctuating levels of alertness.

FRONTOTEMPORAL DEMENTIA (FTD)

FTD affects the front and side areas of the brain. It is characterized by changes in personality, behavior, and language. It often affects younger individuals and progresses more rapidly.

MIXED DEMENTIA

In some cases, individuals can have more than one type of dementia, such as a combination of Alzheimer’s and vascular dementia. Symptoms can vary depending on the areas of the brain affected.

Comprehensive website found at hnlawfirm.com (click Dementia and Alzheimer’s Planning and Asset Protection (click here).

Vocabulary words have meaning both in life and in the law. Below I have listed the most frequent terms used in this website and what each word means. The terms are listed in alphabetical order. I am certain this glossary will be of assistance to you in your reading.

If we at Hanlon Niemann & Wright can be of assistance to you now or in the future, please do not hesitate to contact me (855) 376-5291 or e-mail me at fniemann@hnlawfirm.com.

Acute – A sudden and severe condition that affects a person’s health generally in an adverse way.
Administration on Aging (AOA) – An agency of the U.S. Department of Health and Human Services that advocates for older persons and addresses their concerns at the federal level. AOA works closely with its nationwide network of State and Area Agencies on Aging (AAA). In New Jersey, this office is called the County Office on Aging.
ADLs (Activities of Daily Living) – These are day to day abilities that every person requires to live. For example, being able to dress one’s self, tooth-brushing, bathing, feeding one’s self, being able to coordinate movements to get from one space to another (toileting, etc).
Adult Day Care – Part- or full-time care for older and disabled adults over age 18 provided during the daytime. Also called “Adult Day Service”.
Adult Care Group Home (ACGH’s) – A structured group home or private home for adults, with mental, emotional and/or physical disabilities. The resident needs help with daily tasks (getting to and from appointments; taking meds; meal preparation, etc.), cannot live independently, but because they still maintain a certain level of self-reliance, are not eligible for an assisted living or nursing home. Though some residents are placed in ACGH’s by family, most become residents chiefly through the involvement of government or private agencies.
Advanced Health Care Directive – Written statement of an individual’s preferences and directions regarding health care. Advance Directives protect a person’s rights even if he or she becomes mentally or physically unable to choose or communicate preferences regrading medical treatment.
Age-Associated Memory Impairment – Mild memory loss that increases with age. Mild memory loss is normal and should not be confused with forms of dementia, which are progressive and affect everyday living.
Alzheimer’s – There is much confusion among those both inside as well as outside the scientific community concerning the precise distinction between Alzheimer’s and Dementia. However, though the two terms are often used interchangeably, Alzheimer’s is a specific form of or cause of dementia but, unlike certain forms of dementia, is not curable. The chief symptoms of Alzheimer’s involve its effects on the parts of the brain that control through, memory, and language.
Alzheimer’s Care Unit (Memory Care Facility) – A separate, secured area where those residents with Alzheimer’s (and those suffering from some form of dementia, vascular dementia, Lewy Body Dementia, Huntington’s, Creutzfeldt-Jakob disease to name a few) are cared for by staff who are sufficiently trained and capable of providing the needed support and hands-on care to these patients.
Americans with Disability Act (American Disability Act) – Enacted in1990, this act serves to address the civil rights of the disabled. Among the forms of discrimination now rendered illegal is the failure of all who own public buildings to provide suitable ramps, etc., where needed to ensure access.
Aphasia – The loss of ability to express oneself and/or understand language.
Apraxia – Inability to carry out a complex or skilled movement due to deficiencies in cognition.
Assisted Living Care – Long term care options that offer varying degrees of personal and medical care within a home like setting. Assisted living facilities range from a private room or an apartment to a multiunit facility specializing in Alzheimer’s care. The goal of assisted living care is to maintain maximum independence. Also called “residential care”.
Assisted Living Facility (ALF) – A supportive housing facility designed for those who need extra help in their day-to-day lives but who do not require 24-hour skilled nursing care found in skilled nursing facilities or traditional nursing homes. There are many terms for the facilities that may also be used under this category but may have different licensing criteria depending on services provided, medical or otherwise. Some examples are; Adult Family Homes, Group Homes, Non-Medical Senior Housing, Personal Care Homes, Residential Care, Residential Care Facilities.
Assessment – Determination of a resident’s care needs, based on a formal, structured evaluation of the resident’s physical and psychological condition and ability to perform activities of daily living.
Assisted Living Care – Long term care options that offer varying degrees of personal and medical care within a home like setting. Assisted living facilities range from a private room or an apartment to a multiunit facility specializing in Alzheimer’s care. The goal of assisted living care is to maintain maximum independence. Also called “residential care”.
At Home Care (AHC) – A level of care in which the patient has healthcare issues but, with the assistance of a family member or friend or some other trusted person (i.e., a person who does not need professional training) can manage daily activities such as ensuring medications are taken, meals eaten, etc. Such a level of treatment allows the patient to continue to reside safely in their own home.
Beneficiary – One for whose benefit the living Trust is created or funded.
Cardiopulmonary Resuscitation (CPR) – Emergency procedure performed to support and maintain breathing and circulation.
Caregiver – An individual who cares for another person in need.
Care Plan Meeting – An in-person conference and review of patient care treatments. Meetings typically include care provider(s), loved one(s), some medical professionals, and the resident/patient, as applicable.
Center for Medicaid and Medicaid (CMS) – Agency within the U.S. Department of Health and Human Services that finances and administers Medicare and Medicaid. Among other responsibilities, CMS establishes standards for the operation of nursing care and other facilities that receive funds under the Medicare or Medicaid programs.
Certified Nursing Assistant (CNA) – A trained, licensed nursing professional who assists with the personal care needs, such as bathing, dressing or eating.
Chronic – Lasting, lingering or prolonged illness or symptom.
Cognition – The process of knowing, being aware of thoughts; the ability to reason and understand.
Cognitive Impairment – A diminished mental capacity and cognition, such as difficulty with short-term memory.
Conservator – A Court-Appointed person who acts as the legal representative of a person who is mentally or physically incapable of managing his or her financial affairs only.
Conservatorship – A formal proceeding in which the court appoints another person to act on behalf of another in business and/or personal matters.
Contingent Beneficiary – One entitled to profit from a contract or estate only upon the occurrence of a specified event, usually one who receives assets at the death of the primary or lifetime beneficiary.
Continuing Care Retirement Communities (CCRCs) – Housing communities that provide different levels of care based on resident needs, from independent living apartments to skilled nursing care. Residents move from one setting to another as needed but continue to remain a part of their CCRC.
Decedent – A deceased person.
Decendants – Persons who follow decedent in line of descent.
Dementia: General term used to describe a set of symptoms that affects intellectual and social abilities such as memory, problem solving and communication.
Dementia Care – Specialized care that helps those diagnosed with dementia.
Discharge Planner – Social worker or nurse who assists patients and their families with health care arrangements following a hospital stay.
Do Not Resuscitate Order (DNR) – A written document that instructs medical professionals not to attempt cardiopulmonary resuscitation (CPR).
Duel Eligible – Persons who qualify for both Medicaid and Medicare.
Durable Healthcare Power of Attorney (DPA/HC) – Written authorization that names another person, such as a loved one or family member, as a healthcare agent or proxy
Durable Medical Equipment (DME) – DME refers to equipment or devices used by seniors (as well as others) who can reside in their homes by require medical aids to do so. Medicare, or private health insurance, will cover, all or in part, many such items. Check with your insurance provider to see what is covered.
Emergency Medical Services (EMS) – This term refers to the emergency medical treatment (by paramedics) and, when necessary, the transport (by ambulance service professionals) to those who have experienced a possibly life-threatening health situation following events like a car accident or an accident.
Emergency Response System – Electronic monitors that provide automatic response to medical or other emergencies.
Estate Taxes – The death taxes imposed by the Federal Government on the transfer of assets at death. Estate taxes are generally paid by the executor of the state or the Trustee of a living Trust.
Executor – The person or institution who is appointed by the testator or testatrix in his or her will to take care of the funds and property after death (also referred to as “Personal Representative” of the estate). The executor functions under the jurisdiction of the Probate Court.
Geriatric Care Manager (GCM) – An aging and elder care specialist who assists caregivers, older adults and persons with disabilities or chronic needs.
Guardian – The person who has the legal duty to care for and maintain the person and/or property of an unmarried minor child.
Healthcare Provider – Any person, organization, or institution that offers healthcare services to consumers.
Hospice Care – Care philosophy focused on reducing suffering rather than curing a condition. Hospice addresses physical, spiritual, social and emotional needs of dying individuals and loved ones. Hospice care can include pain medication, therapy or counseling.
Incontinent – Partially or totally unable to control bladder and/or bowel functions.
Infusion Therapy – Administration of liquid medications or solutions (e.g. nutritional additive, antibiotics or chemotherapy) directly into the body using an intravenous (IV) route.
In-home care – Care that takes place at home. It may be unpaid or paid care provided by loved ones, friends or professional caregivers. In-home care typically includes assistance with day-to-day tasks, such as bathing, walking or cooking.
Inter Vivos – Between the living.
Instrumental Activities of Daily Living (IADL’s) – ADLs relate to basic abilities like dressing one’s self and performing basic hygiene. IADLs refers to more advanced and complicated tasks like balancing a checkbook, grocery shopping, meal preparation, driving, or taking public transportation.
Intestate – A situation where a person dies without leaving a valid will.
Irrevocable Trust – A Trust in which an interest is given to another and in which the settlor retains no incidents of ownership or control.
Issue – Lineal descendants of all degrees (e.g., children, grandchildren, great-grandchildren, etc.).
Joint Tenancy – A co-ownership of property by two or more parties in which each owns an undivided interest that passes to the other co-owners on his or her death (known as the “right of survivorship”).
Last Will and Testament – An instrument whereby one makes a disposition of his property to take effect after his or her death.
Licensed Practical Nurse (LPN) – Certified professional who provides basic bedside care under the direction of a registered nurse (RN) or physician.
Life Tenant – A Trust beneficiary whose interest consists solely for the use of, and income flow from, the Trust funds during his/her lifetime.
Living Trust – A legal entity established by means of a written Trust Agreement during the lifetime of the creator of the Trust. The terms of the Trust Agreement govern the operation of the Trust funds.
Living Will – Legal document that specifies medical or life-sustaining treatments in the event the patient is unable to make decisions or communicate.
Long Term Care – A broad spectrum of medical and support services provided to persons who have lost some or all capacity to function on their own, and who are expected to need such services over a prolonged period.
Long Term Care Insurance – Private insurance to cover long term care needs and associated costs.
Managed Care – “Managed” is the key term here, as in being thoroughly organized. This approach to health care is predicated on the coordination of the actions of all caregivers (whether professional or nonprofessional) involved in the care of a given senior. Sharing information among themselves regarding the patient’s status, the network of caregivers seeks to avoid the mistakes that can arise when any one of them is out of the loop. These managed health care services are generally coordinated by caseworkers employed by insurance companies.
Medicaid – A joint federal and state health insurance program available to those with limited income and resources. Eligible individuals include pregnant women, children age 19 or younger, persons age 65 or older, and those who are blind, disabled or in need of nursing home care. Medicaid will pay for nursing facility care, provided the nursing facility is certified.
Medical Care – Diagnosis, treatment and prevention of disease, illness, injury and other physical and mental conditions.
Medical Director – Physician who oversees medications, examinations and treatments at nursing home or assisted living residences.
Medicare – Health insurance program administered by the federal government. Medicare is available to people who are age 65 or older, permanently disabled, or affected by kidney failure or long-term kidney disease. Medicare does not provide a comprehensive long-term care component.
Medicare Part A – Hospital insurance that helps pay for inpatient hospital care, limited skilled nursing care, hospice care, and some home healthcare. Most people automatically get Medicare Part A when they turn 65.
Medicare Part B – Medical insurance that helps pay for doctors’ services, outpatient hospital care, and some other medical services that Part A does not cover (like some in-home healthcare). Part B helps pay for these covered services and supplies when they are medically necessary. A monthly premium must be paid to receive Part B.
Medicare-Certified Bed – A nursing care facility bed that has been determined to meet federal standards for Medicare patients.
Medicare Supplemental Insurance – Private insurance that pays Medicare deductibles and co-insurances and may cover services not covered by Medicare. Most plans will pay for skilled nursing care, but only when that care is covered by Medicare. Also called “Medigap”.
Medication Management, aka Medication Administration – These terms both apply to the method employed (whether by a professional nurse, a non-professional caregiver, or the patient himself, in either senior housing or the patient’s home) to ensure that everyone involved knows which medications (whether prescription, over-the-counter, or herbal supplements) are to be taken by the patient, and that each is taken at the prescribed time and in the correct amount. All caregivers must share information regarding any changes in the patient’s drug or supplement regimen as well as data regarding the patient’s reactions to that regimen.
Medigap Insurance – A term commonly used to describe Medicare supplemental insurance policies available from various companies. Medigap is private insurance that may be purchased by Medicare-eligible individuals to help pay Medicare deductibles and co-payments. Medigap policies generally do not pay for services not covered by Medicare.
Occupational Therapy – Occupational Therapy involves the assessment of an individual’s physical state and capabilities. The goal is to maintain the patient’s maximum degree of independence, given that person’s current limitations. Following a thorough assessment of the patient and that patient’s surroundings in the home (whether their own or a facility of some kinds), the Occupational Therapist will recommend, if need be, specialized equipment (e.g. a wheelchair, cane, walker) or training (such as a driver rehabilitation) that will benefit patient.
Office of Aging – The Office of Aging is a division of the New Jersey Department of Human Services. This agency is dedicated to promoting matters of interest for older people and their caregivers. The Office of Aging works to develop effective home and community-based long-term care, services of many types. Additionally, the office administers funds to support those services.
Older Americans Act of 1965 – Enacted July 14, 1965, this was the first ever US federal-level initiative geared to protect the interests of seniors by creating the National Aging Network. The NAN is comprised of a three-tier network of agencies: (1) the federal Administration on Aging, (2) State Units on Aging, and (3) local level Agencies on Aging. This network is responsible for providing funds for nutrition, supportive home and community-based services, disease prevention/health promotion.
Ombudsman – A state agency that advocates for patient/resident rights and improvements in the long-term care system.
Patient Care Assessment – Determination of a resident’s care needs, based on a formal, structured evaluation of the resident’s physical and psychological condition and ability to perform activities of daily living.
Personal Care – Assistance with “activities of daily living,” such as getting out of bed, bathing, using the toilet, dressing, walking or eating.
Person-Centered Approach (PCA) – Also termed Person-centered care (PCC) or Resident-centered Care (RCC). This approach to caregiving for is geared for those suffering from dementia or Alzheimer’s. This approach is based on interaction between the caregiver and the loved-one. Studies have shown that it is beneficial to the patient for the caregiver to actively engage the attention of the patient, encouraging him or her to continue the activities and interests that they have enjoyed before the dementia or Alzheimer’s set in.
Personal Care Services – Refers to the services performed by healthcare workers in assisting their patients in basic, everyday activities which the patient can no longer accomplish alone. Such services would include, but are not limited to, meal preparation, bathing, dressing, getting to and from appointments, and shopping.
Physical Therapy – While anyone of any age could theoretically benefit from the attentions of a PT, aging persons specifically require the skills of a PT to recover from injuries, surgeries, or following a stroke. The PT, likely advised by an Occupational Therapist, will assist their patient in the prescribed exercises, coach them in proper use of equipment and provide other advice so that the patient may improve, possibly even regaining their former physical abilities.
Primary Care Provider – This term refers to the doctor who oversees a patient’s everyday healthcare needs. If required by the patient’s Medicare insurance plan, the PCP must be consulted by the patient for a referral before that patient can make an appointment with another doctor or specialist. If the PCP denies the validity of the request, should the patient make an appointment with that other doctor or specialist, Medicare disavows all responsibility for the resulting charges meaning the patient is solely responsible for the resulting charges.
Probate – A legal proceeding in which the court is given full jurisdiction over the assets of a decedent. Probate starts with the filing of the decedent’s Will with the Probate Court, and ends after all taxes and lawful debts of the decedent have been paid and the assets are accounted for and distributed in accordance with the terms of the decedent’s Will. Probate usually lasts for at least nine months and can often endure for two years or more.
Registered Nurse (RN) – Nurse who has graduated from a formal nursing education program and passed a state-administered exam. RNs have completed more formal training than licensed practical nurses (LPNs) and have a wide scope of responsibility including all aspects of nursing care.
Rehabilitative Care – Care services that assist those recovering from illness, injury or disease. Rehabilitative care treatments help patients regain abilities lost as a result of life-changing events.
Resident – Person living in a long-term care facility.
Resident Care Plan – A written plan of care for a patient at a nursing facility. Resident care plans are developed by an interdisciplinary care team and specify measurable objectives and service timetables to meet a resident’s medical, nursing, mental and psychosocial needs.
Residential Care Facility – A facility that provides custodial, but not medical, care to persons who, because of physical, mental or emotional disorders, are not able to live independently. RCFs can be known by other names. For instance, if there are 16 or more beds onsite, the facility may be termed an Assisted Care Facility.
Residents’ Rights – Protected legal rights of those persons living in an assisted living facility or a skilled nursing care facility.
Respite Care – A short term relief program offered in a variety of care facilities. Respite care gives both caregivers and loved ones a break. In respite care, a skilled care professional assumes caregiver responsibilities for a predetermined amount of time.
Reminiscence Therapy – This therapy has proven effective in engendering a sense of comforting security, belonging, and empowerment to those suffering Alzheimer’s or dementia. Stimulating memories of positive episodes and happier times from times past can be achieved through various mediums including those of sight, sound, smell, and taste.
Revocable Living Trust – A living Trust governed by a Trust Agreement whose terms may be amended, modified, or otherwise revoked by the settlor during his/her lifetime.
Settlor/Trustor/Grantor – Parties who establish a Trust by transferring property to their name in Trust.
Skilled Nursing Care – 24/7 comprehensive care provided in a home-like setting. Skilled Nursing Care centers promote autonomy and choice. They offer a variety of services, social activities and recreational activities.
Social Worker – Care professional committed to advancing social rights.
Speech Therapy – Speech therapy is applied to those suffering from speech or communication impediments, the specific mode of treatment dependent on that patient’s needs. In the case of a senior, this could refer to their need for assistance to regain or refine their power of speech following a stroke, a head injury following a fall, or while dealing with dementia.
Spousal Impoverishment Protection Law – Law that allows a spouse to keep some of the couple’s income assets, while still qualifying the nursing home spouse for Medicaid.
Sprinkling Power – The power vested in a Trustee to distribute income to others in a discretionary manner.
Successor Trustee – Individual who succeeds to the power to manage Trust assets.
Tenancy in Common – Tenancy in lands by more than one person in such a way that each owns an undivided share.
Therapy – Treatment of various health conditions, with the goal of restoring or improving abilities and reducing further deterioration or injury.

Fredrick P. Niemann Esq.

Have questions about Elder Care? If so, call our office today. Ask for Mr. Niemann to personally discuss your questions and individual situation toll-free at (855) 376-5291 or e-mail him at fniemann@hnlawfirm.com.

Written by Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, New Jersey Elder Care Attorney

Elder Care Attorney serving these New Jersey Counties:

Monmouth County, Ocean County, Essex County, Cape May County, Camden County, Mercer County, Middlesex County,
Bergen County, Morris County, Burlington County, Union County, Somerset County, Hudson County, Passaic County