ABBREVIATED UNDERWRITING:
In this type of underwriting, the long term care insurance application asks few health-related questions which are designed to determine who may be immediately eligible for benefits, or eligible for benefits within a short period of time.

ACCELERATED DEATH BENEFIT:
A life insurance policy benefit that lets the insured person use some of the policy's death benefit prior to death for purposes such as long-term care.

ACTIVITIES OF DAILY LIVING: 
Routine activities that people tend do everyday without needing assistance. There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence. An individual's ability to perform ADLs is important for determining what type of long-term care (e.g. nursing-home care or home care) and coverage the individual needs (i.e. Medicare, Medicaid or long-term care insurance).

Examples of ADLs are:
Bathing
Dressing
Grooming
Eating
Bed mobility
Transferring
Toileting
Walking
Many insurance policies use the inability to perform a certain number of ADLs (such as 3 of 8) to determine eligibility for benefits. See also Instrumental Activities of Daily Living (IADL).

ACUTE:
Short term, severe symptoms.

ACUTE CARE:
The care provided for a medical condition from which a patient is expected to recover and resume a "normal" lifestyle, even though it may not be the same as before onset of the condition. Acute care usually refers to physician and/or hospital services of less than three months' duration.

ADL:
Acronym – Activity of Daily Living

ADMINISTRATION ON AGING (AOA):
An agency of the US Department of Health and Human Services.

ADULT DAY CARE:
Community-based care designed to meet the needs of functionally and/or cognitively impaired adults who, for their own safety and well-being, can no longer be left at home alone during the day.  It is a helpful option for individuals living at home whose family caregivers work and who require someone to be with them throughout the day.  Adult day centers offer protected settings which are normally open five days a week during business hours and include a mixture of health, social an support services. Many programs provide meals and transportation services to and from a patients home, and specialized programs for individuals with Alzheimer's disease or related disorders.

ADULT GUARDIAN:
The person appointed by a court, usually a probate or surrogate court, to perform court-ordered tasks of caring for an incapacitated adult's financial affairs and personal needs.

ADULT PROTECTIVE SERVICES:
State or county run program(s) designed to protect adults who may be physically, emotionally or financially abused and/or neglected.

ADVANCE DIRECTIVE FOR HEALTH CARE:
A written document that specifies how the signer wants medical decisions to be made. A health care advance directive may include a Living Will, a Durable Power of Attorney for Health Care or both.

AGITATION:
Extreme emotional disturbance; perturbation.

ALZHEIMER’S:  
the most common form of dementia, a neurologic disease characterized by loss of mental ability severe enough to interfere with normal activities of daily living, lasting at least six months, and not present from birth. AD usually occurs in old age, and is marked by a decline in cognitive functions such as remembering, reasoning, and planning.

AMBULATE:
To walk.

AMBULATORY:
Able to walk.

AMBULATORY AIDS:
Ambulatory aids include a range of devices to help seniors move about safely and independently when additional support is needed. Types of ambulatory aids include: walkers, cruisers, forearm crutches, canes, wheelchairs, and motorized scooters. These aids are often paid for by Medicare/Medicaid or private insurance.

ANALGESICS:
A class of drugs used to reduce pain. Aspirin, Tylenol, Darvon, Codeine, Demerol and Dilaudid are analgesics.

ANCILLARY SERVICES:
Those services needed by a nursing home resident, but not provided by a nursing home, such as podiatry, dentistry, etc., and which may not be included in the basic rate of the facility.

ANNUITANT:
The person entitled to receive an annuity.

ANNUITY:
A series of payments made periodically for a specific period of time. The payment amounts can be variable or fixed. Many insurance companies sell a wide variety of annuity contracts with payments that begin immediately upon purchase of the contract or are deferred until some time in the future. Some annuity contracts waive their surrender charges (early withdrawal penalties) in the event of a lengthy hospital stay, nursing home confinement, or terminal illness.

APHASIA:
A speech/language disorder that impairs a person's ability to communicate. It is most commonly the result of a stroke, but can occur from any severe head injury

AREA AGENCY ON AGING (AAA):
Local government agency that grants or contracts with public and private organizations to provide services for older persons, created by a provision of The Older Americans Act. Services include information and referral for in-home services, counseling, legal services, adult day care, skilled nursing care/therapy, transportation, personal care, respite care, nutrition and meals.

ASPIRATION:
Withdrawing fluid by suction.

ASSIGNMENT:
A method of billing Medicare for services. The provider agrees to bill Medicare directly for services and agrees to accept Medicare's allowed charge as payment in full. Medicare pays the provider directly. The provider can then bill the beneficiary for deductibles and coinsurance.

ASSISTED LIVING:
A living arrangement in which people with special needs, especially seniors with disabilities, reside in a facility that provides help with everyday tasks such as bathing, dressing, and taking medication.

ATROPHY: Reduction in size of normal organ.  Loss of strength and mass in muscle tissue caused often by lack of movement.

ATTORNEY-IN-FACT:
In legal terms, the person who is granted power-of-attorney.

AUTHORIZED REPRESENTATIVE OR REPRESENTATIVE PAYEE:
The person designated by a Social Security (SS) beneficiary or Supplemental Security Income (SSI) recipient to represent him/her before the Social Security Administration

AUTOMATIC COMPOUND INFLATION (ACI):
An inflation protection feature that helps premiums remain constant while benefits increase by a fixed percentage each year. Under the FLTCIP, benefits increase automatically by 5% compounded annually with no corresponding increase in premium.

BEDSIDE COMMODE:
A chair-like, potable toilet.

BED HOLD:
Reservation of a nursing home bed when a nursing home resident is temporarily hospitalized or out of the facility on therapeutic leave. State Medicaid programs may pay for bed holds, but are not required to. Nursing facility residents on Medicaid have a right to return to the first available bed in the facility which they temporarily left, even if the state has not paid to hold their original bed.

BED RESERVATIONS:
A benefit which pays the nursing home, assisted living facility or hospice facility to hold the insured's bed during a temporary absence so that the insured may return to the facility.

BENEFIT(S):
Payment an insurance company makes for a service covered under an insurance plan.

BENEFIT AMOUNT:
The maximum an insurance company will pay for covered service per a designated unit of time (usually per day, per week, or per month).

BENEFIT BOOKLET:
The document you receive from Long Term Care Partners if you apply for coverage and your application is approved. This Booklet, together with your schedule of benefits, describes your coverage under the Federal Program.


BENEFIT MAXIMUM:
The limit a health insurance policy will pay for a certain loss or covered service. The benefit can be expressed either as 1) a length of time (e.g., 60 days), or 2) a dollar amount (e.g., $350 for a specific illness or procedure), or 3) a percentage of the Medicare approved amount. The benefits may be paid to the policyholder or to a third party. This may refer to a specific illness, time frame or the life of the policy.

BENEFIT PERIOD:
The number of years an insurance policy will provide benefits. Many long-term care insurance policies offer terms between three and five years. Some offer lifetime benefits.

BENEFIT TRIGGER:
A term used by insurance companies for the requirements you must meet in order to become eligible for benefits. Benefits would actually be payable after you meet the benefit trigger and satisfy the required waiting period.

BENIGN:
Not malignant.

BEREAVEMENT:
The feeling of desolation after the loss of a loved one.

BILATERAL:
Two sides.

BOARD AND CARE HOME:
A small to medium-sized group residence that provides private or shared rooms, meals, and assistance with activities of daily living, but not skilled nursing.  A type of assisted living which is able to provide, generally, a higher level of care and supervision than a larger assisted living community.  Industry jargon describing assisted living facility based in single family home usually licensed for 10 and under.

CAPITATION:
A method of compensation for health care services under which doctors and other health care providers are paid a fixed monthly fee for each HMO member under their care, rather than for each service or treatment they perform.

CARE COORDINATOR – Also Care Manager – Also Case Manager:
A person, sometimes a registered nurse (RN), working on behalf of the insurance company to perform care coordination services. This often includes, but is not limited to, selecting physicians, specialists, care centers, etc.

CARE PLAN:
The detailed formulation of a program of action that addresses consumer needs.

CAREGIVER:
One who provides care for another individual.  A caregiver is the person who helps you accomplish the basic everyday activities you can no longer manage without assistance, due to illness, injury, cognitive impairment, or the natural aging process.

CAREGIVER TRAINING:
Training given to an informal provider who has not received formal training or has no experience providing this type of care.

CATHETER:
A small, hollow tube, usually flexible.

CERTIFIED:
A long-term care facility, home health agency, or hospice agency that meets the requirements imposed by Medicare and Medicaid is said to be certified. Being certified is not the same as being accredited. Medicare, Medicaid and some long-term care insurance policies only cover care in a certified facility or provided by a certified agency.

CERTIFIED NURSES AID (CNA):
A person who has satisfactorily completed a certified program providing her/him with basic patient care training.  CNAs are trained and certified to help nurses by providing non-medical assistance to patients, such as help with eating, cleaning and dressing.

CERTIFICATE OF INSURANCE:
A statement given to the insured stating the insurance benefits and terms.

CHRONIC ILLNESS:
A physical or mental disability that continues or recurs frequently over a long period of time; often associated with disability.

CHRONICALLY ILL:
A condition that is verified by a physician that renders the individual unable to perform at least two of the activities of daily living or the person has a severe cognitive impairment from which the person is not expected to improve or recover.

CLAIM:
A submitted request to the insurance company by the claimant to receive payment and/or reimbursement for expenses covered under the claimant's policy.

COGNITIVE IMPAIRMENT:
Deterioration of intellectual ability, such as disorientation as to people, places or time; impairment of short-term or long-term memory; and/or impairment of one's ability to reason; that has progressed to the extent that a person requires substantial supervision by another person. Cognitive impairment includes Alzheimer's disease and senile dementia. The existence of cognitive impairment is determined by clinical evidence and standardized tests that reliably measure the person's impairment.

COINSURANCE:
The amount, usually 20% of Medicare allowed charges, not reimbursed by the Medicare program.

COMMUNITY-BASED SERVICES:
Services designed to help older people live independently in their own homes, such as adult day care and senior centers.

COMPANION SERVICES:
Volunteers, business and agencies that provide friendly assistance and companionship to elders. Can include conversation, light housekeeping and meal preparation, running errands and providing transportation.

COMPREHENSIVE OPTION:
A plan feature which covers both facilities-based and home-based care. Under the FLTCIP, this option covers services provided in a nursing home, assisted living facility, adult day care center, care at home, hospice care (in a facility or at home), respite services (in a facility or at home), bed reservations and caregiver training.

CONCEALMENT:
Intentionally withholding information on an insurance application to hide facts from the insurance company.

CONGESTION:
Accumulation of fluid.

CONSTIPATION:
Few and difficult bowel movements.

CONGREGATE HOUSING:
Apartment houses or group accommodations that provide health care and other support services to functionally impaired older persons who do not need routine nursing care.  Assisted Living is Congregate housing.

CONSERVATOR:
Person appointed by the court in a legal proceeding to act as the legal representative of a person who is mentally or physically incapable of managing his or her own affairs.CONTEST THE VALIDITY:
When an insurance company can cancel your coverage as if it had never been issued and return all the premiums paid due to falsification of information by the certificate holder.

CONTINENCE:
An activity of daily living - the ability of the body to control urination or bowel movements or both.

CONTINENT:
To have control of the bladder or bowel.

CONTINUING CARE FACILITY, Multi-level Facility, Buy-In Facilities:
These facilities provide all levels of care, ranging from independent to skilled care. Usually the resident has to pay a monthly fee plus an entrance fee.

CONTINUING CARE RETIREMENT COMMUNITY (CCRC):
A retirement community that offers a broad range of services and levels of care based on what each resident needs over time. Sometimes called "life care," it can range from independent living in an apartment to assisted living to full-time care in a nursing home. Residents move from one setting to another based on their needs. Care in CCRCs can be expensive, with a large payment often required before moving in, and monthly fees thereafter.

CONTINUUM OF CARE:     
A comprehensive system of Long-Term Care services and support systems in the community, as well as in institutions. The continuum includes 1) community support services such as senior centers; 2) in-home care, such as home delivered meals, homemaker services, home health services, shopping assistance, personal care, chore services and friendly visiting; 3) community-based services such as adult day care; 4) non-institutional housing arrangements such as congregate housing, shared housing and Board and Care Homes; 5) nursing homes and sub-acute and acute facilities if necessary.

CONTRACTURE:
Shortening, drawing up of muscle tissue.

CONVALESCING:
Recovering from an illness, operation, or injury.

CO-PAYMENT:
This is the portion of a medical expense that is the member's financial responsibility. HMOs generally have fixed low co-payments, usually around $5-$10.

CPR
Cardio-Pulmonary Resuscitation.

CUEING:
Directing or supervising the actions of someone with cognitive impairment (for example, showing them how to eat, reminding them which medications to take at the appropriate times, giving visual or verbal reminders for dressing or toileting, etc.).

CUSTODIAL CARE:
Help and supervision with daily living activities - dressing, eating, personal hygiene, and similar functions.  Services aimed at maintaining your health and/or preventing deterioration in your functional status, provided on an extended basis. Long term care includes custodial care.  Care which does not require a licensed medical person such as a Registered Nurse, Licensed Vocational Nurse, or specialized therapist.

DAILY BENEFIT AMOUNT:
This is the maximum amount your insurance will pay in any single day.

DECLINATION:
The refusal of an insurer to issue a policy based on the review of the application for insurance and other relevant factors.

DEDUCTIBLE:
A common cost-sharing arrangement of traditional indemnity insurers under which a policyholder must pay a set amount toward covered services before the insurer is required to pay claims. Typically, HMO members do not pay deductibles.

DEFECATE:
To eliminate wastes and undigested food from the rectum.

DEGENERATION:
Lessening of the physical state.

DEHYDRATION:
Less than normal amount of fluid in the body.

DEMENTIA:
The loss of intellectual functions such as thinking, remembering and reasoning to the extent that a person's daily functioning is affected. It is not a disease in itself, but rather a group of symptoms which may accompany certain diseases or physical conditions. The cause and rate of progression of dementia vary. Some of the well-known diseases that produce it include
Alzheimer's Disease,
Multi-infarct Dementia,
Huntington's Disease,
Pick's Disease,
Vascular Dementia
Creutzfeldt-Jakob Disease, and
Parkinson's Disease.

DEMENTIA FACILITY:  Assisted living facilities that has been designated “locked” or “secured” by licensing agency and focuses primarily or solely on providing care for residents exhibiting dementia characteristics.

DEPENDENT CARE TAX CREDIT:
Federal income tax credits for certain home care services and adult daycare services. Consult the IRS or a tax advisor for details.

DEPRESSION:
An under-diagnosed condition among seniors. Symptoms include a persistent sad, anxious or "empty" mood, loss of interest or pleasure in activities once enjoyed, and difficulty sleeping. With proper medical care, depression is reversible.

DIASTOLIC PRESSURE:
Blood pressure reading when the heart is resting between beats; the second number in a blood pressure reading. See Systolic Pressure.

DIETICIAN:
One qualified by training and education in establishing dietary procedures and planning menus for regular and special diets.

DIRECTOR OF NURSING:
A Registered Nurse (RN) who oversees the nursing department, including nursing supervisors, Licensed Practical Nurses, nurses aides and orderlies. A Director of Nursing typically writes job descriptions, hires and fires members of the nursing staff and writes and executes procedures and policies for nursing practice.

DISCHARGE PLANNER:
A social worker or other health care professional who assists hospital patients and their families in transitioning from the hospital to another level of care such as rehabilitation in a skilled nursing facility, home health care in the patient's home, or long-term care in a nursing home.

DISORIENTED:
Not aware of, or confused regarding time, place, person, or purpose.

DIURETICS:
A class of drugs given to help the body rid itself of excess fluid; often used on older persons with heart disease.

DO NOT RESUSCITATE ORDER (DNR):
A code or order indicating that in the event a patient's heart or breathing stops, there should be no intervention. This does not mean that the individual does not receive care. Continuing care is provided as it would to any individual (medications for pain, antibiotics, etc.) except as stated above.

DURABLE MEDICAL EQUIPMENT:
Medical equipment that is ordered by a doctor for use in the home. These items, such as walkers, wheelchairs, and hospital beds, must be reusable. Durable medical equipment is paid for under Medicare, subject to a 20% coinsurance of the Medicare-approved amount.

DURABLE MEDICAL POWER OF ATTORNEY:
A legal document which names a person who will make health care decisions for the principal if that individual becomes incompetent or unable to express wishes for himself or herself.

DYSFUNCTIONAL:
Difficulty in functioning normally.

DYSPHAGIA:
Difficulty in swallowing.

DYSPNEA:
Difficulty in breathing.

DYSURIA:
Difficulty in urinating.

EDEMA:
Fluid accumulating in body tissues that result in swelling.

EFFECTIVE DATE:
The date on which insurance coverage begins.

ELDERCARE:
A wide range of services provided at home, in the community and in residential care facilities, including assisted living facilities and nursing homes. It includes health-related services such as rehabilitative therapies, skilled nursing, and palliative care, as well as supervision and a wide range of supportive personal care and social services.

ELDER LAW ATTORNEY:
An attorney who specializes in the laws that deal with the rights and issues of the health, finances, and well-being of the elderly and the power of other individuals and the government to control them.

ELDER MEDIATION:
Elder mediation, a sub-specialty of family mediation, is a relatively new field that brings together family members and professionals who can help them address and cope with major life changes related to aging. Potential areas of conflict or stress, such as housing options, daily caregiving needs, financial and legal decisions, end of life issues, etc. are discussed and explored with the guidance of an experienced mediator. The goal of elder mediation is to allow seniors to make informed decisions about their lives, while helping other family members adjust to their changing roles and responsibilities.

ELIMINATION PERIOD:
The length of time an insured person must pay for covered services before the insurance company will begin to pay benefits. Unless otherwise noted in the insurance policy, no benefits are payable for any days of an elimination period.
Emergency Monitoring System (Personal Emergency Response System)
An electronic device, usually worn as a pendant or bracelet, which can be activated at the touch of a button in an emergency situation. When the alarm is activated, it sends a signal to a 24-hour emergency response center where an operator attempts to establish two-way contact with the client and dispatch appropriate assistance. Emergency monitoring services are usually private pay, and are rarely covered by Medicare/Medicaid.

ERYTHEMA:
Reddened skin area.

ESTATE PLANNING:
The process of planning for what will happen to a person's property after the person's death. Estate planning often requires the services of an attorney.

ESTATE TAX:
A tax that may be levied on a person's estate.

EXCLUSION:
A health condition, situation, item, service or expense that an insurance policy does not cover. Medicare excludes coverage for most prescription drugs, long-term care, and custodial care in a nursing or private home.

EXACERBATION:
Increase in symptoms.

EXCORIATION:
Superficial loss of skin, such as that due to scraping or scratching..

EXECUTOR:
The person or institution appointed in a will, or by a court, to settle the estate of a deceased person.

FACILITY:
A healthcare center which is usually used as a place of continuation of care after a hospital stay, or when the patient requires care beyond that which is within the realm of possibility within his or her own home; a nursing home, retirement center, etc.

FACILITIES-ONLY OPTION:
A plan feature which covers facilities-based care only. Under the FLTCIP, this option covers services provided in a nursing home, assisted living facility, hospice care in a facility, respite services in a facility, bed reservations and caregiver training.

FAMILY MEMBER:
Means spouse, child (natural, step or adopted), parent, sibling, in-laws, or grandchild for purposes of determining whether benefits are payable for formal caregivers and informal caregivers.

FEBRILE:
With fever.

FEEDING TUBE :
Nutrients, either a special liquid formula or pureed food, are delivered to a patient through a tube directly into the gastrointestinal tract, usually into the stomach or small intestine.

FIDUCIARY:
A person, such as a trustee or guardian, who holds the assets of another person, often with the legal authority and duty to make decisions regarding financial matters on behalf of the other party.

FLTCIP:
Refers to the Federal Long Term Care Insurance Program.

FREE-LOOK PERIOD:
The time period (usually 30 days) during which an insurance policy can be cancelled for any reason.

FULL UNDERWRITING:
Means that applicants will have to answer numerous health-related questions. It may also include a review o medical records and/or an interview with a nurse.

FUTURE PURCHASE OPTION:
An inflation protection feature that allows the insured to periodically purchase additional coverage without proof of good health. The FLTCIP offers a future purchase option that increases your benefits every other year with an increase in premiums.

GAIT:
Manner of walking.

GERIATRIC CARE MANAGER:
One who develops and implements a plan for all aspects of long-term care to assist an elderly person and, indirectly, the person's family members.
A geriatric care manager will usually hold a graduate degree, and may be certified or licensed by a professional organization or by state statute or regulations.

GERIATRIC SOCIAL WORKER:
A licensed professional who assists the elderly and their families in understanding and coping with the social, emotional, and psychological aspects of aging.

GERIATRICIAN:
A medical doctor with special education and training in the diagnosis, treatment, and prevention of disabilities in older people.

GERIATRICS:
The branch of medicine dealing with the problems of the elderly.

GERI-CHAIR:
A wheelchair that cannot be self-propelled and has a high back, a foot ledge and a removable dining tray.

GERONTOLOGIST:
A professional who specializes in the mental and behavioral characteristics of aging.

GERONTOLOGY:
The study of the aging process.

GRAB BAR:
Bars or railings placed around tubs, showers and toilets to be used to steady oneself.

GRACE PERIOD:
This means that payment of your premium must be received by the 30th day after the date it is due. If your premium is not received by the end of the grace period, a written notice of termination of coverage will be sent to you by first class mail. You will have 35 days from the date of the termination letter to pay your premium, otherwise your coverage will end.

GUARANTEED RENEWABLE:
Most Medicare Supplement and long-term care insurance policies are guaranteed renewable. That is, the policy cannot be cancelled by the insurance company unless (1) you committed fraud in your application for the policy, (2) you have not paid the required premium and the policy has lapsed, or (3) benefits have been exhausted. A guaranteed renewable policy cannot be cancelled because of a change in your health condition, or your marital or employment status. However, the insurance company may increase premiums, but only on an entire class of policies, not just on your policy, and never because of any claims paid to you.

GUARDIAN:
An individual appointed by a court of law to manage a person's financial and/or personal affairs because the court has found that the person is not competent to manage his or her own affairs. A conservator is similarly appointed, but only for financial affairs.

GUARDIANSHIP:
The process in which an individual is appointed by a court of law to manage a person's financial and/or personal affairs because the person is not able to or is not competent to manage his/her own affairs.

HANDS-ON ASSISTANCE:
When a person require physical help by another person without whom this person would not be able to perform the activities of daily living. Some insurance companies measure the inability to perform activities of daily living based on the need for hands-on assistance only.

HEALTH CARE FINANCING ADMINISTRATION (HCFA):
An executive department of the Department of Health and Human Services that has ultimate authority over Medicare and Medicaid.

HEALTH INSURANCE INFORMATION COUNSELING ASSISTANCE PROGRAM (HIICAP)
Program for Medicare beneficiaries where peer counselors respond to questions and requests for help in navigating the private and public insurance systems.

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA):
Federal health insurance legislation passed in 1996 that specifies conditions under which certain long term care insurance policies qualify for Federal tax advantages.

HEMATURIA:
Blood in the urine.

HEMIPLEGIA:
Paralysis of one side of the body.

HOME CARE:
Services provided in the home to promote, maintain, and restore health or to minimize the effects of illness and disability. Home care can be for short-term purposes, such as rehabilitative care after a hospital discharge or care for the terminally ill.

HOME HEALTH AGENCY:
An organization that provides home care services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, and care by home health aides.

HOME HEALTH AIDE:
A person who provides personal care including bathing, dressing and grooming, and some household services.

HOME HEALTHCARE:
Health services provided in the homes of the elderly, disabled, sick or convalescent. The types of services provided include nursing care, social services, home health aide and homemaking services, and various rehabilitation therapies (e.g., speech, physical and occupational therapy).

HOMEBOUND:
Unable to leave home or cannot leave home without considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for nonmedical reasons, such as a trip to the barber.

HOSPICE:
Medical and social programs for terminally ill patients and families either at home or in a facility. Hospice care emphasizes pain control, symptom management, and emotional support rather than life-sustaining equipment.
Incapacitated Adult
A person impaired by sickness, accident, injury, mental illness, mental disability, chronic use of drugs, chronic intoxication or any other causes, to the extent that the person does not have sufficient understanding or ability to make or communicate responsible decisions concerning his/her day-to-day care.

INCOMPETENCE:
A legal determination that one is incapable of handling assets and exercising certain legal rights.

INCONTINENT:
Without bowel or bladder control.

INDEPENDENT SENIOR HOUSING:
Self-contained apartments designed to promote independence, and provide common space and activities; also called Independent Living Facilities.

INFARCT:
A localized area of tissue death caused by poor, or ceasing of, blood circulation to that body part.

INFECTION:
Bacteria-caused condition in the body.

INFORMED CONSENT:
A legal term that refers to a person's consent to a proposed medical intervention after receiving relevant information. The information that is legally required includes diagnosis, nature and purpose of the proposed intervention, risks and consequences of the proposed treatment, probability that the treatment will be successful, feasible treatment alternatives and prognosis if the treatment is not given.

INFLAMMATION:
redness, heat, pain, and swelling in body tissue.

INFLATION PROTECTION:
A feature or option of long term care insurance coverage that increases the value of benefits over time to keep pace with increasing costs of care.

INFORMAL CARE:
Care provided by an unlicensed caregiver whose services are not arranged and supervised by a home care agency.

INSTITUTIONALIZATION:
Admission of an individual to an institution, such as a nursing home, where he or she will reside for an extended period of time or indefinitely.

INSURED:
A person covered under an insurance policy.

INSURER:
The insurance company that agrees to pay losses of benefits. Also, the insurer can be any company whose primary business is selling insurance to the public.

INTERMEDIATE CARE FACILITY (ICF):
A nursing facility that provides help with personal or social care and a minimum of medical supervision.; often a section of a nursing home or personal care home.

INTERMITTENT CARE:
Skilled nursing and home health aide services furnished up to 28 hours per week over any number of days per week so long as they are offered less than 8 hours per day.

INVASIVE PROCEEDURE: 
An operation that causes bleeding or the possibility of bleeding

JAUNDICE:
Yellowish color of the skin and eyes.

LAP ROBE:
Light weight covering for the lap and legs.

LAPSE:
The termination of insurance coverage when premium is not paid.

LESION:
Damage to tissue, broad term including many types of tissue damage.

LICENSED HEALTH CARE PRACTITIONER:
A physician (as defined by the Social Security Act) or a registered professional nurse, licensed social worker, or any other health care worker who meets the requirements of the U.S. Treasury Department.

LICENSED PRACTICAL NURSE (LPN):
One who has completed one or two years in a school of nursing or vocational training school. LPNs are in charge of nursing in the absence of a Registered Nurse (RN). LPNs often give medications and perform treatments. They are licensed by the state in which they work.

LIFE CARE ARRANGEMENT OR LIFE CARE CONTRACT:
Contract between a resident and a nursing home in which the resident assigns to the home all of his/her personal assets in return for a guaranteed lifetime of care.

LIFE EXPECTANCY:
The average number of years of life remaining for a group of persons given age according to a particular mortality table.

LIFE TENANCY:
After the owner sells a home, he or she leases it back and receives a written guarantee (life tenancy) that he or she can continue to live in the home for the rest of his or her life. A life tenancy is often arranged with an annuity set up to pay the rent.

LIFETIME MAXIMUM:
The maximum amount of policy benefits available to an insured person during his or her lifetime.

LIVE-IN HOME CARE:
Live-In Home Care is provided by a caregiver who lives on a round-the-clock basis with a senior in his or her own home. The caregiver may provide a wide range of medical or non-medical assistance, depending on the type of care required and the caregiver's level of experience. This type of intensive support allows seniors to remain in their homes rather than relocate to assisted care facilities or nursing homes.

LIVING TRUST:
A trust created during the life of the grantor. An irrevocable living trust is often used in estate and tax planning. All assets become the property of the trust and, generally, the trust is liable for income tax payable on amounts earned by those assets, but may result in removing assets from the estate and, therefore, reducing possible estate tax liability. It should be noted, however, that the transfer of assets to the trust may result in gift tax liabilities.

LIVING WILL:
A document that makes known a person's wishes regarding medical treatments in the event the person becomes incompetent or is unable to speak.

LONG-TERM CARE:
A general term that describes a range of medical, nursing, custodial, social, and community services designed to help people with chronic health impairments or forms of dementia.

LONG-TERM CARE INSURANCE:
This type of insurance policy is designed to cover long term care expenses in a facility or at home. Neither Medicare nor Medicare supplemental insurance (Medigap) will pay for these expenses.

LONG-TERM CARE FACILITIES:
Institutions that provide nursing care to people who are unable to care for themselves and who may have health problems ranging from minimal to serious. These facilities are often used for short-term rehabilitation after hospitalization.

LONG-TERM CARE OMBUDSMAN PROGRAMS:
Independent, nationwide, federally-funded services that work to resolve problems between residents and assisted living facilities, nursing homes and other residential care facilities.

MALAISE:
Uneasy feeling of things not being just right physically.

MALIGNANT:
Condition or disease which has a tendency to become progressively worse, not benign.

MANAGED CARE:
Used as a description for an entire array of programs. Generally, managed care implies that there is some form of influence in the delivery of health care by persons other than the caregiver and patient. It includes several concepts as part of its program quality assurance, aggressive care management, peer review and data gathering and dissemination to providers. The gatekeeper - one person, usually a primary care physician - opens the door to the various disciplines and specialty providers, providing the necessary coordinated care. This type of care emphasizes that the use of services is controlled to manage costs.

MAXIMUM LIFETIME BENEFIT:
This is the maximum amount of benefits that the insurance coverage could pay. The maximum lifetime benefit can also be referred to as a "pool of money". For the FLTCIP, your maximum lifetime benefit is calculated by multiplying your daily benefit amount times the number of days in the benefit period you selected.

MEDICAL DIRECTIVE:
See Living Will.

MEDICAID (MEDI-CAL):
The joint Federal-state program that pays for health care services for individuals who meet their state's poverty guidelines. Medicaid can be accessed only when all prior assets and funds are depleted to state required levels.

MEDICARE:
Federal program providing health care coverage/insurance for people over 65 years of age, certain younger people with disabilities, and people with End-Stage Renal Disease (ERSD) (permanent kidney failure that must be treated with dialysis or a transplant). Part A covers inpatient care, skilled nursing facility, hospice and short-term health care. Part B covers doctors' services, outpatient hospital care, and durable medical equipment. It does not provide for long-term care of the elderly except under limited conditions.

MEDICARE SUPPLEMENTAL INSURANCE (Medigap):
This is private insurance (often called Medigap) that pays Medicare's deductibles and co-insurances, and may cover services not covered by Medicare. Most Medigap plans will help pay for skilled nursing care, but only when that care is covered by Medicare.

METASTASIS:
Transfer of a disease from one organ or part of the body to another.

NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC):
An association of the chief insurance regulators in all 50 states, Washington D.C., and four U.S. territories. The NAIC's primary responsibility is to set guidelines to protect the interests of insurance consumers.

NAUSEA:
The feeling that vomiting may occur.

NECROSIS:
Death of cells of the tissue.

NOCTURIA:
Excessive nighttime urination.

NONCANCELLABLE POLICIES:
Insurance policies that cannot be cancelled by the insurance company, except for non-payment of the required insurance premiums; rates can never be changed by the insurance company.

NON-FORFEITURE:
A feature that provides paid-up long term care insurance coverage for a shortened benefit period if coverage lapses. Contingent non-forfeiture is one type of non-forfeiture benefit and the type that is included in the FLTCIP.

NURSE:
Means a registered professional nurse (R.N.), licensed practical nurse (L.P.N.) or licensed vocational nurse (L.V.N.) who is currently licensed in the jurisdiction in which the services are provided.

NURSING CARE:
Services requiring the professional skills of a nurse (R.N.), licensed practical nurse (L.P.N.) or licensed vocational nurse (L.V.N.).

NURSING HOME:
A state-licensed residential facility that provides a room, meals, help with activities of daily living, recreation, and general nursing care to people who are chronically ill or unable to take care of their daily living needs. It may also be called a Long Term Care Facility. If it has been certified as such by Medicare, it is also referred to as a Skilled Nursing Facility.

OCCUPANCY AGREEMENT:
Generally, assisted living facilities have occupancy agreements that outline terms of residency. The terms should clearly define specific living arrangements for the community and for individuals.

OCCUPATIONAL THERAPIST:
A person trained to conduct therapy to maintain, restore or teach skills to improve manual dexterity and hand-eye coordination.

OLDER AMERICANS ACT:
Law enacted in 1965 (PL 89-73) that gives elderly citizens more opportunity to participate in and receive the benefits of modern society. For example, adequate housing, income, employment, nutrition and health care.

OMBUDSMAN:
An ombudsman is a person who acts as a trusted intermediary between an organization and some external constituency while representing the broad scope of constituent interests.  An Ombudsman is an advocate for residents of nursing homes, board and care homes, and assisted living.

PALLIATIVE:
A relieving, but not curing, treatment.

PARAPLEGIA:
Paralysis of the lower portion of the body.

PARESIS:
Incomplete paralysis.

PARKINSON'S DISEASE:
Parkinson's Disease ("PD") is a progressive disorder of the central nervous system which affects more than one million Americans. Individuals with PD lack a substance called dopamine, which is important in the central nervous system's control of muscle activity. PD is often characterized by
Tremors,
Stiffness in limbs and joints,
Speech impediments, and
Difficulty in initiating physical movement.
Late in the course of the disease, some individuals develop dementia and eventually Alzheimer's disease. Medications such as levodopa, which prevents degeneration of dopamine, are used to improve diminished motor symptoms in PD patients but do not correct the mental changes that it causes.

PARTICIPATING PROVIDER:
An institution, facility, agency, health professional or other person certified or licensed by the appropriate agency of the state having jurisdiction, and holding a current signed participation agreement with the Medicaid agency.

PATIENT BILL OF RIGHTS:
A list of policies and procedures to be followed to ensure that patients receiving health care services will be treated with dignity and will participate fully in decisions relevant to their health care.

PATIENT CARE PLAN:
A plan formulated by a Registered Nurse in conjunction with a physician for the on-going care and rehabilitation for a nursing home resident to their optimum potential.

PERSONAL CARE:
Care to help you meet personal needs such as bathing, dressing and eating.

PHYSICAL THERAPIST:
A licensed professional who treats impaired motion or disease through exercise, massage, hydrotherapy, or mechanical devices to improve physical mobility.

PHYSICIAN ASSISTANT:
A person who performs a number of tasks that were traditionally performed by the physician (i.e., taking medical histories or making routine examinations). Training for Physician Assistants usually includes a specialized 2-year program. Physician Assistants always work under the supervision of a physician.

PLAN OF CARE:
The written plan that describes the services and care you need for your health problem. Your plan of care must be prepared or approved by your doctor.

POLICY HOLDER:
An individual or group sponsor that has a written and signed policy agreement with their insurance provider. The U.S. Office of Personnel Management is the policyholder for the Federal Long Term Care Insurance Program.

POLYDYPSIA:
Excessive thirst causing frequent drinking.

POLYURIA:
Excessive urination.

POWER OF ATTORNEY:
The simplest and least expensive legal device for authorizing a person to manage the affairs of another. In essence, it is a written agreement, usually with a close relative, an attorney, business associate or financial advisor, authorizing that person to sign documents and conduct transactions on the individual's behalf. The individual can delegate as much or as little power as desired and end the arrangement at any time.

PRE-EXISTING CONDITION:
An illness or disability for which you were treated or advised within a certain time period (typically 6-12 months) before applying for an insurance policy. Any pre-existing condition would not be covered during a designated time period (again typically 6-12 months) after the effective date of the policy.

PREMIUM:
The money paid to an insurance company for coverage.

PRIMARY CARE PHYSICIAN (PCP):
The doctor who is consulted first when a health problem occurs and on whom the patient relies for advice, referrals, and ongoing care.

PRIMARY CAREGIVER:
The person, usually the spouse or adult child, who takes on the primary day-to-day responsibility of caring for the physical, psychological and social needs of another person.

PRIVATE-PAY:
Many eldercare services are not covered by Medicare, Medicaid and/or insurance. These services are paid for directly by the individual. Examples of private-pay eldercare services include non-medical homecare, companion services, assisted living, adult daycare, and many home medical products etc.

PROGNOSIS:
The probable outcome of the disease, illness, or physical condition.

PSYCHOTROPIC MEDICATIONS:
Drugs used in the treatment and control of mental illness.

QUADRAPLEGIA:
Paralysis of the arms and legs.

RCFE:
Acronym – Residential Care facility for the elderly

REGISTERED NURSE:
A graduate nurse who has completed a minimum of two years of education at an accredited school of nursing. RNs are licensed by the state in which they work.

REHABILITATION HOSPITALS:
Rehabilitation hospitals provide a multidisciplinary approach to goal setting, planning and delivery of patient care. The treatment team may include physicians, nurses, physical therapists, occupational therapists, speech therapists, respiratory therapists, social services, psychological services and orthotic/prosthetic services. Nursing care is available 24-hours-a-day. Therapies are provided throughout the day.

REHABILITATION THERAPY:
Therapy aimed at restoring or maintaining the greatest possible function and independence. Rehabilitation therapy is especially useful to persons who have suffered from stroke, an injury or disease by helping them recover the maximum use of the affected area(s) of the body.

RESIDENTIAL CARE FACILITY:
A generic term for a group home, specialized apartment complex or other institution that provides care services where individuals live. The term is used to refer to a range of residential care options including assisted living facilities, board and care homes.

RESPIRATOR:
a breathing device for administering long-term artificial respiration

RESPIRATORY THERAPY:
Exercises and/or treatments designed to help patients regain lung function.

RESPITE SERVICES:
Services by a substitute caregiver, from a few hours to a few days, to give time off to the regular caregiver.

RESTRAINT:
A device used to prevent a person from falling out of a chair (e.g., a belt around the waist tied to a wheelchair or a jacket with straps tied to a wheelchair). A jacket restraint could be used to prevent a person from crawling over the side rails of a bed. Wrist restraints are used under unusual circumstances. Restraints should be used as protection for the resident only when other means are not reasonable.

RETIREMENT COMMUNITIES:
This is a housing option for those who want to be in an environment that offers social activities and meals but who want to maintain their independence. Seniors are generally in good health and are able to live independently.

REVERSE MORTGAGE:
A financial instrument that enables elderly homeowners to convert the equity in their homes to monthly income or a line of credit.

REVOCABLE TRUST:
A trust in which a Grantor reserves the right to revoke or change. To protect the final wishes of the Grantor, a trust can become irrevocable upon the death of the Grantor.

RIDER:
A written contract agreement between insurer and insured which changes the policy or certificate.

SCHEDULE OF BENEFITS:
Specific to the Federal Long Term Care Insurance Program (FLTCIP): The customized listing of your coverage under the FLTCIP. You will receive a copy of your schedule of benefits from Long Term Care Partners if you apply for coverage and they approve your application. This schedule, together with your Benefit Booklet, describes your coverage under the FLTCIP.

SEDATIVE:
Medication that calms activity, nervousness, irritability, fears.

SEIZURE:
Sudden attack usually referring to involuntary contraction or spasming of muscles which ordinarily move voluntarily.

SENIOR CASE MANAGEMENT:
This service is offered many times from the local senior center as a means of reaching out to those seniors who are homebound or those who are restricted in some way from resources. Usually this service is free and it provides a few visits or phone calls to the older relative. It also offers assistance with getting connected to additional resources and low cost services within the community.

SENIOR CENTER:
A community facility for the elderly. Senior centers provide a variety of activities for their members including any combination of recreational, educational, cultural or social events. Also, some centers offer nutritious meals and limited health care services.

SENIOR COMPANION SERVICES:
Companion services offer a variety of support for seniors in their homes. Personal companions generally do not provide medical services and are not trained as home health aides or nurses. They do provide daily living services such as driving the senior to doctor's appointments, shopping errands, and social engagements. They may assist with paying bills, light secretarial work, meal preparation, light housework, reading, or simply conversation. Senior companions may work on a part-time, full-time, or round the clock schedule, depending on the client's needs. Companions offer personal contact for seniors who may otherwise be left alone during the day, and they are able to keep in touch with family members if there are any concerns about the senior's health or well being.

SEVERE COGNITIVE IMPAIRMENT:
A deterioration or loss in intellectual capacity that results in impairment of some or all of the following: short and long term memory; orientation to people, place, and time; deductive and abstract reasoning (including judgement); and ability to perform activities of daily living.

SKILLED NURSING CARE:
Skilled care that must be given or supervised by Registered Nurses. Examples of skilled nursing care are intravenous injections, tube feeding, and changing sterile dressings on a wound. Any service that could be safely done by an average non-medical person without the supervision of a Registered Nurse is not considered skilled care.

SKILLED NURSING FACILITY:
Skilled nursing facilities provide residential care and are usually licensed under state or local authorities to provide 24-hour skilled nursing care and rehabilitation services to its residents. Skilled nursing facilities or nursing homes provide a protective environment for people who do not need to be in a hospital setting, but who can no longer safely live on their own. These facilities are Medicare and Medicaid eligible, and offer intensive, specialized care for their residents.

SOCIAL SECURITY:
The comprehensive federal program of benefits providing workers and their dependents with retirement income, disability income, and other payments. Individuals qualify for Social Security retirement benefits as early as age 62 if they have held a job and paid Social Security taxes for at least 10 years.

SPEECH THERAPIST:
A rehabilitation professional who provides therapy to overcome speech and communication problems, such as speech difficulties following a stroke. A speech therapist may also provide assistance for managing swallowing problems.

SPEND DOWN:
Under the Medicaid program, a method by which an individual establishes Medicaid eligibility by reducing gross income through incurring medical expenses until net income (after medical expenses) meets Medicaid financial requirements. A resident spends down when he/she is no longer sufficiently covered by a third-party payor (usually Medicare) and has exhausted all personal assets. The resident then becomes eligible for Medicaid coverage.

SPOUSAL BENEFITS;
Options offered by some insurance programs to spouses. The options may include allowing spouses who both qualify for the insurance to pay premiums that are less than if each person had purchased individual coverage and/or allowing spouses to use each other's benefits.

SPOUSAL IMPOVERISHMENT:
The community property and assets of a community spouse of a nursing facility resident may be divided according to standards set by the Health Care Financing Administration and state law as a means of protecting the assets of the non-institutionalized spouse.

STANDBY ASSISTANCE:
When you require the presence of another person, within arms reach of you, to help you perform the activities of daily living. Some insurance companies measure the inability to perform activities of daily living based on the need for standby assistance, rather than or in addition to hands-on assistance. The FLTCIP measures such inability based on either the need for hands-on assistance or standby assistance.

SUB-ACUTE CARE:
Typically following a stay in a hospital, this is maintenance care for serious medical conditions that are not urgent or life-threatening. Hospitals typically do not provide sub-acute care on an ongoing basis. Sub-acute care may include long-term ventilator care or other procedures provided on a routine basis either at home or by trained staff at a skilled nursing facility.

SUPPLEMENTAL SECURITY INCOME (SSI):
A federal program that pays monthly checks to people in need who are 65 or older and to people in need at any age who are blind or disabled. The purpose of the program is to provide sufficient resources so they can have a basic monthly income. Eligibility is based on income and assets.

SYMPTOM:
A sign or indication a person experiences bodily, which is not in accordance with it’s usual condition.

SYNCOPE:
To faint.

SYNDROME: Group of symptoms characteristic of a disease or condition.

TACHYCARDIA:
Rapid heart beat.

TAX-QUALIFIED:
Conforming to Federal standards that enable the enrollee in a long term care insurance plan to receive Federal tax advantages.

TERMINAL:
Without expectation of recovery; fatal.

TERMINAL ILLNESS OR TERMINALLY ILL:
An illness or injury determined by a physician or other licensed healthcare professional to be likely to result in death within 6 months.

THERAPIST:
A person who is licensed or certified to provide therapy services.

THERAPY SERVICES:
Physical, respiratory, speech, or occupational therapy services provided by a therapist.

T.I.A.:  
Acronym - Transient Ischemic Attack.

TOILETING:
An activity of daily living - getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene related tasks.

TRACHEOTOMY: 
a surgical procedure in which a cut or opening is made in the windpipe (trachea).

TRANSIENT ISCHEMIC ATTACK:
Brief episodes of cerebra dysfunction, caused by temporary impairment of blood flow to the brain (Mini Stroke).

TRANSFER:
To move from one place to another; when a patient is moved from a bed to a wheelchair; when a patient is moved from location to location, such as a hospital to an extended care facility.

TREMOR:
Involuntary quivering.

TURN Q 2H:
Turn every two hours. A nursing home resident who is unable to move himself/herself for a physical or mental reason must be turned frequently to a different position to prevent skin breakdown and other physical problems.

UNDERWRITING:
The process of reviewing an individual's health status to determine eligibility for coverage under a long term care insurance plan.

UNLIMITED BENEFIT PERIOD:
An option under some insurance plans, including the FLTCIP, that pays benefits for as long as the insured needs care, subject to your daily, weekly, or monthly benefit amount. An unlimited benefit period is sometimes called a "lifetime benefit".

URINARY CATHETER:
A small tube placed into the bladder (held in place by a small, built in inflatable balloon), which is connected via a larger tube to a drainage bag continually draining urine from the body.

UTILIZATION REVIEW:
A cost control device that requires any participating hospital or nursing home to evaluate the appropriateness of Medicare and Medicaid patients' admission to and continued stay in the institution. Such a review is conducted by a utilization review committee composed of physicians and other health professionals who must review 1) the medical necessity of the admission and 2) the medical necessity of continued institutionalization.

VERTIGO:
Dizziness.

VETERANS ADMINISTRATION (VA):
The Department of Military and Veterans Affairs administers a variety of programs to assist veterans and their families.

VIATICAL SETTLEMENTS:
Viatical settlements refer to situations where an individual sells the benefits of their life insurance policy to a third party at a discount in order to get cash to pay for costly health care services. Viatical settlement companies may pay 60 percent of the face value of a policy to a person with a life expectancy of two years or less or as much as 80 percent to an individual with a life expectancy of six months or less. The industry generally uses the term "Viatical Settlement" to refer to a transaction involving a terminally- or chronically-ill insured and a "Life Settlement" to refer to a transaction involving an insured who is not terminally or chronically ill, generally over the age of 65.

VISITING NURSE (PRIVATE DUTY NURSE):
A visiting nurse service provides registered nurses to administer health care to seniors in their own homes. Visiting nurse agencies may provide a wide range of services, both medical and non-medical. Visiting nurses evaluate and manage their patient's care at home, working with their physicians to ensure that all medical needs are being met. Visiting nurse services allow seniors to remain in their homes, even when they become ill or physically disabled. Most visiting nurse services are covered by third party insurance, including Medicaid, Medicare, private insurance, and HMOs.

VISITING PHYSICIAN (HOUSE CALLS):
Visiting physician services recall the "old-fashioned" tradition of doctor's housecalls. For many seniors who are ill or who have severe physical limitations, visiting a doctor's office can be extremely difficult. A visiting physician service may be the best solution for these patients. Visiting physicians can provide a broad range of medical care, from routine exams to more comprehensive treatment in the patient's home. Visiting physicians are usually accompanied by a medical assistant or nurse, as well as portable diagnostic equipment. Visiting physicians work closely with other caregivers to monitor and manage all aspects of the patient's medical care.

VITAL SIGNS:
Temperature, Pulse, Respiration and Blood Pressure.

VOID:
To urinate.

WAITING PERIOD:
The time between becoming eligible for benefits and when your long term care insurance actually begins paying those benefits. Sometimes known as an elimination period or a deductible, it helps keep premiums affordable. The longer the waiting period, the lower the premiums. The waiting period can be measured in calendar days or days-of-service. A days-of-service waiting period is the number of days you must be eligible for benefits and receiving covered services before your benefits begin. The FLTCIP includes a days-of-service waiting period.

WAIVER OF PREMIUM:
A provision of long term care insurance plans, including the FLTCIP, that allows the insured to stop paying premiums while receiving benefits.

WEEKLY BENEFIT AMOUNT:
Benefit amounts for covered services calculated on a weekly basis (seven times the daily benefit amount). Available with the Comprehensive option under the FLTCIP, the insured may exceed the daily benefit amount on any one day and may be fully reimbursed, as long as the total of that week's qualified long term care expenses does not exceed the weekly benefit amount.