Glossary

Access Services: One of three priority services designated in the Older Americans Act to help meet the aged's needs, refers to such services as transportation, outreach, and information and referral which help facilitate "access" to existing supportive services.

Activities of Daily Living (ADL's): The most basic of personal care tasks: feeding, continence, transferring (in and out of bed or chair), toileting, dressing and bathing.

Administration on Aging (AoA): Federal agency within the Department of Health and Human Services (DHHS) responsible for administering all programs authorized by the Older Americans Act. Also performs an advocacy role for the elderly.

Ageism: Prejudice or negative attitudes toward aging and the aged.

Aging Network: A highly complex and differentiated system of federal, state and local agencies, organizations and institutions which are responsible for serving and/or representing the needs of older people.

Area Agency on Aging (AAA or "Triple A"): An agency designated by the State Unit on Aging in a planning and service area (PSA) to develop and administer the area plan for a comprehensive and coordinated system of aging services.

Assisted Living: A program for frail, nursing-home eligible older adults that provides apartment style living and services such as meal preparation, bathing and dressing and routine nursing services.

Benefits Eligibility Screening Services (BESS): A service for individuals that can generate a list of benefits for which they are eligible along with application information.

Case Management: The coordination of the various services needed by vulnerable clients or patients which are offered by different agencies and providers. Important elements include an assessment of client needs, the development of an individualized care plan, the arrangement for provision of services, and subsequent evaluation of the effectiveness of the services provided.

Certificate of Need (CON): A state regulatory mechanism for review and approval by health planning agencies of capital expenditures and service capacity expansions by hospitals, nursing homes and other health care facilities.

Community-Based Long-Term Care (CBLTC): Care that is available in the community.

Community-Based Services: A wide range of non-institutional services, including supportive, health and personal care, which help older people who need assistance maintain maximum independent functioning in their own homes or a substitute environment of their choice.

Community Focal Point: A facility established to encourage the maximum collocation and coordination of services for older people.

Congregate Care: Multiple unit housing with shared services and common spaces, often with various types of living units. Primarily for those who need some supervised care, but who do not need institutionalized care.

Congregate Meals: A program which provides, five or more days a week, at least one hot or other appropriate meal per day to older persons in a group setting. Congregate nutrition programs may also include nutrition education and other appropriate services for older people. are not accessible.

Continuing Care Retirement Community (CCRC): A retirement community that provides a range of care options for residents.

Continuum of Care: A range of services developed and organized to address the variety of needs individuals have as they age. This concept recognizes and considers the availability and extent of short-term and long-term care systems and services in the community and in institutional settings. Included in the continuum of care are residential alternatives, in-home care, community programs, and institutional services.

Cost of Living Adjustment (COLA): A systematized adjustment of Social Security benefits to keep up with inflation.

Diagnosis Related Groups (DRG's): Health benefit payments to hospitals under Medicare, Part A, are now based upon a prospective payment system that utilizes a predetermined rate per case or type of discharge. Rates are adjusted annually and to reflect regional and wage differences. DRGs are based upon the patient's diagnosis, age and sex, treatment procedure, and discharge status.

Durable Power of Attorney (DPOA) (also known as: Durable Power of Attorney for Health Care): A legal document which authorizes another person to make health care decisions for you if you lose the capacity to make informed health care decisions for yourself.

Elder Cottage Housing Opportunity (ECHO): A separate, self-contained unit designed for temporary installation in the side or backyard of an adult child's home. (see also "Granny Flats")

Geriatrics: Specialty in medicine focusing on the physical disabilities and diseases associated with aging and older persons. Increasingly aging is recognized as a normal process, not a disease state.

Gerontology: The study of aging from a broad perspective including but not limited to the clinical and biological aspects of aging, the social, psychosocial, economic, historic, and political realms.

Granny flats: Self-contained living units placed or located on or near the residence of a relative. May be mobile or permanent structures, and are sometimes referred to as echo housing or granny cottages.

Health Care Financing Administration (HCFA): Federal agency created in 1977 to provide quality assurance for the Medicare and Medicaid programs under the Social Security Act. Includes oversight of the Professional Standards Review Organization, End-Stage Renal Disease Program, long-term care program and other health and safety standards for health care providers.

Health Maintenance Organization (HMO): An organization to which Medicare pays a pre-determined annual fee for each Medicare eligible person who enrolls. The HMO then provides the older person with any necessary medically authorized health care during the year.

Home Delivered Meals (HDM): A program which provides, five or more days a week, at least one home delivered hot or other appropriate meal per day to older persons who are homebound or for whom congregate meals are not accessible. Also referred to as "meals on wheels".

Home Health Agency (HHA): An agency that provides health services (e.g. home health aide) in the home setting.

Home Health Care: Health services provided in the individual's home including nursing, physical, occupational or speech therapy, medical appliances, and health-related homemaker or social services.

Homes for the Aging: A category of long-term care homes in Ohio, licensed by the state, that provide specifically designated types of personal care. They are permitted to offer skilled nursing services and may or may not qualify for Medicare/Medicaid certification.

Hospice Care or Services: Care that addresses the physical, emotional, familial and social, psychological, legal and financial needs of a patient and family members. Generally provided by an interdisciplinary team of practitioners and volunteers, such services are provided in both institutional and home settings.

In-Home Services: Refers to such services as home health aide, family respite services, visiting and telephone reassurance and chore maintenance which enable older persons to remain in their homes for as long as possible. They offer an alternative to premature institutionalization.

Institution-Based Long-Term Care (IBLTC): Care that is available in an institutional setting such as a nursing home.

Instrumental Activities of Daily Living (IADL's): The more complex activities needed for daily living (e.g. handling personal finances, shopping, meal preparation, phone use, housekeeping, using transportation).

Intermediate Care Facility (ICF): Supervised environment for persons with stable chronic medical conditions requiring continuous supervision of and/or assistance with the activities of daily living, but not requiring skilled nursing or hospital care.

Level of Care (LOC): The type of professional long-term care required to meet a patient's (or resident's) health, psychological, social and rehabilitative needs. The LOC must be determined before application for Medicare and/or Medicaid benefits.

Licensed Facility: Nursing home which meets the requirements of Ohio's Revised Code Chapter 3721 and regulations establishing the minimum standards for the operation of a nursing home within the state.

Life Care Communities: Facilities with residential service contracts that specify the lease terms of the residential units. May include an entrance fee, a monthly maintenance fee and other set fees or charges for services.

Life Expectancy: A statistical measure of the average number of years individuals born in a given year can be expected to live under the environmental conditions prevailing in that year. Life expectancy is measured at birth and at other periods in life and changes as the individual ages.

Long-Term Care (LTC): Encompassing a wide-range of services, no one definition is possible. In general, it refers to a range or a continuum of services to meet the personal, health and social needs of vulnerable individuals whose need(s) will continue and possibly increase over an indeterminate period of time.

Managed Care: Coordination of members use of health services in order to contain costs, improve quality or both. Care plan can be fully capitated, partially capitated , or fee-for-service.

Meals-on-Wheels (MOW's): Funded through Title III of the Older Americans Act (OAA), a community-based nutrition program that provides and delivers daily hot meals to home-bound elderly. Eligibility standards vary. Privately funded programs also exist.

Means Test: The determination of eligibility for a program or for services based upon an individual's or family's income and/or assets. Examples of such programs include Medicaid and Supplemental Security Income.

Medicaid: National health care program created by Title XIX of the Social Security Act and administered by the states to provide health care to indigent and medically indigent persons of all ages.

Medicare: National medical insurance program created by Title XVIII of the Social Security Act that provides health and medical insurance for persons over age 65 and others eligible for Social Security benefits. Administered by (HCFA). Includes hospital insurance protection (Part A) and voluntary medical insurance (physician services) protection (Part B) for a monthly premium.

Multi-Purpose Senior Center (MPSC): A community facility providing services and activities for older persons. Representative programs include education, recreation, social, nutrition and health services. Funded in part under Title III of the Older Americans Act (OAA).

National Association of Area Agencies on Aging (NAAAA): Membership includes Area Agencies on Aging, advisory council members, service provider agencies and private sector representation. Its primary objective is to promote cooperation and communication within and among the aging network, the federal government, and other organizations and to provide technical assistance to its members and other interested individuals and groups promoting service development and delivery on behalf of the elderly.

National Association of State Units on Aging (NASUA): The coordinating organization of the State Units on Aging (SUAs) of the 50 states, the District of Columbia, and the United States territories. It collects and analyzes information for use by the SUAs and develops training programs for use by the states and other organizations.

Nursing Home: A facility or institution that provides specialized professional services, such as nursing and health care, personal and social care for residents who require some form(s) of continuing, supervised care. The various needs of residents are met by different categories of nursing homes which are licensed by the states. Categories in Ohio include county and rest homes, homes for the aging, mental nursing homes, skilled nursing facilities (SNF), and intermediate care facilities (ICF).

Nursing Home Ombudsman Program (NHOP): Organizations responsible for responding to questions and complaints about nursing homes and long-term care facilities. Also includes the involvement of state regulatory agencies in the resolution of problems if necessary. Each state must have a state ombudsman.

Ohio Association of Area Agencies on Aging (OAAAA): An organization of Ohio's twelve area agencies on aging providing advocacy, information, education and training to area agencies and other agencies in the aging network.

Ohio Department of Aging (ODA): The designated State Unit on Aging (SUA) responsible for the planning, coordination, implementation and evaluation of programs and services for older Ohioans.

Ohio Network of Educational Consultants in the Field of Aging (ONECA): An advisory body to the Ohio Department of Aging on matters of education and training. Members also assist area agencies with training planning and serve as a general resource for area agencies.

Ohio Senior Health Insurance and Information Program (OSHIIP): A health insurance and information program that is a joint effort of the Ohio Departments of Aging, Insurance and Human Services. It helps provide answers to questions about Medicare, Medicaid, private health insurance and Medicare supplemental insurance.

Old-Age, Survivors and Disability Insurance (OASDI): Federal program under the Social Security Act providing benefits to eligible individuals who are fully insured, have reached entitlement age, and have applied for retirement insurance benefits, or to those persons who are the eligible survivors of the deceased, insured worker.

Older Americans Act (OAA): Legislation designed to ensure full participation for older Americans in all aspects of society. Defines ten objectives, or rights for older persons, creates AoA, authorizes a variety of social and nutrition programs, provides for the development and implementation of training, research and multidisciplinary gerontology centers, promotes community service employment opportunities for older Americans, and authorizes grants to tribal organizations for social and nutritional services. Amended every three years.

Ombudsman: An advocate who represents residents of long-term care facilities or nursing homes, or other, interested individuals, who have questions, concerns, complaints or who believe their rights as nursing home residents have been violated.

Outreach: Programs designed to seek out older individuals in need of services and to refer them to the appropriate agencies. These programs often rely upon the reports of family, neighbors, and community workers who identify isolated or needy elderly. Title III of the Older Americans Act funds a variety or outreach programs for older persons.

PASSPORT Administrative Agency (PAA): The regional administrative office of the PASSPORT program (located in the 12 area agencies on aging and at Catholic Social Services in Sidney, OH).

Planning and Service Area (PSA): A geographical area in a state or state jurisdiction that is designated for purposes of planning, development, delivery and overall administration of services under an area plan that is administered by an Area Agency on Aging (AAA). Ohio has 12 Planning and Service Areas.

Power of Attorney (POA): A legal document which authorizes another person (usually a relative) to make financial decisions for you.

Pre-Admission Screening (PAS): A process by which an individual is screened to determine if the individual has severe mental illness and/or mental retardation or is developmentally disabled and ,if so, whether they need the level of services provided by a nursing facility or specialized services.

Pre-Admission Screening and Annual Resident Review (PASARR): Process by which those (from the PAS) who are in a nursing facility are reviewed annually to see if they still meet the definition of severely mentally ill or mentally retarded or developmentally disabled and continue to meet the level of services for a nursing facility or specialized services.

Pre-Admission Screening System Providing Options and Resources Today (PASSPORT): The Ohio Medicaid waiver program that provides in-home alternatives to nursing home care for low-income seniors frail enough to receive daily nursing care.

Qualified Medicare Beneficiaries (QMB's): A program that pays out-of-pocket Medicare cost-sharing expenses for very low-income elderly or disabled persons.

Quality Assurance (QA): The application of standards, law, policies, procedures, and individual commitments to ensure the delivery of services consistent with anticipated outcomes.

Residential State Supplement (RSS): A program for low-income, blind or disabled Ohioans who need help living on their own but do not need nursing home care. OSS recipients may live in licensed rest homes, mental health residential facilities, or in adult foster, family or group homes that are willing to accept the payment received.

Rest Homes: A category of long-term care homes in Ohio that provide personal care and assistance with the activities of daily living, but are not permitted to offer nursing services. Must be licensed by the state.

Skilled Nursing Facility (SNF): Skilled nursing and/or skilled rehabilitative services furnished under the direction of a physician and requiring the skills of technical or professional personnel, such as an RN, LPN, licensed physical therapist or speech therapist. These personnel may either give direct care or may supervise care by other staff members.

Social Security Act (SSA): Enacted in 1935, provides income to workers and eligible dependents upon retirement, disability, or death; health and hospitalization insurance for the aged, disabled and low-income; means-tested supplemental security income for the needy; and block grants for state social services, including homemaker, chore, protective and day care services. It is administered by the Social Security Administration.

Social Services: Programs providing services and activities to promote independent living and individual welfare, enhance social relationships and life satisfaction, reduce isolation and to manage problem areas. Examples include day care centers, transportation services, counseling, and educational and recreational programs.

Spenddown: A method whereby individuals and/or families seek to establish Medicaid eligibility by reducing gross income through medical expenses or by transferring assets in order to meet program requirements. The concept may also be used in reference to other means-tested programs.

State Unit on Aging (SUA): Mandated by the Older Americans Act (OAA), each state designated a single agency to plan, coordinate, secure funding for and evaluate programs for older persons as authorized by both federal and state government.

Supplemental Security Income (SSI): National means-tested income support program created by Title XVI of the Social Security Act for low-income aged, blind and disabled persons.

Telecommunication Device for the Deaf (TDD)/Teletype (TTY): A device that connects with most standard telephones which enables people who are deaf, hard-of-hearing or speech impaired to communicate with others who also have the TTY/TDD.

Universal Pre-Admission Review (UPAR): A statewide service to help older persons and their family make informed decisions about long-term care. The review helps ensure that the services received by older persons are appropriate to meet their needs.

Utilization Review (UR) (as it relates to Ohio's PASSPORT Program): An evaluation of the type and amount of services that a PASSPORT client is using and a determination of whether or not the services are justified.

Veterans Administration (VA): Administers benefits for former Armed Services members and their dependents. Coverage and benefits include disability and death, pensions, medical treatment and hospitalization, nursing home and domiciliary care, and burial.

White House Conference on Aging (WHCOA): A national conference called for the purpose of reviewing existing policies which affect the elderly and making recommendations on how those policies can be strengthened and improved. The first national Conference on Aging was held in 1950. Subsequent White House Conferences on Aging have been held in 1961, 1971, 1981, and 1995.

Sources:
American Association of Retired Persons, Acronyms in Aging, Washington, D.C., 1986; U.S. DHHS, PHS, NIA, Age Words: A Glossary on Health and Aging, Washington, D.C., 1986; Springer Publishing Co., The Encyclopedia of Aging, New York, 1987; American Association of Retired Persons, Housing Options for Older Americans, Washington, D.C., 1984; National Association of State Units on Aging, An Orientation to the Older Americans Act, Washington, D.C. 1985; Scripps Gerontology Center, Miami University and the College of Social Work, Ohio State University, A Study of Ohio's PASSPORT Program, Oxford, Ohio, 1987; Ohio State Bar Association, What You Need to Know About Ohio's Living Will Law, Columbus, Ohio, 1991; U.S. DHHS, SSA, Social Security Handbook, 9th ed., Washington, D.C., 1986.