ACCESSORY APARTMENTS -
Complete private living units built into or attached to an existing single-family home. The two units share, at most, an entrance, yard and parking. Such apartments utilize unused space in a home more effectively. Advantages include additional income for the homeowner from the renter, and arrangements can be made for the renter to provide personal support services or assistance in maintenance and chores, in exchange for a reduction in rent. Disadvantages include initial construction costs, neighborhood opposition, and enhanced property value may result in increased property taxes.

ACTIVITIES OF DAILY LIVING (ADLs) -
A term used to describe basic personal tasks that are a necessary part of most people's regular day. ADLs include, for example, eating, bathing, dressing, moving around, and using the toilet.

ADULT DAY CARE -
A service which provides activities during the day in a group setting to support the personal independence of older adults and promote their social, physical and emotional well-being. Adult Day Care services include a variety of activities designed to meet the individual needs and interests of the participants, and referral to and assistance in using community resources. Also included are meals and snacks, and arrangements for transportation when needed.

ADULT DAY HEALTH CARE -
A service which provides activities during the day in a group setting to support older adults; personal independence, and promote social, physical, and emotional well-being. Adult Day Health Care services must include health care services and a variety of activities designed to meet the individual needs and interests of the participants, and referral to and assistance in using appropriate community resources. Also included are meals and snacks, and arrangements for transportation when needed.

ADULT CARE HOMES -
Non-Medical institution that provides room, board, laundry, 24 hour care, some personal care and recreational and social services for two or more residents. Different types of Adult Care Homes are: rest homes, group homes, and family care homes.

ADULT PROTECTIVE SERVICES -
Provided through the county Department of Social Services. Protective services for adults focus on protection of the disabled adult from abuse, neglect, or exploitation. Social workers may arrange for services, counsel caregivers, and initiate legal action on behalf of an incompetent adult to ensure the adult's health and safety.

ADVOCACY -
Assisting older individuals to uphold their rights and to obtain the services they need.

AREA AGENCY ON AGING (AAA) -
An Agency established under the Older Americans Act, that serves to facilitate and support the development of county based programs on aging and address issues of regional importance. Typically located within Councils of Government.

ASSESSMENT -
A method used to collect information about an individual's health, finances, mental, and social status to determine need and/or eligibility for a service.

ASSISTED LIVING -
Any group housing and services program for two or more unrelated adults providing one meal daily, housekeeping and personal care services.

ASSISTIVE TECHNOLOGY -
Any device or equipment that can be used by a person with a disability which allows them to become more independent.

CAPITATION -
A payment method whereby a managed care plan is paid a fixed amount for each person enrolled, regardless of the type or amount of service provided.

CARE MANAGEMENT -
A service which assists clients and their families, with complex needs, to obtain services to enable a high-risk older adult to remain at home.

C.A.C. -
Community Advisory Committee - A committee of volunteers who monitor for residents' rights' in long-term care facilities under the supervision of the Regional Long-Term Care Ombudsman.

C.A.P -
Community Alternatives Program: in home personal care services which serve as an alternative to placement in a nursing home.

CHORE -
A service which includes household cleaning, yard work, and minor home repairs for individuals physically unable to perform these tasks.

CHRONIC ILLNESS -
An illness that lasts a long time-possibly even a lifetime and requires ongoing monitoring and care. Examples include arthritis, diabetes, glaucoma, and heart disease.

CLAIM -
A request for payment from a provider of care to the person who is covered or to an insurance company that contains information about health care provided to a particular patient. A health plan or an insurer uses the claim to process payment to the provider or patient.

COINSURANCE -
Sharing the costs between insured and insurer according to a predetermined percentage. In many traditional health insurance policies, once the deductible is met, the insured pays a 20 percent coinsurance and the insurer pays the rest.

COPAYMENT -
The amount a patient pays at the time a medical service is delivered, for example $5-$10 per visit.

CONGREGATE HOUSING -
A group living arrangement for the older and disabled person who would benefit from assistance in maintaining an independent life style. There is no such thing as "typical" congregate housing. However, congregate housing generally provides private living quarters, meals in a central dining room, shared living spaces and access to social and recreational facilities. It is a good alternative for people who do not require licensed healthcare facilities but find home maintenance, shopping, cooking, household duties and personal care difficult or impossible to manage.

CONGREGATE NUTRITION -
A congregate meal is a hot or cold meal that is provided in a group setting which assures a minimum of one-third of the daily Recommended Dietary Allowance (RDA).

CONTINUING CARE RETIREMENT COMMUNITY -
A Continuing Care Retirement Community, or Life Care Community offers living arrangements for older persons where rent payments include utilities, taxes, property maintenance, food, and supportive health care. Before entering, be certain that you understand your contract and have it reviewed by an attorney. Be aware of the contract's duration, and the policy for refunds or adjustments in fees at the time of death or upon leaving the Community.

COUNSELING -
Offers guidance and assistance to older persons in coping with personal problems. Depending on the agency providing the service this may involve such areas as family, financial, employment and other areas of counseling.

DEDUCTIBLE -
The amount a patient pays out-of-pocket before insurance benefits are paid.

DISCHARGE PLANNING -
Transferring patients from a hospital to a less expensive health care facility to limit hospital stays while ensuring appropriate care.

DISENROLLMENT -
Cancellation of membership in a health plan.

DOMICILIARY CARE FACILITY -
Non-medical institution that provides room, board, laundry, 24 hour care, some personal care and recreational and social services for two or more residents. Different types of domiciliary care homes are: rest homes, group homes and family care homes and are referred to as Adult Care Homes.

ELDER HOSTEL -
A learning enrichment program for anyone 55 and over.

EMPLOYMENT PROGRAMS FOR OLDER ADULTS -
Designed to help older workers find employment or link them with training programs that will help them qualify for employment in the general labor market as well as community service, for example: Green Thumb.

ESCORT -
A service for persons with limited mobility to help them obtain needed services. It involves accompanying and personally assisting an individual with transportation.

FAMILY CARE HOME -
An Adult Care Home that serves six or fewer adults in a residential "home-style" setting.

FEE FOR SERVICE -
The traditional method of paying for medical service after the service has been performed. A fee for each service rendered is paid to the health care provider.

FOSTER CARE SERVICES FOR ADULTS -
Assistance to, or on behalf of, aging, blind or disabled individuals and other adults in need of a licensed substitute home suitable to their particular needs. It is specifically for individuals who are unable to remain in their own homes or for adults who are in transition after just moving out of institutional care. Services include: assessment with the individual and/or the family concerning the need for placement; determining the need and arranging for appropriate services to support the social, emotional, and physical well-being of the individual during the placement; counseling, to help the individual attain and maintain an adequate psychosocial adjustment; and counseling and casework services to support and strengthen the individual's relationship with his/her own family.

FRIENDLY VISITING -
Personal contact for persons who live alone and are homebound.

GATEKEEPER -
A primary care doctor who coordinates a beneficiary's care and decides if tests or specialists are needed. Generally, to be covered, your primary doctor must refer you for tests or a specialist's care.

GROUP HOMES -
An Adult Care Home that provides residential care for two to nine adults who have been diagnosed as having a developmental disability.

GROUP RESPITE SERVICES -
Services preformed in a safe group setting where caregivers can take a care receiver who does not need personal care to get a break from their responsibilities. It offers participants unique opportunities for socialization and a variety of activities.

GUARDIANSHIP -
The performance of legal and financial transactions on behalf of a client based upon legal transfer of responsibility.

HEALTH CARE FACILITY -
A facility such as a hospital, skilled nursing facility, intermediate care unit, psychiatric ward, rehabilitation, surgical or other health care unit.

HEALTH MAINTENANCE ORGANIZATION (HMO) -
A type of managed care plan that provides comprehensive medical services to its enrolled members on a prepaid basis. Members are usually required to receive covered services from the HMO's participating providers.

HEALTH MAINTENANCE ORGANIZATIONS (HMOs) -
HMOs provide a wide range of health services to members. HMO members have a primary care physician who is responsible for coordinating their care. These physicians also are the "gatekeepers" for special services.

HEALTH PROMOTION -
Activities to maintain and improve the health and well-being of older adults. Health promotion activities focus on areas that may include; exercise/physical fitness, nutrition/diet, drug management, accident prevention/injury control, smoking cessation, mental health/stress management, immunization, dental health, vision care, foot care, and environmental health.

HEALTH SCREENING -
Consists of the evaluation of personal and family medical history; testing for diseases or health problems; and identification of factors that may make a person at risk for a condition or problem. In addition, Health Screening also includes health counseling and referral for those individuals at risk for developing health problems or abnormalities.

HOME AND COMMUNITY CARE BLOCK GRANT -
A source of funding for counties to provide services for older adults, which represents the consolidation of applicable Older Americans Act funds, Social Services Block Grant funds for respite care, portions of the State In-home and Adult Day Care funds, and other applicable state and federal funds.

HOME DELIVERED MEALS -
A home delivered meal is delivered to a home-bound older person which provides one-third of the daily Recommended Dietary Allowances (RDA). Home-bound is defined as being confined to the home due to reason of illness or incapacitating disability.

HOME EQUITY CONVERSION -
Also known as "Reverse Equity Plans" is designed to allow homeowners to convert the value of their home (equity) into cash. Under these plans, a home is either mortgaged or sold to an individual or institutional investor but is occupied by the homeowner until death or a negotiated future date. In addition these plans also state that elderly homeowners have the option of increasing their monthly cash resources by drawing on the equity in their homes. Examples include Reverse Mortgage Plans, Shared Appreciation Reverse Mortgages, a Sale-Leaseback, or Deferred Payment Loans.

HOME HEALTH SERVICES -
Health related services provided in the home of the elderly, the disabled, sick or the convalescent. It provides an alternative to hospitalization or care in a nursing home.

HOMEMAKER SERVICES -
Providing assistance in management of household budgets, housekeeping, shopping assistance and nutritious meal preparation and basic personal and health care available to persons unable to perform day-to-day household tasks.

HOSPICE -
Care given to the terminally ill in the home and/or special facility to enhance the dying person's quality of life.

HOUSE MATCHING -
A program that assists individuals seeking a shared housing arrangement to find a mutually beneficial "match". Most programs make matches with few restrictions as to the age of the potential house-sharers, frequently finding that matching young people with unrelated older home-owners.

HOUSE SHARING -
A living arrangement in which several unrelated persons reside together, sharing living expenses and housekeeping duties. Advantages are a reduction in costs, means of remaining in the neighborhood with friends and community connections, help in overcoming loneliness, a sense of security and a peer support system. Disadvantages include the requirement of thoughtful decisions before entering this type of living arrangement, privacy may be reduced, and may not be adaptable to meeting special needs. Restrictive zoning ordinances may be a problem.

INDEMNITY PLAN -
Traditional health insurance that pays benefits for specific covered visits and procedures.

INDIVIDUAL PRACTICE ASSOCIATION -
An HMO which contracts with doctors to provide services to the plan's enrolled patients on either fee-for-service, capitation, or some other basis.

INFORMATION & REFERRAL -
The provision of information about services available, or who may provide what services and assistance to receive those services.

IN-HOME AIDE SERVICES -
Services to assist the individual and/or family with home management, personal care tasks and supervision to enable the individual to remain and function effectively at home as long as possible.

IN-HOME RESPITE SERVICES -
Services preformed in the home that provide respite or relief for a caregiver. These services consist of housekeeping, shopping, cooking and companionship.

INPATIENT -
A patient who is admitted to a hospital or other health care facility for at least an overnight stay.

INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADL's) -
Basic tasks that are essential (instrumental) to living independently. Examples include paying bills, shopping, cleaning house, and using the telephone.

INTERMEDIATE CARE FACILITY -
An institution that provides health care and services to individuals who do not need the degree of care or treatment normally received from a hospital or skilled nursing facility.

LEGAL ASSISTANCE -
Provides information on legal rights, legal advice, benefits, entitlements and/or appeals. Also includes preventive measures such as community education.

LONG TERM CARE OMBUDSMAN PROGRAM -
The ombudsman program provides advocacy services for residents in long term care facilities (nursing and domiciliary homes). The objectives of the program are to: provide training and support to Nursing Home Community Advisory Committees and Domiciliary Home Community Advisory Committees; ensure that Nursing Home and Domiciliary Home Patients' Bill of Rights are adhered to; work to resolve grievances and complaints made by or on behalf of individuals who are residents of long term care facilities; educate the public on long term care issues; promote community involvement in long term care facilities (i.e. volunteers); and monitor the development and implementation of federal, state, and local laws, regulations, and policies with respect to long term care facilities.

MEDICAID -
A national medical program for the reimbursement of medical and health services to individuals who are financially needy. It is administered by the state of North Carolina.

MEDICAL SAVINGS ACCOUNT (MSAs) -
Medicare medical savings accounts present a major departure from other Medicare insurance coverage. Rules governing these new MSAs still need to be established. However, the concept behind MSA is to combine a higher deductible, lower cost health insurance policy with a tax free savings account.

MEDICARE -
A national health insurance plan for individuals over 65 and for some individuals under 65 who are disabled.

MEDICALLY NECESSARY CARE -
A term used by insurers to describe medical treatment that is appropriate and given in accordance with generally accepted standards of medical practice. While there is consensus among insurers and providers about a great deal of medical care, there is a wide disagreement about what is "medically necessary" for many other conditions.

NURSING HOME -
Provides two levels of health care: Intermediate care which is nursing care for at least 8 hours a day; and Skilled care which is nursing care 24 hours a day.

NUTRITION -
A program to aid individuals in identifying and understanding their nutritional and health needs. Individual meals are available at county senior centers and other nutrition sites, or are delivered to the home of a senior citizen who qualifies. Emphasis is on proper nutrition for healthy living.

OCCUPATIONAL THERAPY -
Rehabilitation designed to help persons return to their everyday life by teaching a specific occupation.

OLDER AMERICANS ACT (OAA) -
The federal legislation, enacted originally in 1965, that supports planning, development, and delivery of services for people age 60 and older, regardless of their economic status. These services include congregate and home-delivered meals, a variety of individual home care services, and support for community involvement.

OUTREACH -
An effort to identify and familiarize people with services available to them. It is aimed primarily at isolated and/or homebound elderly in need of services.

OUT OF POCKET COST -
The portion of payments for health services that must be paid by the consumer who is insured, including copayments, coinsurance, deductibles and the consumer's share of monthly payments.

OUTPATIENT -
A patient who is treated in a health care setting-such as a clinic, a division of a hospital, or a physician's office-but is not admitted to a hospital for an overnight stay.

P.C.S -
Personal Care Services in the home.

PERSONAL CARE -
Assisting an individual with medication, dressing, feeding, personal appearance, etc. under the direction of medical professionals.

POINT OF SERVICE PLAN (POS) -
An open ended option offered by an HMO in which enrollees may obtain services outside the plan's network of physicians, but at a higher cost sharing than if they use one of the plan's
providers.

PRECERTIFICATION -
Advance approval required for admission to a hospital or for a surgical procedure.

PREMIUM -
The amount of money paid periodically to obtain health insurance coverage. The costs of premiums is usually shared by employers and workers. In Medicare, beneficiaries bear the cost of any premiums charged by their managed care plans.

PRIMARY CARE -
Regular, basic medical care, such as would be provided by a family doctor, a pediatrician, internist, obstetrician, gynecologist, a nurse practitioner or physician's assistant. A primary care physician in an HMO may be called a gatekeeper.

PROTECTIVE SERVICES -
Provided to individuals who are unable to manage their personal and financial affairs due to the severity of their functional incapacity.

PREFERRED PROVIDER ORGANIZATIONS (PPOs) -
PPOs create networks of independent physicians who are officially connected to the plan. If a member receives care from an "out of network" provider, the PPO will require the customer to pay a much larger part of the bill. PPOs do not require members to select a primary care physician.

PRIVATE FEE FOR SERVICE PLANS -
As opposed to traditional Medicare fee for service, the plan will reimburse doctors, hospitals, and other providers on a fee for service basis, but at a rate determined by the plan, not the Medicare rate. People enrolled in this plan are not restricted to providers who contract with the plan.

PROVIDER -
An individual (physician, nurse, therapist, etc.) or institution (hospital, nursing home, etc.) providing medical care.

PROVIDER SPONSORED ORGANIZATIONS (PSOs) -
PSOs are similar to HMOs. They are operated by a health care provider, such as a hospital or a group of doctors such as a geriatric unit of a hospital. The PSO will provide a substantial portion of covered services through that provider or group.

REHABILITATION THERAPY -
Designed to restore or maintain the greatest possible functioning and independence; recommended for those who have suffered a stroke, injury or disease.

REPAIRS, MAINTENANCE, RENOVATIONS -
The improvement and/or maintenance of an individual's residence and appliances.

RESIDENTIAL CARE FACILITY -
Includes Adult Care Homes and any other residential care related facility whether publicly or privately owned.

RESPITE SERVICE -
A service which provides respite or relief for a caregiver. It may be provided to an individual in his/her own home, in the home of his/her caregiver or in a group setting. Respite Care may consist of any level of home management or personal care tasks.

REST HOME -
An Adult Care Home that serves seven or more adults who need 24-hour supervision and assistance with activities of daily living.

SCREENING -
An assessment performed by a social worker and/or a nurse, to determine the person's current functional abilities and resources in six areas: physical health, mental health, social support, activities of daily living, environmental conditions, and financial situation in order to provide information for developing a client service plan which is appropriate for the individual being screened.

SECTION 8 HOUSING -
Is a form of subsidized housing in which the owner is given a certificate for the federal government to pay the difference between 30% of the renter's income and the unit rental price - up to a fair market rent established by HUD.

SELF-HELP, SELF-CARE -
A health care concept that teaches individuals that they can manage many of their own health problems when given instruction, appropriate medications and knowledge of when to seek professional help.

SENIOR CENTER -
A community center for the elderly that promotes activities of interest and involvement in the community. Centers offer many educational, recreational, cultural and social events.

SENIOR CENTER DEVELOPMENT -
The acquisition, construction, expansion, renovation and the purchase of equipment for a multipurpose senior center. The term "multipurpose senior center" means a community facility for the organization and provision of a broad spectrum of services, which include, but are not limited to, the provision of health, social, nutritional, and educational services and the provision of facilities for recreational activities for older individuals.

SENIOR COMPANION PROGRAM -
A part-time volunteer opportunity for low-income persons 60 years or older who are interested in community service. Senior Companions provide support, task assistance and/or companionship to adults with exceptional needs, developmental disabilities, functional impairments, or persons who have other special needs for companionship. The volunteer earns a small stipend to help cover their expenses.

SENIOR TAR HEEL LEGISLATURE (STHL) -
A legislative group created by the NC General Assembly in 1993 to help give older adults a voice about their needs and concerns. Each county has a delegate and alternate member who represent the older adults in their home county.

SERVICE AREA -
The geographical area defined by a managed care plan which it will provide health care services to its members.

SUPPLEMENTAL SECURITY INCOME (SSI) -
A federal program designed to provide a minimum monthly income to financially needy people age 65 and older, and to financially needy younger adults who are blind or disabled and/or is eligible for Medicaid. The SSI program is administered by the Social Security Administration.

SWING BED -
A hospital program that makes available skilled nursing and intermediate care beds when these beds are not needed for acute hospital care.

TRANSPORTATION -
Transportation service provides travel to or from services and community resources (i.e. nutrition sites, medical appointments, senior centers or other daily assistance).