Hospice Glossary of Terms
Activities of Daily Living (ADLs)
Basic actions that independently functioning individuals perform on a daily basis:
- Bathing
- Dressing
- Transferring (moving to and from a bed or a chair)
- Eating
- Caring for incontinence
Many public programs determine eligibility for services according to a person’s need for help with ADLs. Many long-term care insurance policies use the inability to do a certain number of ADLs (such as 2 of 6) as criteria for paying benefits.
Advanced Directive (also called Health Care Directive, Advanced Health Care Directive, or Living Will)
Legal document that specifies whether you would like to be kept on artificial life support if you become permanently unconscious or are otherwise dying and unable to speak for yourself. It also specifies other aspects of health care you would like under those circumstances.
Assessment
The gathering of information to rate or evaluate your health and needs.
Benefits
Monetary sum paid by an insurance company to a recipient or to a care provider for services that the insurance policy covers.
Chain of Trust
A term used in the HIPAA Security NPRM for a pattern of agreements that extend protection of health care data by requiring that each covered entity that shares health care data with another entity require that that entity provide protections comparable to those provided by the covered entity, and that that entity, in turn, require that any other entities with which it shares the data satisfy the same requirements.
Confidentiality
Your right to talk with your health care provider with full confidence of information being held secret and private.
Discharge Planning
A process used to decide what a patient requires for a smooth move from one level of care to another. This is done by a social worker or other health care professional, and it includes moves from a hospital to a nursing home or to home care. Discharge planning may also include the services of home health agencies to help with the patient’s home care.
Custodial Care (also called personal care)
Non-skilled service or care, such as help with bathing, dressing, eating, getting in and out of a bed or chair, moving around, and using the bathroom.
Dementia
Deterioration of mental faculties due to a disorder of the brain.
Disabled
For Medicaid eligibility purposes, a disabled person is someone whose physical or mental condition prevents him or her from doing enough work or the type of work needed for self-support. The condition must be expected to last for at least a year or be expected to result in death. Persons receiving disability benefits through Supplemental Security Income (SSI), Social Security, or Medicare automatically meet this criterion.
Do Not Resuscitate Order (DNR)
Written order from a doctor that resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. A DNR order may be instituted on the basis of an Advance Directive from a person, or from someone entitled to make decisions on the person’s behalf, such as a health care proxy. In some jurisdictions, such orders can also be instituted on the basis of a physician’s own initiative, usually when resuscitation would not alter the ultimate outcome of a disease. Any person who does not wish to undergo lifesaving treatment in the event of cardiac or respiratory arrest can receive a DNR order, although DNR orders are more common when a person with a fatal illness wishes to die without painful or invasive medical procedures.
Durable Medical Equipment (DME)
Medical equipment that is ordered by a doctor for use in the home. These items must be reusable, such as walkers, wheelchairs, or hospital beds. DME is paid for under both Medicare Part A and Part B for home health services.
Durable Power of Attorney
Legal document that gives someone else the authority to act on your behalf on matters that you specify. The power can be specific to a certain task or broad to cover many financial duties. You can specify if you want the power to start immediately or upon mental incapacity. For the document to be valid, you must sign it before you become disabled.
Financial Eligibility
Assessment of a person’s available income and assets to determine if he or she meets Medicaid eligibility requirements.
Homemaker or Chore Services
Help with general household activities such as meal preparation, routine household care, and heavy household chores such as washing floors or windows, or shoveling snow.
Hospice Care
Short-term, supportive care for individuals who are terminally ill (have a life expectancy of six months or less). Hospice care focuses on pain management and emotional, physical, and spiritual support for the patient and family. It can be provided at home or in a hospital, nursing home, or hospice facility. Medicare typically pays for hospice care.
Medicaid
Joint federal and state public assistance program for financing health care for low-income individuals. It pays for health care services for those with low incomes or very high medical bills relative to income and assets. It is the largest public payer of long-term care services.
Medical Power of Attorney
Legal document that allows you to name someone to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions for yourself.
Medicare
Federal program that provides hospital and medical expense benefits for people over the age of 65, or those meeting specific disability standards. Benefits for nursing home and home health services are limited.
Medicare Part A (Hospital Insurance)
Hospital insurance that pays for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Medicare Part B (Medical Insurance)
Medicare medical insurance that helps pay for doctors’ services, outpatient hospital care, durable medical equipment, and some medical services that aren’t covered by Part A.
Medicare Supplement Insurance (also called Medigap coverage)
Private insurance policy that covers gaps in Medicare coverage.
Nutrition
Attaining enough of the right foods with vitamins and minerals a body needs to stay healthy. Malnutrition, or the lack of proper nutrition, can be a serious problem for older people.
Palliative Care
Care for the seriously and terminally ill is focused on providing comfort by addressing physical and emotional pain and suffering.
Respite Care
Temporary care is intended to provide time off for those who care for someone on a regular basis. Respite care is typically 14 to 21 days of care per year and can be provided in a nursing home, adult day service center, or at home by a private party.
Sources: U.S. Department of Health and Human Services and Centers for Medicare & Medicaid Services