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ELDER CARE: Caring for California's Aging Population : RESOURCE GUIDE: CARING FOR THE ELDERLY : Glossary

May 20, 1990

ACUTE CARE--Medical services provided by physicians, nurses and other health-care professionals for a person who has disease or ailment that requires immediate but short-term attention.

ADULT DAY CARE--Centers that provide recreation, rehabilitation or nursing care for adults who suffer from memory loss, depression and loneliness.

ATTENDANT CARE--Full-time aides who help with feeding, bathing and other basic services for disabled people.

BOARD-AND-CARE FACILITIES--Also known as residential-care facilities, these are living quarters for the elderly in private homes, hotels or apartments. They must be licensed by the state and do not provide nursing care.

CASE MANAGERS--Also known as care managers, these professional advisers help evaluate the changing social, psychological, financial and housing needs of the elderly. Often trained as social workers or nurses, case managers evaluate an elderly person's situation and make recommendations for the purchase of equipment or the hiring of household workers. They also can find new living quarters and coordinate medical, legal and financial services. Fees vary enormously.

COMPANIONS--Non-medical personnel who are hired or volunteer to take care of an elderly person who can't be left alone.

CONSERVATOR or GUARDIAN--A person, usually a friend or relative, appointed by the court to handle to the affairs of an elderly person when that person requests help or is deemed incapable of managing alone.

DAY HOSPITALS--A cross between mini-hospitals and clinics, these facilities--also called geriatrics centers--offer services for individuals with multiple illnesses who need detailed medical and psychological evaluations.

FEE-FOR-SERVICE CARE--The form of health care provided under so-called indemnity insurance plans. Consumers are allowed to go to the physician or hospital of choice and they must pay premiums and a deductible, usually the first $100 to $500 in medical bills each year. Patients must also co-pay or assume responsibility for part, typically 20%, of doctors and hospital charges.

HMO--Health maintenance organization, also known as a prepaid health plan or a prepaid group practice plan. Services range from office visits and medications to surgery. Patients may be limited in the number and types of procedures they can receive and may not always get to see the physician or specialist of choice.

HOME-HEALTH AIDES--Working under the supervision of a nurse, these trained medical assistants bathe, administer medications, give injections, change bandages. Such services, provided by public and private agencies, can be covered by insurance or Medicare if they are deemed medically necessary and ordered by a physician.

HOMEMAKERS--Individuals who provide in-home support services: household chores, light cleaning, laundry, shopping and food preparation. Homemakers placed through agencies are often experienced with the problems of the elderly, but care should be taken to check references and conduct interviews first.

HOSPICE CARE--Specially planned medical, social and psychological care provided at home, in hospitals or in special facilities for the terminally ill. The goal of hospice care is to make the patient as comfortable as possible.

IN-HOME SUPPORT SERVICES--Household chores, shopping and personal care, including bathing and dressing, are provided by private businesses and government agencies. Fees vary by location and type of services needed. Financial assistance for in-home care is provided for low-income individuals by government agencies and some private churches and foundations.

LIFELONG CARE COMMUNITIES--Some retirement complexes provide a variety of housing alternatives in one location, ranging from separate apartments for fully independent and mobile residents to full-service nursing care for the mentally or physically disabled. Fee structures vary but are normally high because care is available no matter what the need. Because the communities are so new, few government regulations exist.

MEDICAID/MEDI-CAL--The federal and state governments provide health insurance for people 65 and older and those who are disabled and have low incomes and few assets. Medi-Cal in California covers the costs of nursing homes for those who cannot afford to pay themselves.

MEDICARE--Part of the Social Security Act, this federal health insurance program pays part of the costs of acute hospital care for people 65 and older after the patient has paid a deductible and at least 20% of the hospital bill. Part B of the act requires the patient to pay monthly fees, similar to those in private insurance programs, in return for payment of some doctors' fees by the plan. The plan covers little, if any, of the costs of nursing home care.

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