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Glossary of Terms

In the field of aging, aging professionals use terms to describe conditions, situations, entities, ways of doing things, etc. The following list was compiled by the PTCOG Area Agency on Aging. With their permission, we have recreated it online for you and updated it with some new additions.

A

Activities of Daily Living (ADLs)
A term used to describe basic tasks that are a part of most peoples regular day. These include bathing, toileting, dressing, moving around the house and eating.

Administration on Aging
Primary agency within the federal government having responsibility to administer the provisions of the Older Americans Act and to advocate for the needs, concerns, and interests of older citizens.

Adult Care Homes
An assisted living residence in which the housing management provides 24 hour scheduled and unscheduled personal care services to two or more residents, either directly or, for scheduled needs, through formal written agreements with licensed home care or hospice agencies. Adult care homes and family care homes are subject to licensure by the Division of Health Service Regulation.

Adult Care Home Community Advisory Committee( ACH CAC)
Members are appointed by the local board of commissioners to work to maintain the spirit of the Residents Bill of Rights as well as promote community education and awareness of the operation of adult care homes in that county and the needs of the persons residing in these homes.

Adult Day Care
The provision of group care and supervision of adults (who may be physically or mentally disabled) in a place other than their usual residence on a less than 24 hour basis. Services are designed to support the adult's personal independence, as well as physical, social and emotional well-being. Adult day care programs are subject to certification by the Division of Aging and Adult Services.

Adult Day Health Care
A community-based day care program that provides health, social and recreational care, along with rehabilitative services. Staffing is by trained paraprofessionals and is under the supervision of a registered nurse. The program is ideal for the elderly or physically impaired adult who needs assistance in a protective setting during the day. Adult day health programs are subject to certification by the Division of Aging and Adult Services.

Adult Home Specialist
The person(s) in the county Department of Social Services given primary responsibility for assessing the need for adult care homes in the county, responding to all inquires regarding licensure, and monitoring homes for compliance with licensure rules.

Adult Placement Services
Helps aging or disabled adults find appropriate living and healthcare arrangements when their health, safety, and well-being can no longer be maintained at home. Placement arrangements are made in adult care homes, nursing homes, other substitute homes, residential health care settings, or institutions. Adults and their families receive help to complete medical evaluations and financial applications, and locate and move to new settings. They also may receive counseling to help them adjust to the change. All 100 county Departments of Social Services provide Adult Placement Services.

Adult Protective Services (APS)
Disabled adults are vulnerable to abuse, neglect, and exploitation. County Departments of Social Services receive and evaluate reports to determine whether disabled adults are in need of protective services and what services are needed (as required by Article 6, Chapter 108A of the North Carolina General Statutes). Disabled adults or disabled emancipated minors present in North Carolina who are reported to be abused, neglected, or exploited and in need of protective services are eligible to receive this service without regard to income.

Advance Directive
A notarized written statement made by an alert, competent adult that indicates his/her wishes regarding a treatment plan in the event that he/she is unable to self-advocate and suffers from an incurable illness that puts his/her life at immediate risk.

Advanced Health Care Directive Registry
A clearinghouse where North Carolina Residents may record their end of life choices and other medical directives for a small fee. www.nclifelinks.org or (919) 807-2162

Advocacy
Promoting the rights, needs and interests of older persons & caregivers.

Aging and Disability Resource Center
A cooperative effort by the Administration on Aging and Centers For Medicare and Medicaid seeking to create a single, coordinated system of information and access to those seeking long-term care supports.

Aging Network
A nationwide network of organizations and agencies concerned with aging issues.  The term typically refers to the network consisting of the Administration on Aging, the State Units on Aging, Tribal and Native Organizations, the Area Agencies on Aging,  local service providers and advocacy groups such as the Senior Tarheel Legislature, Coalition on Aging and Governor’s Advisory Council.

Aging Resources Management System
N.C.’s web-based reimbursement system for Home and Community Care Block Grant and related services.

Alzheimer's Disease
A progressive, degenerative disease that attacks the brain and results in impaired memory, thinking, and behavior.

Americans With Disability Act of 1990 (ADA)
Federal law which provides comprehensive civil rights protections for persons with disabilities. The Act defines disability as a physical or mental impairment that substantially limits one or more major life activities.

Area Agency On Aging
Area Agencies on Aging (AAA) plan, coordinate, and advocate for the development of a comprehensive service delivery system to meet the needs of older adults in a specific geographic area. They administer state and federal funds for community based services. The AAA's provide training and technical support to county agencies that offer services to older adults and local public officials.

Assessment
Activities performed by a clinical professional (social worker and/or a nurse) to determine a 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. Assessment may include a home visit. Once the assessment is completed, activities related to developing and implementing a client service plan becomes part of client care management.

Assisted Living
Assisted Living Residence means any group housing and services program for two or more unrelated adults, by whatever name it is called, that makes available, at a minimum, three meals a day, activities and housekeeping services and that provides personal care services directly or through a formal written agreement with one or more licensed home care or hospice agencies.

Assistive Device
Assistive device refers to any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.

Assistive Technology
Any technology or device which enables an individual to be more independent and/or enables an individual to accomplish a task. Examples of assistive technology include motorized wheelchairs, TTY communicators, print readers, computers, voice-activated devices, etc.

B

Blindness
Two services provided by the Division of Services for the Blind have eligibility criteria requiring that a consumer be legally blind. They are In-Home Level I and Special Assistance for the Blind. However, DSB provides many other services that only require the consumer to be severely visually impaired and eligibility determination is made based on the consumer's eye report.

C

Caregiver
(Defined by the 2000 National Family Caregiver Support Program) A caregiver is an adult family member, friend, neighbor, relative, domestic partner, spouse or other, who is an informal care provider to an older and/or disabled individual or is the primary caregiver of a child who is 18 years of age or younger.

Care Management or Case Management
This service provides professional assistance (typically by registered nurses and/or social workers) to older adults and their families by identifying, accessing, and coordinating services that are necessary to enable the older adult to remain in the least structured environment.

Care Recipient
(Defined by the National Family Caregiver Support Program) An older and/or disabled individual or child 18 years of age or younger that receives informal care by a family member, friend, neighbor, relative, domestic partner or spouse.

Case Assistance
The preliminary screening requests from older adults and their families for assistance, referral to appropriate services and follow-up to determine if needs were satisfactorily addressed.

Certified Nursing Assistant
A paraprofessional who provides frontline care and assistance to individuals with disabilities or impairments in home and institutional settings.

Certificate Of Need
A competitive application process managed by the Division of Health Service Regulation by which providers acquire new institutional health care services (i.e., nursing home beds, hospital beds, rehabilitative beds, home health agencies and hospices, etc.) in accordance with the State Medical Facilities Plan. This serves as a quality assurance process for the state to manage quantity and costs of medical services.

Choices For Independence
A demonstration initiative of the Administration on Aging, promoting consumer-directed,  community-based long-term care options and evidence-based health interventions.

Chore Services
*See In-Home Aide Services (Level 1)

Client-Centered
A focus on the individuals quality of life in the formulation of goals and strategies, to assure that basic needs are met and desired opportunities are available. (As opposed to focus on the federal/state funding used to pay for a service.)

Cognitive Impairment
A term that refers to damage or loss of intellectual or mental functioning. The act or process of "knowing", including awareness or judgment, is impaired. Alzheimer's disease is the most common cause of permanent cognitive impairment among older adults.

Community Alternatives Program for Disabled Adults (CAP/DA)
A Medicaid waiver program that provides community-based services to disabled adults, mentally retarded adults, children, and persons with AIDS who meet the medical requirements for nursing home level care. CAP services may include traditional Medicaid home health services (nursing, physical therapy, home health aide, etc.), as well as services not generally available under Medicaid (home delivered meals, respite care, in-home aide services, etc.).

Congregate Living
A living arrangement in which two or more unrelated individuals reside in a house or apartment.

Congregate Nutrition Program
A program that provides 1/3 of the recommended daily dietary allowance (RDA) in a meal. This occurs in a group setting that promotes socialization among the participants. The site for meals can be in churches, schools, senior centers, or recreational centers.

Consumer-Family Advocacy Committee
The role of CFAC is to communicate concerns, provide advice, and comment on all state and local plans regarding mental health reform.

Continuing Care Retirement Community (CCRC)
A facility that offers a continuum of care- from independent living, assisted-living, or rest home care, to nursing home care. Individuals are offered an independent living lifestyle with the security of knowing supportive and health care services are available if needed.

Core Services
The 2000 NC Institute of Medicine Report on Long-Term Care for NC stated: every North Carolinian should have access, either in the county or within a reasonable distance from the county, to the following long-term care services:

• Long-term care information and assistance services
• Transportation
• Housing and home repair and modification
• Home delivered meals
• Durable medical equipment and supplies
• Medical alert or related services
• Nursing services
• Respite care/adult day care/day health care or attendant care
• In-home aide services
• Home health care
• Adult care homes (various types)
• Nursing homes
• Care management for high-risk or complex conditions

In addition to the long-term care services listed above, older adults and people with disabilities need other medical, mental health, dental, vision, and hearing services to meet their health and functional needs. Individuals who have functional, medical or cognitive impairments may also need guardianship services or protective services to ensure that their long-term care needs are being met.

Consumer Contribution/Cost Sharing
The purpose of the Consumer Contributions Policy is to extend the availability of in-home and community based services administered by the North Carolina Division of Aging and Adult Services (DAAS) and the North Carolina Division of Social Services (DSS) by soliciting from recipients of specific services a portion of the cost for services rendered based upon their ability and willingness to contribute. Revenues collected from service recipients will be retained by the local service provider and used to increase services to other individuals in need of such services. Failure to contribute toward the cost of services received does not terminate or limit service eligibility.

Consumer Directed Care
(See Real Choice Systems Transformation)  Grant-funded pilot projects that provides disabled persons with more autonomy in choosing from an array of long-term care service options, including community-based and Medicaid waiver services.

Continuum of Care
The entire spectrum of specialized health, rehabilitative, and residential services available to the frail and chronically ill.  The continuum of care focus is on the social, residential, rehabilitative and supportive needs of individuals, as well as needs that are essentially medical in nature.

Councils On Aging (COA)
A private, nonprofit organization or public agency that may serve as a county focal point on aging. Traditionally, it provides supportive services to older adults (located in some, but not all counties). Sometimes they serve as advisory boards to the county board of commissioners. Department on Aging is the term typically used when it is a public agency; or part of county/city government.

County Department Of Social Services (DSS)
A public agency that provides a range of services and public assistance to older and disabled adults, as well as children. County DSS's are located in all 100 counties in North Carolina. Services potentially available to adults include: Adult Protective Services, Guardianship, Foster Care Services and Placement, In-Home Aide Services, Transportation, At-Risk Case Management, Individual & Family Adjustment, and Adult Care Home Case Management. DSS's are also responsible for the primary consultation involved in monitoring of adult care homes and adult day care/day health programs.

D

Deaf-Blind
The inability to understand conversation with optimum amplification. Visual acuity usually does not exceed 20/200 in the better eye with corrective lens. Visual acuity is greater than 20/200 if the visual field is constricted to 20 degrees or less or a progressive condition that will lead to significant hearing and vision loss. A deaf-blind individual may prefer a qualified tactile or up-close interpreter.

Developmental Disability
North Carolina General Statute 122C-3(12a) defines a developmental disability as "a severe, chronic disability of a person which: is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the person attains age 22, unless the disability is caused by traumatic head injury and is manifested after age 22; is likely to continue indefinitely; results in substantial functional limitations in three or more of the following areas of major life activity (self-care, receptive understanding) and expressive language learning, mobility (ability to move), self-direction (motivation), the capacity for independent living, and economic self-sufficiency); reflects the person's need for a combination or sequence of special interdisciplinary services which are of a lifelong or extended duration and are individually planned and coordinated; or when applied to children from birth through four years of age, may be evidenced as a developmental delay."

Direct Services
Activities used to support, maintain or improve an individuals condition or circumstance. Such basic services for high-risk older adults include:

• in-home aide services
• nursing services
• transportation for required care
• assistance with durable medical equipment and medical supplies;
• adult day care or attendant care
• home-delivered meals
• physical, speech and occupational therapy

These services are provided by the agency receiving the public funds.

Durable Medical Equipment
Equipment often prescribed by a doctor to serve a medical purpose i.e. wheelchairs, bedside commodes and hospital beds. Insurance considers payments on rental or purchase of this equipment.

Durable Power of Attorney
A notarized document authorizing a designated party to make business and health care decisions for a person should they become incapable of doing so.

E

Elder Abuse
The intentional infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. This includes deprivation by an individual of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. (see Adult Protective Services)

Evidence-Based Health Promotion
Health and wellness programs that are proven effective in achieving stated objectives.  Usually, these programs are well researched, delivered in a standardized format and target specific health issues of a given population.  The Chronic Disease Self-Management Program from Stanford University is an example of an evidence-based health program.

F

Family Care Home
A licensed adult care home that provides residential care for two to six adults who require some supervision and assistance with activities of daily living along with room and board, to assure their safety and comfort.

Family Caregiver Support Program (FCSP)
The Older Americans Act Amendments of 2000 established the National Family Caregiver Support Program to assist the aging network to develop a multi-faceted system of supports for caregivers. The Division of Aging and Adult Services and Area Agencies on Aging are administering the program in North Carolina.

FL-2
This is a prior approval form summarizing long-term services for a patient's medical requirements and which reflect the attending physician's recommendation for the level of care needed in an institutional setting. An approved FL-2 is required for any Medicaid recipient in a skilled nursing facility (SNF) or an intermediate care facility (ICF). An FL-2 must also be completed by the attending physician prior to admission to an adult care home and at least annually thereafter. (changes are pending - 2007)

Food Stamps
A federal program that provides a monthly allotment of Food Stamp benefits issued via Electronic Benefit Transfer cards (ATM cards). The Food Stamp Program is an entitlement program, so all eligible individuals and households can receive assistance. Food Stamp benefits may be used to purchase most foods at participating stores. They may not be used to purchase tobacco, pet food, paper products, soap products, or alcoholic beverages. Administrative costs are 50% federal and 50% county. The stamps are 100% federal.

Foster Care Services For Adults
A service than involves recruiting, developing, and evaluating adult care homes to determine if they meet the needs of residents and to help them improve upon their service. All county Department of Social Services (DSS) that have an adult care home in their county provide this service.

Functional Disability
A physical or mental that limits an individual’s capacity for independent functioning.

G

Grandparents Raising Grandchildren
Program concept created to support grandparents, and other relatives raising minor children. (See Kinship Care)

Group Home for Developmentally Disabled Adults
Provides care for 2 to 9 people. These are small residences, usually located in a regular neighborhood. Only adults who are developmentally disabled can live in these homes. They must be able to participate in community activities (ADAP, Sheltered Workshop jobs), be ambulatory, and either have or be able to develop self-help skills. The care provided includes room and board, personal assistance, supervision, and training with goal planning to help people develop self-help skills.

Group Respite
Uses trained volunteers to offer temporary, part-time relief to family caregivers of older adults and to provide seniors with meaningful activities. (See Institutional Respite, In-Home Aide and Adult Day Services)

Guardianship
The legal authority and duty given by the court to a person (guardian) for the purpose of assuming responsibility for the care and maintenance of another person (ward), who has been determined incapable of handling his/her own personal affairs. The powers and authority conferred upon a guardian depend on what type of guardianship is granted by the court.

• Guardian of the Estate
  Is responsible for collecting, preserving, and administering the property and income of the ward.
• Guardian of the Person
  Is entitled to custody of the ward and is responsible for the ward's care, comfort and maintenance. The guardian makes decisions such as where the ward will live, gives consent for medical or professional treatment for the ward. The Guardian of the Person is responsible for the basic physical care of the ward and his/her immediate personal effects.
• General Guardian
  Performs the duties of both the Guardian of the Estate and Guardian of the Person.

H

Healthcare Power of Attorney
A legal document that allows an adult to appoint someone to act as their spokesperson to make health care decisions should it be determined by their physician that they are no longer able to make these decisions for themselves.

Health Insurance Portability and Accountability Act (HIPAA)
Federal legislation passed in 1996 that set standards for health care data access, portability of records and for privacy of health care information.

High Risk Older Adults
Those who experience multiple functional impairments in Activities of Daily Living (ADLs) that jeopardize their independence and control over the quality of their lives. Individuals at high risk often need multiple health and social service interventions to substitute for lost functions and to maintain and rehabilitate other areas of functioning.

Home And Community Care Block Grant (HCCBG)
Federal and state funds administered by the North Carolina Division of Aging and Adult Services. The Division receives funds from the federal Older Americans Act and Social Services Block Grant, as well as the State General Assembly.

Home Delivered Meals
A nutrition program that utilizes volunteers to deliver at least one hot nutritious meal per day (usually 5 days a week) to homebound adults. The meal offers one-third of the Recommended Daily Dietary Allowance.

Home Health Services
Health care prescribed by a physician and given in the home to an older adult in need of medical care. Allowable services are skilled nursing services, therapy services (physical therapy, occupational therapy and speech therapy), medical social services and health promotion services.

Homemaker Services
See In-Home Aide Services (See level 1)

Hospice Care
A service provided for terminally ill patients and their families. A hospice agency provides medical, nursing, and supportive services to meet the needs of families and patients in the last six months of the patient's life. Hospice care emphasizes pain control, symptom management and emotional support for the client and family.

I

Intermediate Care Facility Mentally Retarded (ICF-MR)
Intermediate care facilities for the mentally retarded. (see ICF)

In-Home Aide Services
The in-home aide services previously known as Chore, Homemaker, Homemaker-Home Health Aide, Respite and Personal Care Services have been incorporated into a single service entitled, In-Home Aide Services. These are paraprofessionals that assist children and adults, their families or both, with essential home management tasks, personal care tasks, supervision or all of the above. The program purpose is to allow these individuals to function effectively in their own homes and the community for as long as possible with the help of a certified nursing assistant.

Four Levels of Care

• Home Management Level I
  In-Home Aide Services at this level are intended to provide support to those needing assistance with basic home management tasks, such as housekeeping, cooking, shopping, and bill paying. Personal care tasks may not be performed at this level.
• Personal Care Level II
  In-Home Aide Services at this level are intended to provide support to persons/families who predominately require assistance with basic personal care (bathing, shaving, toileting, and personal hygiene), and associated home management tasks.
• Home Management Level III
  In-Home Aide Services at this level are intended to provide intensive education and support to persons/families in carrying out home management tasks and improving family functioning skills.
• Personal Care Level III
  In-Home Aide Services at this level are intended to provide substantial activities of daily living (ADL) support to individuals/families that require assistance with health and personal care tasks. Provision of these tasks involves extensive "hands-on" care and potential assistance with a wide range of health related conditions.
• Home Management Level IV
  In-Home Aide Services at this level are intended to provide a wide range of educational and supportive services to persons/families who are in crisis or who require long term assistance with complex home management tasks and family functioning skills. Provision of the service involves quick and creative response to individual/family crisis situations identified by the case manager. It also may focus on conducting appropriate learning sessions with small groups of persons from different families who have similar needs.
• Respite service can be offered as Level I - IV
  the primary intent is to provide service that relieves a family caregiver.

The Divisions of Aging and Adult Services and Services for the Blind have information about this service.

Information And (Case) Assistance(I & A)
The provision of I & A for older persons and their families is designed to: assess and evaluate an individual's needs; inform and educate about programs and services available across the long-term care continuum; refer and/or directly connect the individual to appropriate resources; provide assistance to negotiate the service delivery system; work with long distance caregivers in identifying and locating needed services; and advocate on behalf on individuals or a group to obtain change in the delivery or availability of services.

Information and Referral (I&R)
An information systems program (telephone, web-based and/or walk-in) designed to link people with services and resources appropriate to their needs.

Institutional Respite Care
Provides temporary facility placement to give needed relief to primary caregivers of individuals who cannot be left alone because of mental and physical problems. (See Group Respite, In-Home Aide and Adult Day Services)

Instrumental Activities Of Daily Living (IADL)
Basic tasks that are essential to living independently, such as cooking meals, housekeeping, laundry, paying bills, shopping, and using the telephone.

Intermediate-Level of Care
A level of care in a nursing facility that provides 24-hour assistance, with a minimum of eight hours of coverage daily by a licensed nurse, but no requirement for 24-hour skilled nursing services. Medicaid pays for skilled and intermediate care. Medicare pays only for skilled care.

J

K

Kinship Caregiver
A family situation in which a grandparent or another relative is the primary caregiver for a child or children when the birth parents are unable to fill this role. (See Grandparents raising Grandchildren)

L

Legal Services
A service to provide older people with information on their legal rights, legal advice, legal benefits, entitlements and/or appeals when referral to a human service, agency or a pro bono (for free) service is inappropriate; also includes preventive measures such as community education.

Living Will
A legal document in which an individual states his/her wishes regarding prolonging life by extraordinary or artificial means when without such effort death is likely to result.

Local Management Entities
Created through the NC Mental Health reform of 2004 to manage and coordinate mental health and substance abuse services at the local level. This management includes screening, assessment, referral, emergency services, service coordination, consultation, education and prevention.

Long-Term Care Insurance
A type of insurance designed to pay some or all of the costs of nursing home, community, or home health care. The Seniors' Health Insurance Information Program provides useful information on this form of insurance, including a fact sheet. SHIIP and the Division of Aging and Adult Services have developed a Consumer Bill of Rights for Buyers of Long-Term Care Insurance. (see SHIIP)

Long-Term Care Ombudsman
A professional staff member of the Area Agency on Aging who serves as an advocate for long-term care residents of nursing homes and adult care homes. Advocacy includes educating individuals about their rights and complex rules or regulations governing the long-term care system. An Ombudsman can be requested to investigate concerns and serve as a mediator for conflict resolution should a resident encounter difficulty exercising rights. Ombudsmen are available to:

• Serve as a resource for anyone who has questions about long-term care regulations
• Be involved in the care planning process or family meetings
• Provide training to staff, resident councils, or family councils
• Provide information and referral
• Provide state survey results on local facilities
• Talk about any situation that may arise from being a resident, family member, or staff person of a facility

The Long-Term Care Ombudsman program is federally mandated through the Older Americans Act. There is at least one Ombudsman for each of the 17 aging regions in North Carolina. Each county also has local Community Advisory Committees (CACs). These are volunteers who are appointed by the county commissioners to serve as grass roots advocates for residents in the facilities.

M

Medicaid (Title XIX)
A federal and state funded health care program for income eligible persons. Administered by the state, the program provides medical care for qualifying recipients. Applications for Medicaid are made through the local department of Social Services.

Medicare
A federal health insurance program for persons aged 65 and over who are eligible for Social Security or Railroad Retirement benefits and for some people who are disabled regardless of age. There are three parts: Part A is hospital insurance which is automatic, for those eligible and Part B is voluntary and requires a monthly premium. The newest part is Part D (Medicare Prescription Drug Benefit) which covers prescription drugs and is available for purchase.

Medicare Prescription Drug Benefit
Also known as Medicare Part D the prescription drug benefit under Medicare that began January 01, 2006. Anyone with Medicare is eligible to enroll in a Part D plan. Medicare is contracting with insurance companies and other private companies to offer a variety of prescription drug plans to beneficiaries. In NC, 16 companies have been approved to offer 38 Part D plans. Each plan varies in terms of formularies (drugs covered), monthly premium costs, drug co-pay costs, and pharmacy networks. Medicare beneficiaries have the option of joining a stand-alone drug plan that offers the standard prescription drug benefit or a private health plan that offers enhanced benefits.

Medigap Insurance
Health Insurance, available for purchase, to supplement Medicare in the payment of services not covered under this federal program. This type of coverage is generally provided through private insurance carriers.

Mental Heath Reform
To improve access to cost-effective care, choice of treatment, and system accountability. The focus of reform is to reduce the reliance on institutional/facility care and to move toward a person-centered planning system where the individual is in charge of a planning process to decide on real life outcomes he/she wants and to determine ways to achieve these outcomes.

Mix of Services
Any combination of services designed to meet complex needs of older adults to enable them to remain as independent as possible.

Money Follows The Person
Grant projects administered by Centers For Medicare and Medicaid and designed to shift Medicaid funding from traditional long-term care services and into home and community based services.  Part of the President’s New Freedom Initiative for disabled and mental health services.

Multipurpose Senior Center
A community facility where older adults come together for services and activities that reflect their skills and interests and respond to their diverse needs. Centers are a resource for the entire community, providing services and information on aging, and assisting family and friends who care for older adults. For older adults at risk of losing their self-sufficiency, senior centers are the entry point to an array of services that will help them maintain their independence. Any variety of services to individuals or groups may be accessed depending on local community circumstances. Persons of differing backgrounds share and learn from each other. Persons of all ages with all types of skills and interests are needed to perform vital roles and enhance the services and programs at the centers.

N

NC CareLINK
Web-searchable database, administered by N.C’s Department of Health and Human Services, designed to assist consumers in locating community resources and organizations.

Nursing Homes
A congregate living setting that is licensed by the state and federal government to provide housing and personalized healthcare in a professionally managed setting designed to respond to the individual needs or person 18 years and older who require significant assistance with activities of daily living. The facility provides care for persons who cannot live independently and require 24 hour nursing care.

Nursing Home Community Advisory Committee
Members are community citizens who are appointed by the local board of county commissioners to work to maintain the spirit of the Residents' Bill of Rights as well as promote community education and awareness of the operation of nursing homes in that county and the needs of the persons residing in these homes. The Ombudsman Program supports the work of these advisory committees.

Nutrition Services Incentive Program
(NSIP, formerly Nutrition Program for the Elderly)  Commodities and financial support available through the U.S. Department of Agriculture (USDA) and administered by the Administration on Aging to qualifying programs providing nutrition services to older adults.

O

Occupational Therapist
Occupational therapists assist in rehabilitation through the design and implementation of individualized programs to improve or restore functions impaired by illness or injury.

Older Americans Act (OAA)
Federal legislation established in 1965 providing broad policy objectives designed to meet the needs of all older adults regardless of financial situation. The key philosophy of the program has been to help maintain and support older persons in their homes and communities and to avoid unnecessary or premature institutionalization.

Ombudsman
(see Long-Term Care Ombudsman)

Outreach
Agency activities to increase the public awareness of services to older persons and to provide information on available services.

P

Performance Outcomes Measurement Project (POMP)
Project of the Administration on Aging to evaluate annually the performance of services funded under the Older Americans Act and to fulfill the requirements of the federal Governmental Performance and Results Act.

Personal Care
(see In-Home Aide Services levels II, III, IV)

Personal Care Services
Paraprofessional care (comparable to In-Home Aide Services, Personal Care Levels II and III) paid by Medicaid for eligible persons in the community and institutional facilities.

Personal Assistance
Refers to paid or unpaid assistance provided to a person with a chronic disability living in the community.

Person Centered Care
A culture of care that maintains and enhances personal dignity through recognition of individuality.

Poverty Level
An income guideline established federally to define individuals who are economically disadvantaged. In North Carolina, it is also the income level that establishes eligibility for Medicaid.

Power of Attorney
A Power of Attorney is a legal instrument that is used to delegate legal authority to another.

Protective Services
See Adult Protective Services (APS)

Q

Qualified Medicare Beneficiary/Medicare-Aid (QMB)
Assistance for those who do not qualify for Medicaid, but whose income is very low (pays Medicare Part B premiums and deductibles for A and B, etc).

R

Real Choice Systems Transformation
A series of collaborative federal grants, aimed at removing barriers to community living for disabled individuals.  The initiative includes Systems Transformation Grants, Aging and Disability Resource Center grants, Family to Family Health Care Information and Education Center grants and others.

Rebalancing
(see Money Follows Person)

Resource Development
Generating public and private resources, including grants, donations and volunteer manpower.

Respite
Provides needed relief to primary caregivers of individuals who cannot be left alone because of mental or physical problems or of minor age. (see Grandparents Raising Grandchildren)

Retirement Community
A housing complex designed for older adults. Many of the retirement communities allow monthly rental, while others require purchase of the unit. Persons living in retirement communities are generally able to care for themselves; however, assistance from home care agencies is allowed by some communities. Activities and socialization are provided.

Reverse Mortgage
A Reverse Mortgage is a special home equity loan that allows a homeowner to convert some of the equity in the home to cash while retaining the home ownership. Repayment of the loan begins when the home is sold or changes ownership.

S

Senior Center
(see Multi-purpose Senior Center)

Senior Companion Program
Provides a stipend to low income older adults to volunteer to provide in-home services to the elderly to help them live independently. Available in a limited number of counties in North Carolina.

Senior Health Insurance Information Program (SHIIP)
Sponsored by the N.C. Insurance Commissioners Office, volunteers assist older adults with information about all types of insurance issues, including long-term care insurance.

Senior Friendly Community
Also known as Livable Community. This concept offers a wide range of social and economic opportunities and supports for all citizens, including seniors; values seniors contributions to the community; promotes positive intergenerational relations; considers the needs and interests of seniors in physical and community planning; respects and supports seniors desire and efforts to live independently; and, acknowledging the primary role that families, friends, and neighbors play in the lives of older adults, enhances their capacity for caring.

Senior Tarheel Legislature
NC organization comprised of older adults representatives and created by the NC General Assembly in 1993 to provide information on senior and public policy issues and to promote older adult advocacy and involvement in the legislative process.

Skilled Nursing Facility
(see Nursing Home)

Social Services Block Grant
Federal funds (Title XX of the Social Security Act, with state and county match) provide a variety of services for children and adults. Examples are Adult Protective Services (APS), Placement, Guardianship, In-Home Aide Services, and Transportation.

Special Assistance for Adults (S/CSA)
Special Assistance is a program that provides an income supplement to assist low-income elderly and disabled adults pay for their cost of care (room and board) in an Adult Care Home. SA eligible facilities may include Family Care Homes, Group Homes for the Developmentally Disabled, Adult Care Homes, Group Homes for the Mentally Ill, combination facilities, and some participating Hospice residential facilities. Funding for SA is 50% state dollars and 50% county dollars with 100% of the administrative costs paid by the counties.

Special Care Unit
Long-term care units with services specifically for a certain patient population, such as persons with dementia or brain injury.

State Units on Aging
Lead organization in each state, authorized by the Older Americans Act to administer the plan and services for the aging.

Supplemental Health Insurance
Supplemental health insurance is designed to fill gaps in the original Medicare plan coverage by paying some of the amounts that Medicare does not pay for covered services and may pay for certain services not covered by Medicare.

Supplemental Meals
Meals which are comprised in whole, or in part, of a nutritional supplement product (e.g. Ensure, Ensure Plus, Boost, Sustacal, etc.) meeting 1/3 RDA criteria. They may be reimbursed through federal/state funding.

Supplemental Security Income (SSI)
A federal program that pays monthly checks to people in need who are 65 years or older and to people in need at any age who are blind and disabled. The purpose of the program is to provide sufficient resources so that anyone who is 65, or blind, or disabled can have a basic monthly income. Eligibility is based on income and assets. SSI is administered nationally and locally by the Social Security Administration.

Support Groups
Membership groups which may include caregivers, family members and friends of a person experiencing an illness and/or death. Examples are Alzheimer's disease, cancer, Parkinson's disease, etc. These people are brought together by a common concern, situation or experience. A professional usually facilitates group discussion and sharing of experiences and feelings. Educational programs are also common among support groups.

System of Care
Formal and informal supports and the delivery of services using governmental/private and volunteer support.

Systems Transformation
(see Real Choice Systems Transformation)

T

Transportation
A service provided for general and medical needs. The Division of Aging and Adult Services funds this service as do other non-profit and county government agencies and federal programs such as Medicaid.

Transportation Development Plan (TDP)
A required 5-year county plan for a coordinated system of transportation, submitted to the North Carolina Department of Transportation in order to receive federal funds.

U

V

Veterans Administration (VA)
A federal organization that provides assistance to individuals who have been honorably discharged from the military. Some of the services provided are health care and prescription assistance.

Vocational Rehabilitation
Programs supported by both federal and state funds, allocated specifically to promote vocational services. These services include diagnostic procedures, surgery and treatment, prosthetic devices, hospital convalescent, training material, maintenance, occupational expenses, interpreter services, and transportation.

Volunteer Program Development
The development and operation of a systematic program for volunteer participation. The objective is to involve volunteers of all ages in providing services to older adults in their community. Older adults are also encouraged to volunteer.

W

White House Conferences on Aging
Decennial (every 10 years) events designed to inform and develop recommendations for the President, Congress and the nation about research and action in the field of aging. 

X

Y

Z