Requires listeners to be silent while another is talking so that they can process the entire message—both verbal and nonverbal—paying attention not only to the words, but to the tone of voice, underlying messages, and body language.

Approaching age with acceptance.

Positive emphasis on aging; directly linked to chronological age. Potentially a key motivator to plan for the future.

Refusal to identify oneself as old; perpetuated by society's prejudice toward aging and remaining young.

Approaching life's options and decisions from an "ageless" point of view instead of chronological age.

Prejudice or discrimination based on a person's age.

Technology meeting the needs of older adults and those who care for them, designed with the input of older adults and other stakeholders.

A family structure in which the configuration is more "vertical," meaning there are more generations alive at one time but with fewer individuals in each generation.

Two parents living together with children whom one or both partners bring to the family from previous marriages or relationships; may also include children from their union.

Categorization of age measured by the counting of time that one has existed or the number of birthdays one has had.

A defined group of people with a statistic in common (e.g., being born in the same year).

Contexts of communication

The various circumstances that can affect the effectiveness of communication. These may encompass environmental, relational, psychological, situational, and cultural factors, only some of which can be controlled.

Understanding and acknowledgment of and respect for clients' unique heritages, which enables professionals to care for and support clients in ways that are consistent with their values, beliefs, and preferences.

Informal understandings that govern behavior in a culture.

A sense of meaninglessness about one's life (Erik Erikson).

Intentional actions that cause harm or create a serious risk of harm to an older adult.

Infantilizing communication characterized by simplistic vocabulary and grammar, shortened sentences, slowed speech, elevated pitch and volume, and inappropriate terms of endearment.

A second or third career that combines personal meaning with social impact and continued income.

The systematic writing down or communicating of one's intangible legacy of values to children and family members.

Categorization of age based on what a person is capable of doing and how the person looks.

The entire body of individuals born and living at about the same time or a group of individuals, most of whom are the same approximate age, having similar ideas, problems, attitudes, etc.

The concern of others that develops during middle age with a specific need to nurture and guide younger people and contribute to future generations (Erik Erikson).

The study of the human aging process, including the biological, psychological, and social aspects of aging.

Human development is a lifelong process that continues into old age and when optimized ends in a new perspective. The older person shifts to increased life satisfaction.

A grandparent or kin member (e.g., cousin, aunt, uncle, sibling) raising children because the middle generation (the children’s parents) is absent or unable to parent.

The degree to which someone is able to obtain, process, and understand basic health information and services in order to make appropriate health decisions.

The traditions, beliefs, achievements, and so on that are part of a group or nation. Encompasses ethnicity, ancestry, religion, and culture.

Changing relationships and circumstances that strip people of their identity and force them to see themselves differently.

The ability to interpret one’s life as having been meaningful and purposeful (Erik Erikson).

A stage in life that generally begins sometime in one’s 60s (chronological age).

Free time during which obligatory activities are not performed.

A developmental task of old age during which one looks back over and reassesses one’s life in view of one’s approaching mortality.

Another way of describing life’s transitions, each with defined social roles and physical changes These roles are loosely linked to chronological age but are much more focused on social roles.

A stage in life that traditionally has been thought to last chronologically from about age 40 to age 65.

Multigenerational household

At least two generations of adults and one generation under age 25 living together (according to Pew’s definition; the Census Bureau has another).

Body mass index (BMI) of 30 or more.

The dividing line between later adulthood and “old age” is unclear and somewhat arbitrary. Most distinctions are a result of chronological age and functionality.

Language or images couched in positive terms that have ageist connotations.

Psychosocial stages of development

A term that refers to the interrelationship between a person’s psychological development (thinking and behavior) and social environment. First commonly used by psychologist Erik Erikson in his theory of the stages of social development.

A family structure in which the configuration is more “horizontal,” meaning fewer generations are alive at one time but each generation has more individuals.

A subfield of gerontology, focusing on the social lives of older adults.

A way to share information with a broad audience and engage with other people online. Includes sites such as Facebook, YouTube, LinkedIn, and online news sites.

Sets of expectations or guidelines for people who occupy given positions.

The failure to continue to develop (Erik Erikson).

Categorization of age based on one’s subjective feeling and how one defines their own age.

The remote diagnosis and treatment of patients through electronic communications to improve patients’ health status.

Affirming the thoughts and feelings of people with dementia, rather than correcting or arguing with the person.

Any activity that uses large muscle groups, can be maintained continuously, and is rhythmic in nature. Examples include running, bicycling, and skiing.

A measure of physical fitness, it reflects the ability of the heart and lungs to get oxygen to the muscles during exercise.

Age-related macular degeneration (AMD)

Degeneration of the macula, the light-sensitive tissue at the back of the eye. The leading cause of vision loss in Americans 60 years of age or older.

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WWOA Key Terms

Key terms from the six Parts of the Working with Older Adults course

Term	Definition
Active listening	Requires listeners to be silent while another is talking so that they can process the entire message—both verbal and nonverbal—paying attention not only to the words, but to the tone of voice, underlying messages, and body language.
Age adaptation	Approaching age with acceptance.
Age affirmation	Positive emphasis on aging; directly linked to chronological age. Potentially a key motivator to plan for the future.
Age denial	Refusal to identify oneself as old; perpetuated by society's prejudice toward aging and remaining young.
Age irrelevance	Approaching life's options and decisions from an "ageless" point of view instead of chronological age.
Ageism	Prejudice or discrimination based on a person's age.
AgeTech	Technology meeting the needs of older adults and those who care for them, designed with the input of older adults and other stakeholders.
Beanpole family	A family structure in which the configuration is more "vertical," meaning there are more generations alive at one time but with fewer individuals in each generation.
Blended family	Two parents living together with children whom one or both partners bring to the family from previous marriages or relationships; may also include children from their union.
Chronological age	Categorization of age measured by the counting of time that one has existed or the number of birthdays one has had.
Cohort	A defined group of people with a statistic in common (e.g., being born in the same year).
Contexts of communication	The various circumstances that can affect the effectiveness of communication. These may encompass environmental, relational, psychological, situational, and cultural factors, only some of which can be controlled.
Cultural competence	Understanding and acknowledgment of and respect for clients' unique heritages, which enables professionals to care for and support clients in ways that are consistent with their values, beliefs, and preferences.
Cultural norms	Informal understandings that govern behavior in a culture.
Despair	A sense of meaninglessness about one's life (Erik Erikson).
Elder abuse	Intentional actions that cause harm or create a serious risk of harm to an older adult.
Elderspeak	Infantilizing communication characterized by simplistic vocabulary and grammar, shortened sentences, slowed speech, elevated pitch and volume, and inappropriate terms of endearment.
Encore career	A second or third career that combines personal meaning with social impact and continued income.
Ethical will	The systematic writing down or communicating of one's intangible legacy of values to children and family members.
Functional age	Categorization of age based on what a person is capable of doing and how the person looks.
Generation	The entire body of individuals born and living at about the same time or a group of individuals, most of whom are the same approximate age, having similar ideas, problems, attitudes, etc.
Generativity	The concern of others that develops during middle age with a specific need to nurture and guide younger people and contribute to future generations (Erik Erikson).
Geriatrics	The medical study of aging.
Gerontology	The study of the human aging process, including the biological, psychological, and social aspects of aging.
Gerotranscendence	Human development is a lifelong process that continues into old age and when optimized ends in a new perspective. The older person shifts to increased life satisfaction.
Grandfamily	A grandparent or kin member (e.g., cousin, aunt, uncle, sibling) raising children because the middle generation (the children’s parents) is absent or unable to parent.
Health literacy	The degree to which someone is able to obtain, process, and understand basic health information and services in order to make appropriate health decisions.
Heritage	The traditions, beliefs, achievements, and so on that are part of a group or nation. Encompasses ethnicity, ancestry, religion, and culture.
Identity foreclosure	Changing relationships and circumstances that strip people of their identity and force them to see themselves differently.
Integrity	The ability to interpret one’s life as having been meaningful and purposeful (Erik Erikson).
Later adulthood	A stage in life that generally begins sometime in one’s 60s (chronological age).
Leisure time	Free time during which obligatory activities are not performed.
Life review	A developmental task of old age during which one looks back over and reassesses one’s life in view of one’s approaching mortality.
Life stages	Another way of describing life’s transitions, each with defined social roles and physical changes These roles are loosely linked to chronological age but are much more focused on social roles.
Middle age	A stage in life that traditionally has been thought to last chronologically from about age 40 to age 65.
Multigenerational household	At least two generations of adults and one generation under age 25 living together (according to Pew’s definition; the Census Bureau has another).
Obesity	Body mass index (BMI) of 30 or more.
Old age	The dividing line between later adulthood and “old age” is unclear and somewhat arbitrary. Most distinctions are a result of chronological age and functionality.
Positive ageism	Language or images couched in positive terms that have ageist connotations.
Psychosocial stages of development	A term that refers to the interrelationship between a person’s psychological development (thinking and behavior) and social environment. First commonly used by psychologist Erik Erikson in his theory of the stages of social development.
Pyramid family	A family structure in which the configuration is more “horizontal,” meaning fewer generations are alive at one time but each generation has more individuals.
Social gerontology	A subfield of gerontology, focusing on the social lives of older adults.
Social media	A way to share information with a broad audience and engage with other people online. Includes sites such as Facebook, YouTube, LinkedIn, and online news sites.
Social roles	Sets of expectations or guidelines for people who occupy given positions.
Stagnation	The failure to continue to develop (Erik Erikson).
Subjective age	Categorization of age based on one’s subjective feeling and how one defines their own age.
Telemedicine	The remote diagnosis and treatment of patients through electronic communications to improve patients’ health status.
Validation	Affirming the thoughts and feelings of people with dementia, rather than correcting or arguing with the person.
Aerobic activity	Any activity that uses large muscle groups, can be maintained continuously, and is rhythmic in nature. Examples include running, bicycling, and skiing.
Aerobic capacity	A measure of physical fitness, it reflects the ability of the heart and lungs to get oxygen to the muscles during exercise.
Age-related macular degeneration (AMD)	Degeneration of the macula, the light-sensitive tissue at the back of the eye. The leading cause of vision loss in Americans 60 years of age or older.
Agnosia	Inability to recognize familiar objects in the absence of sensory deficits.
Alzheimer’s disease (AD)	The most common type of dementia. AD is a progressive, gradual disorder in which the brain undergoes specific changes. It is believed that AD develops because of multiple underlying factors rather than a single cause.
Anxiety disorders	Class of psychiatric disorders characterized by a state of tension, apprehension, and fear without a real threat or danger. Symptoms interfere with daily functioning.
Aphasia	Partial or total loss of the ability to speak or understand speech due to a disorder in the brain’s cerebellum.
Apraxia	Difficulty with physical movement despite otherwise normal physical functioning. Change in gait (walking) is one common example.
Basal metabolic rate	The rate at which energy is used by an organism at complete rest. It determines maintenance caloric needs at rest.
Bereavement	The period following the loss of a loved one. Not a mental illness.
Biomarkers	Biological markers assess biological age and predict future health.
Bipolar disorder	Formerly known as manic-depressive disorder. A psychiatric illness characterized by both manic and depressive episodes.
Blood alcohol content	The concentration of alcohol in the blood, which is used as an indicator of intoxication.
Body mass index (BMI)	Estimates the ideal weight of a person based on size and weight. Calculated as the individual’s body mass (kg) divided by the square of their height (meters).
Cellular senescence	The phenomenon, often called the Hayflick limit, that causes cells to stop dividing after about 40 to 60 divisions.
Centenarians	Persons age 100 or older.
Chronic Disease Self-Management Program	A low-cost program of Stanford University that helps individuals with chronic conditions learn how to manage and improve their own health, while reducing health care costs.
Chronic illness	A disease of long duration and generally slow progression. Examples are hypertension, diabetes, and heart disease.
Cognitive behavioral therapy	A short-term psychotherapeutic treatment that focuses on changing a) and behaviors that are associated with mental health symptoms.
Cognitive capacity	The brain's ability to maintain mental functioning and adapt to normal age-related changes in cognition.
Cognitive function	The brain’s ability to execute various processes such as thinking, reasoning, remembering, and decision making.
Cognitive reserve	The brain’s ability to be resilient in the face of attack.
Creativity	The ability and openness to look at things in a different way.
Cross-sectional studies	Data that offer a snapshot of a population at one point in time.
Crystallized intelligence	Intelligence that continues to increase and improve throughout the life span. This type of intelligence involves knowledge that comes from prior learning and experiences and includes reading comprehension and vocabulary.
Damage or error theories	A theory that implies that aging is due to random damage of the aging body and its systems, not programming.
Delirium	Classified as a neurocognitive disorder; characterized by a significant change in mental functioning, particularly a disturbance in attention and awareness that develops over a short time and fluctuates throughout the day.
Delusions	False beliefs that persist in spite of evidence that the beliefs are untrue.
Dementia	A general term for declines in mental ability that are severe enough to affect everyday living. This is a broad term that describes a range of symptoms, rather than being a specific disease (synonym
Depression	A type of psychiatric illness characterized by sad, empty, or irritable mood accompanied by physical and cognitive changes that significantly impact an individual’s ability to function.
Diabetes (type 2)	Most common type of diabetes in which there are high levels of glucose (i.e., sugar) in the blood because either the body does not produce enough insulin or the cells ignore the insulin.
DSM or DSM-5-TR	Diagnostic and Statistical Manual of Mental Disorders. The official listing and definition of psychiatric disorders by the American Psychiatric Association, most recently updated in 2022.
Episodic memory	Stores personal experiences related to a particular place or time. Deficits in episodic memory with aging may stem from problems with encoding, storing, or retrieving the information.
Executive function	Ability to plan and carry out tasks.
Floaters	Small, dark shapes resembling spots, threads, or squiggly lines that seem to dart around like small flies when the eyes move. Floaters are a common complaint of older adults.
Fluid intelligence	The ability to perceive relationships, think and reason abstractly, and problem-solve; peaks in adolescence and then begins to progressively decline beginning around 30 to 40 years of age.
Food safety	Conditions and practices that preserve the quality of food to prevent contamination and foodborne illnesses.
Frontotemporal dementia	Pick’s disease. Precipitated by cell damage that causes tissue shrinkage and reduced function in the brain’s frontal and temporal lobes, which control planning and judgment, emotions, speaking and understanding speech, and certain types of movement.
Generalized anxiety disorder	A type of anxiety disorder in which an individual has excessive worry and anxiety that they cannot control.
Grief	Emotional response to a significant loss.
Hallucinations	Seeing or hearing things that are not there and difficulty differentiating dreams from reality. Hallucinations can occur in any of the five senses.
Healthy aging	Development and maintenance of optimal physical, mental, and social well-being and function in older adults.
Hormones	Chemical messengers in the body that move throughout the bloodstream and attach themselves to and unlock receptors located on the cells in order to carry out their particular action.
Hypertension	High blood pressure. A reading that is greater than 140 over 90 is considered high.
Irreversible dementias	Dementias that worsen as the disease progresses.
Lean body mass	The weight of a person’s body that isn’t fat. It includes muscle, bone, and other nonfat tissue.
Lewy body dementia (LBD)	Associated with abnormal clumps of alpha-synuclein protein (Lewy bodies) in the brain. Less well-understood than other forms of dementia.
Life expectancy	The average length of time one can expect to live.
Life span	The maximum length of life biologically possible for a species, assuming an event such as disease or accident doesn’t occur.
Longitudinal studies	Involve repeated observations of the same variables over long periods of time, which allows change to be measured in the same individual.
Long-term memory	Pertains to information that has been archived because ready access to it is no longer necessary.
Major depressive disorder	A psychiatric illness in which depressive symptoms are present for most of each day for a minimum of two weeks.
Malnutrition	A condition that develops when the body does not get the right amount of vitamins, minerals, and other nutrients it needs to stay healthy.
Mild cognitive impairment (MCI)	A clinical diagnosis in which there is a slight, noticeable, and measurable decline in cognitive functioning that is not severe enough to interfere with everyday independent functioning.
Neurocognitive disorder	A general term for declines in mental ability that are severe enough to affect everyday living. This is a broad term that describes a range of symptoms, rather than being a specific disease.
Neuroplasticity	The brain’s ability to change and adapt in response to environmental demands.
Nutritional supplements	Vitamins, minerals, herbs, meal supplements, sports nutrition products, and related products that are not considered foods and are taken to boost the nutritional content of the diet.
Obesity	A medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. A person with a BMI ≥ 30 is considered obese.
Obsessive-compulsive disorder	A psychiatric illness characterized by upsetting thoughts that cannot be controlled followed by ritualistic behaviors.
Obstructive sleep apnea	A sleep disorder in which breathing repeatedly stops during sleep for more than 10 seconds and restarts.
Osteoporosis	A disease marked by reduced bone strength leading to an increased risk of fractures or broken bones.
Overweight	Having more body fat than is optimally healthy. A person with a BMI between 25 and 29.9 is considered overweight.
Panic disorder	Repeated episodes of intense fear or discomfort that come on unexpectedly.
Parkinson’s disease	Associated with the brain’s loss of a chemical called dopamine, causing movement problems early in the disease.
Perception	How one organizes, identifies, and interprets sensory information to understand one’s environment.
Persistent depressive disorder	A psychiatric illness that is a chronic form of depression; symptoms must be present for a minimum of two years.
Personality disorders	A group of 10 psychiatric disorders characterized by behaviors that are pervasive and inflexible, which dominate and create problems in interpersonal relationships.
Physical activity	Body movement that uses energy.
Pneumococcal disease	A preventable bacterial infection that often causes pneumonia in older adults and can be fatal.
Posttraumatic stress disorder (PTSD)	A psychiatric illness that can develop after someone experiences or witnesses a traumatic event. Symptoms can manifest a month or more after the event.
Preclinical Alzheimer’s disease	Individuals in this stage of AD have measurable changes in the brain, cerebrospinal fluid, and/or biomarkers but do not yet have symptoms.
Processing speed	The rate at which information is processed from the time information reaches the senses to when it is understood.
Programmed theories of aging	Theories that assert human beings are predestined to age and our bodies follow a biological timeline that is influenced by factors that define puberty, maturity, and development.
Proprioception	The innate ability to sense the relative position of one’s limbs without having to look.
Pseudodementia	Psychiatric symptoms that resemble dementia but are due to a depressive episode.
Qigong	A Chinese system of physical exercises and breathing control; related to tai chi.
Resilience	The ability to actively recover from and adapt to major life changes.
Restless legs syndrome	A disorder that is worse at night and causes a strong urge to move one’s legs due to strange and unpleasant feelings.
Reversible neurocognitive disorders	Conditions that impact memory and thinking that improve when treated.
Senescence	The biological process of aging and the accumulative molecular and cellular changes that occur with the passage of time and lead to deterioration and eventually death.
Senior Nutrition Program	A federally funded nutrition program targeted to adults age 60 and over with the greatest economic or social need. It provides congregate and home-delivered meals, nutrition education and counseling, and other supportive and health-related services.
Shingles	An infection caused by the varicella-zoster virus that causes a painful rash. It can occur anywhere on the body but most often appears as a single stripe of blisters that wraps around either the left or right side of the torso.
Short-term memory	Also called primary memory. The memory that the brain retains for a short time; affected minimally or not at all with aging.
Social anxiety disorder	Characterized by feeling anxious or overwhelmingly self-conscious in daily situations. Associated with intense, persistent, and chronic fear of being judged by others or fear of embarrassment when engaged in an activity.
Social connectedness	Involvement in meaningful activities that foster a sense of belonging and intimacy in relationships; it is a vital component of healthy aging.
Specific phobia	An anxiety disorder subtype. Individual has a marked fear or anxiety about a specific object or situation.
Strength training	An approach to improving muscle strength by using resistance or weights to work a muscle group.
Sundowning	A state of confusion that occurs at the end of the day and into the night, generally for those suffering from the middle to later stages of Alzheimer's disease.
Supplemental Nutrition Assistance Program (SNAP)	Formerly known as the Food Stamp Program. Food subsidy program for low-income households.
Tai chi	A Chinese exercise system that uses slow, smooth body movements to achieve a state of relaxation of both body and mind.
Vascular cognitive impairment	Caused by small strokes that decrease blood flow to the brain. Vascular brain changes have also been linked to Alzheimer’s disease and Lewy body dementia.
Active adult communities	Communities that are either “age-restricted” and required by federal and state laws to impose minimum ages on residents, or “age-targeted” and able to market to older adults but not required to impose age restrictions.
Activity of daily living (ADL)	Six basic personal care activities
Acute illness	Severe illness with a rapid onset and a generally short duration.
Advance care planning	A process of reflection and discussion with family members, friends, and health care providers about the kinds of medical treatment one might want or not want in the circumstance of a medical crisis, serious illness, or injury.
Advance directive	Instruction made by an individual, orally or in a written document, concerning medical treatments and personal care to be provided or refused in a future circumstance should the individual be incapacitated and not able to verbalize instructions directly.
Advance health care directive	Also called a medical durable power of attorney. A statement made by an individual, usually in a written document, concerning the medical treatments to be provided and decision maker to be appointed if the patient becomes terminally ill or incapacitated.
Aging and disability resource centers (ADRCs)	In many states, centers that provide information and advice about local services and supports in the local community. ADRCs are funded through the Older Americans Act (OAA).
Aging in place	The ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.
Ambiguous loss	The emotional loss experienced when someone is still alive but, because of changes in his or her health or cognitive status, is “there but not there.”
Anticipatory grief	Feelings of grief and loss, as if a person has already died; usually experienced when relating to someone during the dying process.
Area agencies on aging (AAA)	State agencies that provide information and coordinate a variety of services for older adults that are provided by local agencies; also called the triple As, they are funded through the Older Americans Act (OAA).
Artificial nutrition and hydration (ANH)	Broadly defined, ANH includes provision of fluids or nutrients by any route other than the mouth—for instance, intravenously. ANH is provision of nutrients and fluids using a tube inserted into the esophagus or surgically implanted into the stomach.
Assisted-living facilities	Developments that are licensed and regulated to serve people who don’t require full-time skilled nursing care but might have considerable difficulties performing their activities of daily living.
Attending physician	Physician with primary responsibility for the care of a patient at a particular time or place of care. The attending physician could be the person’s primary care physician, a hospitalist, nursing facility or hospice medical director, or specialist.
Benefit and burden	The comparative likelihood of benefit or burden associated with any medical treatment.
Benefit period	Defined length of time used to measure a patient’s use of services for inpatient hospital and skilled nursing facility care, and separately for hospice care.
Bereavement counseling	Counseling and emotional support for persons who have experienced the death of a family member or friend.
Best interest of the patient	Guideline for use by health care agents, physicians, or hospital ethics committees for determining health care decisions when the person’s treatment wishes are unknown.
Board and care homes and adult foster care (sometimes subsumed under assisted living)	Typically, these are converted single-family homes in traditional residential communities. Residents normally share a bedroom and bath with another resident, and the rest of the house is laid out like a traditional home.
Capacity (see also Competence)	The ability of a person to (1) understand information, (2) evaluate the information in light of values and goals, (3) make a decision, and (4) communicate the decision.
Cardiopulmonary resuscitation (CPR)	Emergency treatment for malfunction or cessation of heartbeat or breathing.
Care recipient	Someone who needs help, from a few hours a week to full-time care, with ADLs and IADLs because of illness, cognitive impairment, or changes caused by aging.
Caregiver assessment	Asking caregivers about their physical, emotional, social, and cognitive challenges in caring for a care receiver, to determine what help the caregiver needs as well as how to best serve the care receiver.
Celebration of life	An event to celebrate the life of a person who has died, or is about to die, usually outside the framework of any religious rite.
Chaplain	Member of health care facility staff or team who attends to spiritual distress related to serious illness or end of life for patients and their families.
Chronic illness	A long-term health condition that lasts for at least one year and requires ongoing medical attention or limits daily activities.
Cohousing	A group of 20 to 40 family residences clustered around a common courtyard or shared green space. The households are anchored by a large, shared common house with a large kitchen and dining room for shared meals.
Competence	In the context of health care, ability of an individual to make autonomous decisions about medical treatments and personal care. Competence is a legal determination often made by a judge.
Complementary therapy	Nonmedical therapy intended to complement medical therapy—for instance, massage, acupuncture, music, aroma-, pet, or other therapies.
Continuing care retirement communities (CCRCs)	Communities that offer a tiered approach to the aging process, accommodating residents’ changing needs.
CPR directive	An advance directive initiated by a person and cosigned by a physician as a medical order indicating refusal of cardiopulmonary resuscitation.
Cremains	Material resulting from cremation of a human body and the container in which it is placed. Colloquially referred to as ashes but typically of a denser, heavier consistency, which may include chunks of bone or teeth.
Cremation	Means of final disposition in which the body is incinerated.
Death with Dignity Act	Law passed in Oregon in the 1990s authorizing and regulating physician-aided death of persons who wished to end their lives prior to the natural conclusion of their terminal illness.
Declarant	A competent individual who executes a living will.
Default process for medical decision making	Process, outlined in state law, to determine delegation of decision-making authority for an incapacitated person in the absence of an advance directive or medical durable power of attorney.
Disposition of remains/the body	Handling of a deceased person’s body, which may include embalming, traditional or green burial, cremation, interment, or whole body donation.
Do-not-resuscitate (DNR) order	Physician’s order, inserted into a patient’s medical chart, stating that if the patient’s heart or breathing malfunctions or stops, cardiopulmonary resuscitation should not be administered.
Domains of care	Care directed toward easing distress in different aspects of a person’s life.
Durable medical equipment (DME) suppliers	Suppliers that provide home care patients with products ranging from respirators, wheelchairs, and walkers to catheter and wound-care supplies.
Elasticity of housing	Residences that are built or modified to adapt to accommodate changing needs as the resident ages.
Ethical and religious directives	A comprehensive code of ethics governing medical treatment and care in facilities operating under the aegis of the Catholic Church.
Ethical will	Documentation or communication of one’s intangible legacy of values, life lessons, or moral tenets.
Euthanasia	An act intended to cause, hasten, or fail to medically prevent the death of another person, justified by relief of the person’s suffering or removal of a class of “substandard” individuals from society.
Exacerbation	Episodes of sudden worsening or intensity of a chronic disease often requiring emergency attention, hospitalization, and/or intensive life-sustaining treatments.
Existential suffering	Suffering experienced by an individual whose personal integrity is threatened by illness, injury, or other external circumstances and manifested as despair, extreme isolation, or emotional or spiritual agony.
Family caregiver	Someone who provides unpaid care to another who requires help with ADLs and IADLs, from a few hours a week to living with the care receiver full time.
Family dynamics	How a family operates together. Generally, different members of a family play different roles, learned while growing up in that particular family, and they interact in ways that differ from how they might interact outside the family.
Family meeting	An opportunity for all family members (and sometimes extended family and friends) to express their perceptions of what is happening, their needs, ways to solve problems, and ways to plan for future care.
Family-centered approach	Including family caregivers as a core part of health care and long-term care; recognizing, respecting, assessing, and addressing the needs of family members.
Financial stress	One of the greatest burdens of caregiving. Long-term care is expensive, and the resources of both the caregiver and the care receiver can be seriously drained by prolonged needs for care.
Five Wishes	An “omnibus” (all-purpose) advance directive legal in many states. Addresses appointment of a medical durable power of attorney, preferences for certain aspects of medical treatment and personal care, funeral/memorial instructions, and personal legacy.
Funeral	Social or religious ritual conducted to honor a decedent whose body or cremains are present.
Funeral director	Individual licensed by the states to arrange or prearrange funeral services.
Funeral home	A commercial establishment in the business of arranging and conducting funerals.
Funeral rule	Trade rule issued by the Federal Trade Commission requiring funeral homes to disclose prices and prohibiting certain deceptive and unfair practices.
Futile treatment	Treatments that are administered solely to sustain or prolong life without contributing to cure, control of the underlying disease, or meaningful recovery of the patient. Also termed nonbeneficial treatment.
Geriatric care manager	Professional who can be brought in to help be the ears and eyes for long-distance caregivers, helping them prioritize, strategize, and manage their responsibilities.
Goals of care	The intended outcomes of care according to the person receiving the care.
Green burial	The practice of burying a body directly in the ground without embalming or other accoutrements of traditional, commercial burial.
Health care agent or proxy	Individual officially appointed in an advance directive or medical durable power of attorney to make health care decisions on behalf of another person when that person is not able to make or express his or her own decisions.
Home care aides	Home care aides are trained to provide help with ADLs, such as dressing, bathing, getting in and out of bed, and using the toilet. They may also prepare meals. They usually are not certified.
Home funeral	Funeral conducted at home with the body present.
Hospice bounce	A dramatic but typically temporary improvement in function following admission to hospice care.
Hospice care	Medical treatment and personal care of persons diagnosed with a terminal illness and their families. Hospice care focuses on relieving suffering—physical, emotional, spiritual, and mental—as well as addressing practical challenges.
Hospice medical director	Physician employed or contracted by a hospice agency to supervise the medical treatment and care of the hospice patients.
Hospice residence	Health care facility specifically built to care for hospice patients. Most hospice residences are decorated and appointed in a more homelike fashion than are nursing facilities or hospitals.
Hospitalist	Physician employed or contracted by a hospital to provide care to patients in the hospital.
Housing Plus Services	An umbrella term coined by the National Low Income Housing Coalition to describe combined housing and service initiatives. Housing Plus Services refers to permanent affordable housing that incorporates various levels of services with housing.
Iatrogenic suffering	Suffering caused by medical treatments or professionals in their efforts to cure or control disease.
Incapacity	A person’s inability, as determined by a physician, to make and/or express his or her own health care decisions.
Instrumental activities of daily living (IADLs)	Shopping, cooking meals, performing household tasks such as laundry, managing money, using the telephone, taking medication; activities needed for independent living.
Integrated model of care	An approach to care that initiates palliative care at the same time as and alongside treatments intended to cure or manage disease and prolong life.
Interdisciplinary team	A team of health care providers addressing a person’s distress from various perspectives in order to provide comprehensive care. Members typically include a physician, nurse, social worker, chaplain, and other therapists or specialists as required.
Interested person	Person with an interest in the care of another person, typically family members and close friends but can also include professional associates and advisors.
Intubation	Insertion of a tube into a person’s trachea to provide ventilation or mechanical respiration.
Licensed practical nurse (LPN)	Licensed practical nurses (known as licensed vocational nurses [LVNs] in California and Texas) exist in most states. LPNs usually have two years of training and have passed state or national boards.
Life-sustaining treatment/procedure	Medical treatment or procedure used to prolong life without reversing underlying medical conditions. This could include blood transfusion, CPR, mechanical ventilation, renal dialysis, and artificial nutrition and hydration, among other treatments.
Living will	Document signed by a competent person stating, typically, that life-sustaining treatment should be withheld or withdrawn when the person is determined to be in a terminal condition and is unable to make his or her own health care decisions.
Long-term services and supports (LTSS)	Services and supports used by individuals of all ages with functional limitations and chronic illnesses who need assistance to perform routine daily activities such as bathing, dressing, preparing meals, and administering medications.
Mechanical respiration/ventilation	Breathing or oxygenation of blood assisted by a machine or device that forces air into a person’s lungs.
Medical aid in dying (MAID)	A legally defined process whereby terminally ill patients with decisional capacity and a prognosis of six months or less may request and obtain lethal medications to end their lives.
Medical durable power of attorney	Legal document prepared by an individual authorizing another person to make health care decisions on the individual’s behalf should the person become unable to make or express his or her own decisions.
Medicare certification	A designation conferred on a health care facility or agency indicating that the facility or agency has met certain standards of patient care and operations.
Medicare hospice benefit	A comprehensive benefit provided by Medicare covering all costs of hospice care for qualified Medicare beneficiaries.
Memorial service	Social or religious ritual to honor a decedent without the person’s body or cremains being present.
Mercy killing	Intentional act of causing a person’s death on the basis of the apparent or supposed suffering the person is experiencing.
National Healthcare Decisions Day	April 16, set aside for the contemplation, discussion, and preparation of advance directives.
Nursing home	Facility that provides private or semiprivate rooms, meals, personal care, nursing care, and medical services to those in need of specialized medical care.
Occupational therapists (OTs)	Therapists that help people improve their ability to perform tasks of daily living. OTs may prescribe physical exercises or other activities to improve cognitive function.
Palliative care	Medical treatment and personal care focused not on curing a disease or condition, but on treating pain, physical symptoms, and emotional and spiritual distress of a person with serious, chronic, or advanced illness and the person’s family.
Palliative care consult	A consultation, usually between a patient and a palliative care interdisciplinary team, to determine the patient’s goals of care and devise a medical treatment and care plan consistent with those goals.
Palliative sedation	The use of any sedating agent to relieve symptoms, carefully titrated to balance the degree of sedation with the severity of symptoms.
Persistent vegetative state	Condition resulting from catastrophic injury to the cerebral cortex, resulting in permanent unconsciousness even though the person might appear to be awake and asleep at times.
Personal care contracts	Legal contracts that formalize the arrangement of payment to family members to be caregivers, so as to lesson tension within a family.
Personal emergency response systems (PERS)	The key to many older individuals living at home is getting help quickly if an emergency occurs. Also called a medical emergency response system or medical alert system.
Physical therapists (PTs)	Therapists who help restore function, improve mobility, relieve pain, and prevent or limit permanent disabilities of patients suffering from injuries or disease.
Place attachment	Emotional or affective ties to a place. This attachment is generally thought to be the result of a long-term connection with a place.
POLST paradigm	An approach to documentation and communication of a person’s preferences regarding certain life-sustaining treatments in the form of portable, actionable medical orders rather than “just” advance directives.
Pre-need arrangements	Arrangements made for disposition of a body, funeral, or memorial in advance of the person’s death, sometimes structured with an agreement to deliver specific goods and services in exchange for prepayment.
Principal	A competent individual making an advance directive or appointing a health care agent by medical durable power of attorney.
Prognosis	Length of time a person is expected to survive with a serious, advanced, or terminal illness.
Psychosocial and spiritual suffering	Distress related to serious or advanced illness affecting or manifesting in a person’s mental state.
Registered nurse (RN)	Professional nurses who often supervise the tasks performed by LPNs, orderlies, and nursing assistants. They provide direct care and make decisions regarding plans of care for individuals.
Rehabilitation services	Services that seek to maximize patients’ quality of life and restore them to the highest possible level of function.
Release of information	Allows the doctor and caregiver to talk to each other, share information, and plan together for care, if the care receiver is no longer capable of doing so alone.
Remains	Body of a deceased person. (Cremains are remains of a cremated body.)
Residential normalcy	A theory that describes the personal impact of where one lives.
Respite care	Occasional care provided by a third party for the purpose of relieving family caregivers for a period of a few hours to several days.
Role inversion	Role change in which the child becomes the caregiver (but the parent is still the parent).
Rule of double effect	An ethical rule in which actions that are intended for good, but have foreseeable and possibly bad outcomes, are permissible when the good effect is intended and cannot be achieved another way.
Sandwich generation	Adults who are caring for both children at home and elderly parents at the same time; might also be juggling work or career.
Self-deliverance/self-determined death	A deliberate self-killing without the sanctioned assistance of any medical personnel in order to end a life of current or anticipated suffering, usually as a result of an incurable disease or irreversible impairment.
Smart homes	Homes that can be fitted with an array of advanced electronic and technological features that control standard functions such as temperature, as well as specialized devices that do such things as automatically call 911 if someone falls in the bathroom.
Social support	Network that provides people with a sense of being loved, cared for, esteemed, and valued.
Social workers	Help people solve personal and family problems. They often see clients who face life-threatening diseases or social problems. Also assist families that have serious domestic conflicts, including those involving elder abuse.
Speech and language pathologists	Sometimes called speech therapists. Therapists who assess, diagnose, treat, and help prevent speech, language, cognitive, communication, voice, fluency, and related disorders. They also work with people who have difficulty swallowing.
Surrogate decision maker	The person legally authorized to make decisions on behalf of another incapacitated/incompetent individual. The surrogate decision maker may hold a medical durable power of attorney, be a designated guardian, or otherwise be legally appointed to the role.
Telehealth service providers	Some agencies are developing telehealth services for the homebound. Through telehealth, a nurse can read an older adult’s vital signs over the telephone.
Telephone reassurance and friendly visitors programs	Provides a regular friendly and familiar voice to people who live alone. If a volunteer calls the home of an older adult and there is no answer, the volunteer calls an emergency contact person to verify the well-being of the individual.
Terminal illness	An illness that is incurable or irreversible and will eventually cause a person’s death. A terminal illness is specifically one that will take a person’s life within six months if the illness is allowed to run its natural course.
Total pain	A concept recognizing that pain is not solely a physical sensation but may manifest in a person’s emotional, psychological, spiritual, or social dimension or in all dimensions all at once.
Total sedation	Sedation to unconsciousness maintained until natural death occurs for terminally ill patients suffering severe and intractable symptoms that have not responded to other less extreme interventions.
Trajectory of illness	Course of decline described in terms of its shape and duration. Each trajectory has different patient experiences, medical and personal responses, and family/caregiver challenges.
Triangulation	A process when interacting with several people in which a person ends up taking sides with one person against another.
Urn	Container used to hold cremains.
Visitation	Practice common in the Roman Catholic tradition in which a reception is held at the funeral home the day or evening before the funeral for friends and family to gather and view the deceased person in an open casket.
Voluntarily stopping eating and drinking (VSED)	Action taken by a person in the context of terminal illness, usually with the intent of hastening or not impeding natural death from the illness.
Whole body donation	A process whereby a living person may donate his or her whole body after death for the purposes of medical or forensic research.
Whole brain death	Complete cessation of activity in all parts of the brain, including the brain stem. Whole brain death constitutes legal death, even if other means can be employed to continue respiration and cardiac function and deliver nutrients.
Accelerated benefits or living benefits	A rider on an insurance policy that allows the insured persons to collect an agreed-upon percentage of the death benefit prior to their death if they become terminally ill. The remainder of the benefit is then paid out upon the death of the insured.
Accumulation period	The period beginning with entry into the workforce and ending with retirement is the wealth accumulation period.
Adjusted gross income (AGI)	Total amount of a person’s wages, dividends, and other financial receipts minus adjustments to income, such as alimony paid and deductible contributions to individual retirement accounts.
Administrator (administratrix)	Person who settles the estate when an individual dies intestate.
Advance directive	Statement made by an individual, usually in a written document, concerning the medical treatments to be provided and decision maker to be appointed if the patient becomes terminally ill or incapacitated.
Annuitant	Recipient of annuity distributions.
Annuity	Income from capital investment paid in a series of regular payments.
Asset	What a person owns. Assets include cash and cash equivalents, invested assets, and use assets.
Asset allocation	An investment strategy that can reduce risk by dividing an investor’s assets among several different asset classes such as stocks, bonds, cash, money market securities, as well as real estate, insurance, collectibles, and other assets.
Asset class	A group of assets with similar return, risk, and liquidity characteristics. The simplest asset class categorization scheme includes only three types of financial assets
Balance sheet	Financial statement listing a client’s assets, liabilities, and net worth as of a specific date.
Beneficiary	In the context of insurance, a person or entity that has a remainder interest in policy proceeds. In the context of trusts, a person who benefits from the trust and who has beneficial ownership of trust assets.
Bond	Debt that represents a legal obligation of the issuer to pay principal and interest when due.
Budget	Financial statement listing expected income and expenses for a future period of time.
Combination annuity	An annuity that allows the owner to allocate premium payments between separate fixed and variable accounts at set intervals, usually annually or quarterly.
Compounding	Process of interest accumulating on both a principal balance and previously earned interest.
Conservator (guardian of the assets)	Person appointed by the court to manage the financial and legal affairs of an incapacitated individual.
Defined benefit plans	An employer-sponsored retirement plan that the company manages for its employees. The employer takes the investment risk. Pension payments represent a lifetime income for retirees.
Defined contribution plans	Tax-deferred retirement plans sponsored by employers for their employees. Employees choose how to allocate their contributions among investment choices and bear the investment risk.
Delayed payout annuity	This is another name for a longevity annuity, also called longevity insurance. It is a special type of deferred income annuity. A delayed payout annuity does not start making payments until the annuitant reaches a certain age.
Distribution	Outflow from a retirement plan. For mutual funds, a payment by a mutual fund to shareholders, either in cash or shares, for dividends received from securities in the fund or capital gains generated from the sale of securi¬ties in the fund.
Distribution period	The period following retirement, during which accumulated funds are withdrawn to meet living expenses.
Diversification	The process or strategy of investing in different types of assets to reduce risk.
Employee Retirement Income Security Act of 1974 (ERISA)	Federal law governing the operation of most private tax-deferred retirement plans. Qualified employer-sponsored retirement plans must comply with ERISA.
Equity	Ownership, in particular pertaining to having the right to share in future profits or appreciation in value (e.g., value of property, stock value).
Equity-indexed annuity	A version of a fixed annuity, it pays a base return and an interest rate based on an outside index such as the stock market. The interest may increase if the index increases.
Estate	All property interests a person owns, including property over which the person exercises decisive control.
Estate plan	Documents that detail the instructions to be followed during disability or after death. People without an estate plan in effect choose to let the laws of the state provide these instructions.
Estate planning	Process of directing one’s affairs to provide income, investments, and appropriation of assets for oneself or others during life and upon disability or death.
Executor (executrix or personal representative)	Representative responsible for distributing property when an individual dies with a valid will.
Fixed annuity	An investment contract that provides the person who buys the annuity from an insurance company (the annuitant) a series of fixed payments for the length of the contract.
Guardian	Court-appointed fiduciary responsible for a minor or incompetent person.
Heir	Person entitled to inherit property under state intestacy statutes.
Incapacity (loss of capacity)	Patient’s inability, as determined by a physician and as a result of pain, medications, brain damage, or an unconscious state, to make his or her own health care decisions.
Indexed annuity	A variation of a fixed annuity. The annuity pays a base return, but the interest rate is based on an outside index, such as a stock market index. If the index increases, the interest rate might also increase.
Individual retirement account (IRA)	Investment plan that any individual with earned income can establish and fund. The IRS sets annual contribution limits for individual taxpayers, based on their filing status.
Inflation	General increase in the level of prices within the economy due to the valuation of the dollar (i.e., more dollars are required to buy a particular item).
Inflation protection	Insurance policy option that provides for increases in benefit levels to help pay for expected increases in the costs of long-term care services.
Inflow	Pertaining to the cash flow statement, the dollars, such as from salary, dividends, interest, rental income, alimony, child support, or investment redemptions, received by an individual during a particular period.
Itemized deductions	Actual expenses that a person paid during the calendar year that are subtracted from adjusted gross income to reduce taxable income.
Life expectancy	Length of time that estimates the number of years a person will live.
Life income annuity	Product in which payments are distributed only until the annuitant dies. No benefits are payable to a beneficiary.
Life income with period certain	Life insurance option in which payments are guaranteed for a stated amount of time, such as 10 or 20 years, after which, if the annuitant is still alive, he or she continues to receive payments until death, but there is no benefit for a beneficiary.
Life settlement	A policyholder no longer wants or needs the life insurance policy and sells it to a third party for a sum less than the face value of the policy but more than the cash surrender value.
Living will	Document signed by a competent person, stating which health care measures should or should not be taken in terminal situations if the person is incompetent to make such decisions at that time.
Long-term care insurance (LTCI)	Coverage for various custodial care expenses in the event the insured becomes incapacitated as defined in the policy.
Lump-sum distribution	Retirement plan distribution that you can take as income (on which you will pay taxes), or roll over to a traditional IRA within 60 days or to another eligible plan
Money purchase pensions	A type of defined-contribution plan similar to a profit-sharing plan. Contribution amounts are fixed rather than variable. Employers are required to make annual contributions to each employee’s account.
Mutual fund	Open-end investment tool that pools the money of many investors and hires an investment advisor to invest that money to achieve one or more financial objectives.
Net worth	Residual value after liabilities are subtracted from assets. Net worth represents the amount that is owned by an individual or family if unencumbered by debt.
Nondeductible IRA	Individual retirement account in which contributions are taxable as part of current income.
Outflow	Expenditure or use of cash.
Permanent life insurance	Life insurance that can have level premiums and builds up a cash value within the policy.
Pour-over will	A legal document that ensures any assets not already in a revocable living trust at the time of death are transferred into the trust so that the instructions in the revocable living trust will be effective.
Power of attorney	Written document executed by one person who authorizes another person to act on his or her behalf.
Probate	Legal process of administering and distributing an estate after death.
Qualified retirement plan	An employer-sponsored retirement plan for employees that meets IRS rules and offers tax advantages.
Required beginning date (RBD)	For individual retirement accounts, qualified plans, and section 403(b) arrangements, the date by which distributions from the plan must begin, based on the plan owner’s birth date.
Required minimum distribution (RMD)	Lowest annual required distribution amount for an IRA holder who reaches age 70 1/2.
Reverse mortgage	A loan available to homeowners who are 62 years or older that enables them to convert part of the equity in their home into cash. The homeowners keep the title to the home and must continue to pay expenses.
Revocable living trust	A trust that can be changed while the grantor is alive; often used to plan for the possibility of mental incapacity.
Rollover	Movement of funds from one retirement plan to another, usually a different type of plan—for example, from a 401(k) to an IRA or from a Roth 401(k) to a Roth IRA.
Roth 401(k)	An employer-sponsored retirement plan that allows employees to make after-tax contributions that grow tax-deferred, similar to a Roth IRA.
Roth IRA	Nondeductible IRA with several unique features
Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)	A plan in which a small business with 100 or fewer employees can offer retirement benefits through employee salary reductions and matching contributions (similar to those found in a 401(k) plan). It can be either a SIMPLE IRA or a SIMPLE 401(k).
Single premium annuity	An annuity that the purchaser pays for in full with one total premium amount at the time of purchase, instead of choosing to pay the total premium amount in regular installments (e.g., monthly).
Social Security	Government program in which covered workers meeting certain past-service requirements and their qualified dependents are eligible for limited retirement, medical, disability, and death benefits.
Spousal IRA	Individual retirement account for a spouse who earns less than the maximum contribution amount or has no earned income from work.
Standard deduction	The amount set by federal law that is subtracted from adjusted gross income to reduce taxable income. It consists of (1) a standard amount for all ages, (2) an additional amount for those age 65 or older, and/or (3) an additional amount for blindness.
Statement of cash flows	Statement of household cash inflows and outflows for a given period—typically a month or a year; also called an Income statement.
Stock	One of the two most common types of investments (bonds are the other). A stock is a type of security that signifies ownership in a corporation and represents a claim on part of the corporation’s assets and earnings. There are two main types of stock
Suitability	A situation (and sometimes a legal requirement) in which an investment strategy meets the objectives and means of an investor. In most parts of the world, financial professionals have a duty to ensure that an investment is suitable for a client.
Supplemental Security Income (SSI)	Federal program funded by general tax revenues designed to help aged, blind, or disabled people who have little or no income and require help meeting basic needs for food, clothing, and shelter.
Target date fund	Mutual fund consisting of a mix of debt and equity that is designed to shift the fund’s allocation away from equities and into debt as a specified date approaches, to reduce risk gradually over time in a specified manner.
Tax credit	Dollar-for-dollar deduction that offsets calculated tax.
Term life insurance	Life insurance that is purchased for a specified period of time and builds no cash value. This type of insurance can become prohibitively expensive at advanced ages.
Testamentary trust	A trust established under a will that is created when the will is probated after the grantor dies to provide for asset management for minors, asset protection for adult heirs, or estate tax planning.
Time diversification	The phenomenon by which average annual investment returns (e.g., for stocks) become more certain (i.e., have less probable risk) as a client’s time horizon lengthens.
Time horizon	The period between making and withdrawing the investment to meet goals or other financial needs.
Treasury bill	Short-term obligation of the US government that is issued at a discount and redeemed at face value upon maturity. Income received upon maturity is not taxed at a state or local level.
Trust	Fiduciary arrangement, set up by a grantor, whereby property is held and managed for a named beneficiary by a third party, known as a trustee.
Variable annuity	Investment product in which the benefits paid out vary according to changes in the value of the portfolio supporting the annuity.
Viatical settlements	The sale of a life insurance policy to a third party when the policy owner is terminally or chronically ill and has a life expectancy of no more than two years.
Will	Legal document that specifies how a person wants to distribute probate property and provides other instructions upon the person’s death.
1115A demonstration program	Medicaid rule that offers flexibility to states in delivering Medicaid long-term care services.
Activities of daily living (ADLs)	Functions that are part of daily living that a person without disability can perform without assistance: eating, bathing, toileting, dressing, mobility (e.g., getting in or out of a bed or chair, walking), and continence.
Adjusted net countable income	The income a veteran (or surviving spouse) has after deducting unreimbursed medical expenses and a 5 percent deductible from his or her gross income.
Aid and attendance	The highest level of income-tax-free VA pension benefit that a veteran or surviving spouse may receive. In addition to meeting the basic pension requirements, the veteran or surviving spouse must also be dependent on others for care and survival.
Average indexed monthly earnings (AIME)	The result of averaging up to 35 years of a worker’s highest indexed earnings and rounding down to the next lower dollar amount. The AIME is used to calculate the worker’s primary insurance amount.
Balance billing	The prohibited practice of charging patients for the balance of any amounts not covered by Medicaid.
Basic pension (improved pension)	The income-tax-free benefit paid to veterans or their surviving spouses.
Benefit period	In the Medicare hospital and skilled nursing facility context, a benefit period starts on the day a beneficiary is admitted to a hospital as an inpatient and ends when they haven't received inpatient hospital or SNF care for at least 60 days in a row.
Categorically needy	Groups of individuals such as the aged, blind, or disabled who are, by definition, eligible for a needs-based program such as Medicaid when their assets and income fall below established thresholds.
Community spouse	A spouse who continues to live at home in the community while his or her spouse lives in a nursing home.
Community spouse resource allowance	Amount of assets that Medicaid regulations permit a community spouse to retain.
Consumer Price Index	An index measuring the change in the cost of typical wage earner purchases of goods and services, expressed as a percentage of the cost of these same goods and services in some base period.
Cost-of-living adjustment (COLA)	Adjustment of wages or salaries in proportion to changes in the cost of living.
Countable income	In eligibility determinations for needs-based programs such as Medicaid and SSI, countable income includes wages, Social Security payments, pension payments, and other income sources that are not exempt from consideration.
Countable resources	In eligibility determinations for needs-based programs such as Medicaid and SSI, countable resources include assets such as bank accounts, certificates of deposit, stocks, bonds, and other assets that are not exempt from consideration.
Delayed retirement credits	Social Security benefits are increased (by a certain percentage depending on a person’s date of birth) if retirement is delayed beyond full retirement age.
Dependency and indemnity compensation	An income-tax-free benefit paid to a veteran’s surviving spouse or other dependents if the veteran dies as a result of a service-connected disability or disease or dies for any reason while having received a 100 percent.
Disability rating	A numerical percentage in increments of 10 that corresponds to the degree of severity of a veteran’s disability or disease. This value is used to determine the veteran’s compensation amount.
Dual eligibles	Individuals who receive both OASDI and SSI benefits and therefore are eligible for Medicare and Medicaid.
Duration of work test	One of two tests a worker must pass to be eligible for Social Security disability benefits. To be fully insured, a worker must have worked a certain number of years prior to the disability.
Early retirement	The minimum age at which beneficiaries can begin collecting Social Security retirement benefits (age 62). Benefits are permanently reduced a fraction of a percent for each month before the beneficiary’s full retirement age.
Estate recovery	A process by which states recoup money they’ve spent on long-term care services from the estates of Medicaid recipients who have died.
Excluded income	Ineligibility determinations for needs-based programs such as Medicaid and SSI.
Exempt resource	For needs-based programs such as Medicaid and SSI, exempt resources are those that are not counted when determining a person’s eligibility for benefits.
Full retirement age	The age at which beneficiaries receive their full amount of Social Security benefits based on the year of birth.
Government pension offset	A federal statutory provision that reduces retirement benefits paid by the Social Security Administration to the spouse, divorced spouse, or widow(er) of a beneficiary who receives a pension or has income on which no Social Security taxes were paid.
Medicare Advantage plans/Medicare Part C	Alternatives to Original Medicare (Parts A and B). Medicare Advantage plans are the fee-for-service program that CMS administers. MA plans are Medicare for the beneficiaries who enroll in them.MA plan members are still enrolled in Medicare.
Medicare medical savings account (MSA)	A Medicare health plan option made up of two parts. One part is a Medicare MSA health policy with a high deductible. The other part is a special savings account, called a Medicare MSA.
Medicare Part D	A voluntary program in which private insurance companies, contracting with Medicare as stand-alone prescription drug plans (PDPs) or as Medicare Advantage plans, deliver the prescription drug benefit. Medicare savings programs.
Medicare summary notice (MSN)	A quarterly notice sent to beneficiaries that identifies the services or items a beneficiary received, the service providers and dates of service, the amounts Medicare approved for payment, the maximum amount the beneficiary owes out of pocket.
Medigap/Medicare supplement insurance	Insurance sold by private companies to beneficiaries with Original Medicare (Parts A and B) that supplements Medicare coverage by covering gaps in cost-sharing and benefits. Federal and state laws regulate Medigap plans.
Miller trust	An instrument to help people with too much income qualify for Medicaid. All the applicant’s income goes into the trust and is used to pay costs related to nursing home care beyond those covered by Medicaid.
Monthly maintenance needs allowance (MMNA)	A portion of the institutionalized spouse’s income that may be kept by the community spouse if he or she qualifies based on income. The MMNA is in addition to the Community Spouse Resource Allowance.
Needs-based program	Refers to public benefit programs such as SSI and Medicaid for which eligibility is based on financial need. The income and asset levels used to determine financial need vary among the programs.
Net worth	The amount of assets a veteran (or surviving spouse) is allowed to own in order to be eligible for VA pension benefits. There is no set formula for calculating allowable net worth for pension benefit purposes.
Noncountable (exempt) assets	Assets owned by the veteran or surviving spouse that the VA does not consider when determining allowable net worth.
Old Age and Survivors Insurance (OASI)	A trust funded by worker taxes under the Federal Insurance Contributions Act (FICA) and the Self-Employment Contributions Act (SECA) that is used to pay Social Security retirement and survivor benefits.
Old-Age, Survivors, and Disability Insurance (OASDI)	Social Security retirement and disability benefits. Beneficiaries are eligible for Medicare.
Original Medicare	Parts A and B of Medicare Insurance.
Pickle amendment	Medicaid eligibility screening tool that may allow certain beneficiaries who were eligible for SSI and Social Security in the same month to receive Medicaid benefits if their income increases to above the SSI threshold.
Presumptive condition	A veteran’s disease that the VA has determined was presumptively caused as a result of his or her military service.
Primary insurance amount (PIA)	The amount of monthly Social Security benefits the worker will receive at his or her full retirement age. The monthly benefit amount may be higher or lower than the PIA if the worker retires before or after full retirement age.
Qualifying service record	For VA compensation benefits, the veteran is not required to meet minimum length-of-service requirements; he or she must only have been discharged from service for reasons other than dishonorable.
Recent work test	One of two tests a worker must pass to be eligible for Social Security disability benefits.
Representative payee	An individual or organization that receives Social Security or SSI payments on behalf of an individual who cannot manage or direct someone else to manage his or her benefits money.
Service-connected disability compensation	An income-tax-free benefit paid to veterans who have sustained or aggravated a disability or disease as a result of their military service. The amount of compensation depends on the veteran’s disability rating.
Spending down	Refers to the process of depleting assets, or spending income on medical care or other eligible expenses, to qualify for Medicaid.
State Health Insurance Assistance Program (SHIP)	A federally funded program that offers free, one-on-one counseling and assistance to people with Medicare and their families via telephone and face-to-face interactive sessions, public education presentations and programs, and media activities.
State Medicaid agency	Agency in each state responsible for administering the Medicaid program and developing a state Medicaid plan that CMS approves in light of federal regulations.
Supplemental Security Income (SSI)	A federal program administered by the Social Security Administration and funded by general tax revenues that provides income support payments to the aged, blind, or disabled.
TRICARE For Life	Lifetime health care benefits provided by the military to retirees; similar to secondary insurance plans that supplement Medicare.
Unreimbursed medical expenses	Certain expenditures that can be deducted from gross income in order to meet the adjusted net countable income test for purposes of determining VA pension eligibility and the benefit rate.
Veterans benefits	A variety of benefits and services offered by the US Department of Veterans Affairs for eligible veterans, including pensions and health, long-term care, and burial and memorial benefits.
Windfall elimination provision	A federal statutory provision that reduces retirement benefits paid by the Social Security Administration to individuals who receive a pension or have other income on which no Social Security taxes were paid while the individual was employed.
Accreditation	Third-party verification that a certification body and its certification program have met a defined set of standards.
Accreditation of educational institutions	A voluntary designation that is awarded by nongovernmental, not-for-profit, freestanding associations that regulate academic programs.
Accreditation of health care organizations	Accreditation by The Joint Commission is awarded to hospitals, nursing homes, and other health care organizations that meet specified criteria regarding patient safety and quality.
Accreditation of professional credentials	The two most known accrediting bodies are the Institute for Credentialing Excellence’s (ICE’s) National Commission for Certifying Agencies (NCCA) and the ANAB National Accreditation Board (ANAB).
Autonomy	The concept that individuals should reign over themselves and can and should make their own decisions about how to live their lives, regardless of whether others think those decisions are good or bad.
Beneficence	An ethical principle of doing the most good.
Certificate	A document, credential, or designation awarded after a person has completed one training or educational course. For life; they cannot be taken away.
Certificate program	A set of education or training courses on a single topic (as opposed to broad-based general education). May include an exam based on course content that is typically written and administered by the course designer or instructor.
Certification	A credential that demonstrates a person has acquired additional knowledge and skills above the basic requirements of a profession or occupation. Certification is not mandatory and is usually controlled by the profession itself, not a regulatory body.
Certification program	A set of criteria (i.e., the standard) for a profession or occupation that is established, administered, upheld, and enforced by a third-party certification body that awards the certification to individuals and professionals who have met the criteria.
Clinical incapacity	The inability to make a specific decision in a specific medical circumstance, as determined by a clinician.
Code	An open disclosure of the way an organization operates, providing visible guidelines for behavior.
Continuum of incapacity	A spectrum of capacity or lack of capacity that can affect an older person’s ability to make an informed decision.
Credential	An attestation by a body (e.g., school, certification body, governmental agency) that says something about the person who holds it.
Degree	A form of a diploma awarded by an educational institution. Institutions that offer both certificate and diploma programs can be accredited or nonaccredited.
Designation	The actual letters or mark (e.g., CPA, MD, RN, CSA, BA, MBA, PhD) that signify an earned credential.
Diploma	A document attesting that a person has completed an entire series of educational or training courses or for an educational program consisting of many courses. A diploma is awarded for life and cannot be taken away.
Elder financial abuse	The illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable older adult at risk for harm by another due to changes in physical functioning, mental functioning, or both; a synonym for exploitation.
Ethics	Society’s standards and rules for what is right and wrong behavior.
Exploitation	The fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including a caregiver or fiduciary, who uses the resources of an older individual for monetary or personal benefit, profit, or gain.
Fiduciary duty	A legal and ethical requirement to act only in the best interests of the client in the care and protection of the client’s money or property.
Guardian	An adult who is appointed by the court to assume responsibility for all legally binding decisions made on behalf of an incapacitated adult.
Higher Learning Commission (HLC)	An independent corporation and one of two commission members of the North Central Association of Colleges and Schools (NCA), which is one of six regional institutional accreditors in the United States.
Incapacitated adult	A person who no longer has the ability to make decisions or care for oneself and has been adjudicated incapacitated after a review of medical or psychological evidence by a court.
Informed consent	A legal condition whereby a person can be said to have agreed, or given consent, to allow something to happen, based on a full appreciation and understanding of the facts and implications of the action.
Joint Commission	An independent, not-for-profit organization, The Joint Commission accredits and certifies more than 20,000 health care organizations and programs in the United States.
Legal incapacity	The inability to make legal decisions for oneself in all or some matters, as determined by a judge (also called incompetency).
License or licensure	A credential issued by a regulatory body (i.e., federal, state, or local government) to allow an individual to practice a profession or occupation.
Magical thinking	A cognitive pattern in which paying clients project their hopes and fears, as well as a desire to be guided or taken care of, onto the professionals they hire.
Medicare fraud	A person, group, or company billing Medicare for services or goods that an older adult never received.
Morals	Principles that enable people to live cooperatively together in a group or in society because they guide individual conduct on what is acceptable and right behavior.
Nonmaleficence	An ethical principle of doing the least harm.
Personhood	A standing or status that is bestowed on one human being by others in the context of relationship and social being and implying recognition, respect, and trust.
Power differential	A difference between expert and client that results in a vulnerability on the part of the client.
Professional boundaries	Boundaries that protect both the client and the professional by defining the limits of a trusted relationship.
Values	Individual beliefs about what is important to us personally.

Created by: SocietyCSA

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