Adaptive equipment

Products that allow individuals to live at home independently. Examples of such products include wheelchairs, walkers, oxygen supplies, hospital beds, commodes, grab bars, hand rails, canes, walkers, tubs seats, traction equipment and lifts. Some of the equipment must be rented, other types purchased, and with some, individuals have a choice to either rent or buy. Other home aids, known as durable medical equipment or hospital equipment may be covered through Medicare Part B. 
If a doctor prescribes durable medical equipment for use in the home, Medicare Part B will cover some of the expense.

Adult Day Care

Adult Day Care provides structured supervision, recreation and sometimes health care services to older people who can’t be left alone so that family members or other caregivers can work or attend to other responsibilities. This care is provided during the day, and the senior receiving the care returns home in the evening.

Area Agencies on Aging

Area Agencies on Aging (AAAs) are often the first stop when looking for programs and services for a loved one. 
The services available through AAAs fall into five categories: information and access services, 
community-based services, in-home services, housing and elder rights. 
AAAs were established under the Federal Older Americans Act (OAA) in 1973 to respond to the needs of Americans aged 60 and over and are located in every local community.

ADLs

ADLs (Activities of Daily Living) is a term used in home based care service that refers to assisting clients with, including but not limited to bathing, dressing, grooming, feeding and toileting.

Alzheimer’s Disease

A degenerative, age-related disease that impairs an individual’s cognitive ability. Symptoms may include forgetfulness, wandering and an inability to recognize others. The disease is caused by neuron dysfunction and death in specific brain regions responsible for cognitive functions. Both genetic and environmental factors likely play a role in the development of Alzheimer’s.

Assisted Living

Assisted living is residential care, primarily serving the elder and/or disabled population. Facilities provide assistance with physical and health related needs. They strive to meet social, emotional, cultural, intellectual and spiritual needs of their residents. Born from the demand for individual centered care, all assisted living facilities should provide services including 24-hour supervision, family and community involvement, activities and assistance with daily functions.

Caregiver

Anyone who provides care (medical, custodial, emotional or spiritual) to another individual. My be paid care or unpaid care provided by a friend or family member.

Congregate Housing

Congregate housing is multi-unit housing with support services for seniors and for adults with disabilities who do not want to live alone. It combines privacy and companionship, by offering each resident a private bedroom or apartment with shared living space and activities.

It also offers support services to help residents remain independent. These may include meals, transportation, housekeeping, building security and social activities. A congregate coordinator evaluates residents and arranges for services.

The state government provides funding to make congregate housing affordable to seniors and adults with disabilities in communities throughout Massachusetts.

Congregate Meals

Group meals for seniors are offered through the Administration on Aging’s (AoA) 
Elderly Nutrition Program, which provides grants to support nutrition services to
older people throughout the country. The program aims to improve the nutrition 
of participants and to offer them opportunities to form new friendships and to create 
informal support networks.

These meals are provided in a variety of settings, such 
as senior centers, schools, individual homes and restaurants. Meals served under the program must provide at least one-third of the daily-recommended dietary allowances established by the Food and Nutrition 
Board of the National Academy of Sciences-National Research Council. While there is no means test for participation in the Elderly Nutrition Program,
services are targeted to older people with the greatest economic or social need. 
There is usually a request for a small donation toward the meal.

Continuing Care Retirement Community

Housing planned and operated to provide a continuum of lodging and services for seniors including, but not limited to, independent living, congregate housing, assisted living and skilled nursing care. A Continuing Care Retirement Community (CCRC) resident contract often involves either an entry- or buy-in fee in addition to the monthly service charges, which may change according to the medical services required.

Entry fees may be partially or fully refundable. The fee is used primarily as a method of privately financing the development of the project and for payment for future healthcare. CCRCs are typically licensed by the state. A CCRC is also referred to as Life Care Community.

Consumer Directed Care

This care allows seniors the ability to choose and hire their own caregiver to perform personal care, homemaking, shopping or other tasks in their home. This care can range from brief ongoing care, daily care or care provided a few times a week. Call your local Area Agency on Aging for information.

Councils on Aging 
and Senior Centers

Councils on Aging and Seniors Centers provide programs and services for seniors who live in the community. They may also offer preventive health screenings, classes, education, advocacy, social programs and trips for active older adults.

Elder Law Attorneys

These attorneys focus on the legal needs of the elderly, and work with a variety of legal tools and techniques to meet the goals and objectives of the older clients. The legal needs of the elderly are many, and include: Age discrimination, durable powers of attorney, elder abuse, estate planning and probate, long-term care, health care decisions, Medicare, Medicaid and other public benefits and trusts.

Geriatric Care Managers


A geriatric care manager is a health and human services professional, such as a gerontologist, nurse, social worker or psychologist with a specialized focus on issues related to aging and elder care. Geriatric care managers work privately with older adults and their families to create a plan of care that meets the needs of the older adult. They will meet with the client to help all parties understand a loved one’s needs and to learn what resources and options are available to meet those needs.

Group Adult Foster Care

Group Adult Foster Care (GAFC) is a MassHealth program that pays for personal care services for eligible seniors and adults with disabilities who live in GAFC-approved housing. Housing may be an assisted living residence or specially designated public or subsidized housing. To qualify, residents must be eligible for MassHealth and need help with at least one daily personal care task such as bathing or dressing.

GAFC pays only for the cost of personal care services and medication management when an individual lives in approved housing. It does not pay housing costs.

Home Delivered Meals (Meals on Wheels)

Home delivered meals, or Meals on Wheels, deliver meals to homebound individuals who are unable to purchase or prepare their own meals. 
The primary source for delivered meals is the Federal Administration on Aging (AoA) through its Elderly Nutrition Program, which provides grants to support nutrition services to older people throughout the country.

Meals served under the program must provide at least one-third of the daily-recommended dietary allowances established by the Food and Nutrition Board of the National Academy of Sciences-National Research Council. Volunteers who deliver meals are encouraged to spend some time with the homebound elderly. The volunteers also offer an important opportunity to check on the welfare of the homebound elderly and are encouraged to report any health or other problems that they may note during their visits. 
There are also private vendors who offer home delivered meals, and some are under contract with governments to perform the service.

Home Care


There are two types of Home Care — 

Nonmedical and Medical Home Health (certified and non-certified agencies).

• Nonmedical Home Care offers personal care, homemaking, shopping, laundry, friendly visitors, companionship and respite. Agencies that provide this care may or may not be licensed, so always ask.
• Certified Medical Home Health Care is provided by doctors, nurses, social workers or home health aides. Types of care can include physical therapy, speech therapy, ventilator care, infusion therapy, chemotherapy or other medically oriented health maintenance. Agencies that provide this type of care are often overseen by state and federal laws, and are often certified by Medicare and Medicaid. A doctor’s consent is usually needed.

Non-Certified Home Health Care may offer the same services as certified care, but can’t bill Medicare or Medicaid and does not need a doctor’s consent.

Hospice Care


Provides humane and compassionate care for the terminally ill and their family members. Care includes physician and nursing services coordination, volunteer support, home health services, grief counseling and pain management. It can be provided in the home, a hospital or a long-term care facility. Hospice care is appropriate for those who have an incurable condition, with a life expectancy of no longer than six months.

Independent Living Center

These centers are typically non-residential, private, non-profit, consumer-controlled, community-based organizations providing services and advocacy by and for persons with all types of disabilities. Many are state supported, with a goal to assist individuals with disabilities to achieve their maximum potential within their families and communities.

These centers also serve as a strong advocacy voice on a wide range of national, state and local issues. They work to assure physical and programmatic access to housing, employment, transportation, communities, recreational facilities, and health and social services. These are just a few of the services offered.

Long Term Care

Provision of services to persons of any age who are afflicted with chronic health impairments.

Long-term Care Insurance

A privately issued insurance policy, which covers the cost of nursing home care, assisted living and home health care. Premiums are based on age, health, length of deductible period, amount paid and duration of benefits. Currently pays only 2 percent of national nursing home costs.

Medicaid

A jointly funded medical financial federal-state health insurance assistance program, offering benefits to individuals with limited financial resources, the disabled and the elderly.

There are income eligibility criteria that must be met to qualify. Medicaid accounts for about 52 percent of the nation’s care costs, and is the source of payment for almost 70 percent of residents in nursing homes. The person must have exhausted nearly all assets and be in a nursing facility that participates in this program. Medicaid can reimburse nursing facilities for the long-term care of qualifying seniors, and in some states, Medicaid pays for Assisted Living care through Medicaid waivers.

Medicare

Federal health insurance program for people age 65 or over and disabled people. Apply three months prior to turning 65.

Three-part program:

Part A — helps pay for medically necessary inpatient hospital care. It will help pay for skilled nursing or home health care if the beneficiary meets certain conditions.

Part B — helps pay for doctor visits, outpatient services and supplies.

Part D — Medicare Prescription Drug Plan helps seniors pay for prescription drug medications. Open to all Medicare subscribers.

Website also provides information on nursing homes, benefit coverage, and the Medicare Prescription Drug benefit.

For more information call 800-MEDICARE or online at www.medicare.gov.

Medigap Insurance

Private health insurance policies that supplement Medicare coverage, covering health care costs above those covered by Medicare Part A or Part B. Does not provide benefits for long term care, covering primarily hospital and doctor bills.

Nursing Home


Nursing Homes provide 24-hour, skilled nursing care for older adults who have severe physical health and/or mental disabilities, but do not require hospital care. Those who qualify also have difficulties performing one or more of the activities of daily living such as bathing, dressing, walking or toileting.

Nursing homes are also suitable for those needing rehabilitation after a hospital stay before they go home. Twenty-five percent of people admitted to a nursing home stay only a short time (3 months or less). Many of the people who stay for a short time are admitted for rehabilitation or for terminal (i.e., end-of-life) or acute care. About half of residents spend at least one year in the nursing home, and 21 percent live there for almost 5 years.

Older American Act (OAA)

The Older Americans Act was established in 1965 by the federal government to provide comprehensive services to older adults. It created the National Aging Network comprising the Administration on Aging on the federal level and State Units on Aging and Area Agencies on Aging at the local level. The network provides funding for nutrition and supportive home and community-based services, disease prevention/health promotion services, elder rights programs, the National Family Caregiver Support Program and the Native American Caregiver Support Program.

Personal Care Attendant Program

The Personal Care Attendant Program (PCA) is a state-offered program that allows consumers, who require physical help with two or more activities of daily living — such as bathing, dressing or meal preparation — to have control over the design and delivery of their own personal care services. With the help of PCA personnel, the consumer hires, trains and supervises the attendant, who can be a friend, parent of an adult child or family member (excluding spouses, surrogates or legal guardians).

Personal Emergency Response System


A personal emergency response device is a signaling system that enables an individual in distress to initiate an alarm and alert appropriate personnel.

It is combined with a locating and tracking system that enables the alerted personnel to monitor the location of the individual in distress. Such a device allows people to maintain their independence while still feeling safe.

It offers a solution for families who are coping with the strains of eldercare and an aid for many people who could not live independently without such a device.

Protective Services and Elder Abuse

Because elder abuse is a growing problem, state governments have set up elder abuse hotlines. Check with your state government office for phone numbers.

Elder abuse refers to any knowing, intentional or negligent act by a caregiver or any other person that causes harm or a serious risk to a vulnerable adult. Abuse may be:

• Physical — Inflicting or threatening to inflict physical pain or injury or depriving an elder of a basic need.
• Emotional — Inflicting mental pain, anguish or distress on an elder through verbal or nonverbal acts.
• Sexual — Nonconsensual sexual contact of any kind.
• Exploitation — Illegal taking, misuse or concealment of funds, property or assets.
• Neglect — Refusal or failure by those responsible to provide food, shelter, health care or protection.
• Abandonment — The desertion of an elder by anyone who has assumed the responsibility for care or custody of that person.
• Self-neglect — Accounts for the majority of cases reported to adult protective services. It can include behaviors such as hoarding, failure to take essential medications or refusal to seek medical treatment for serious illness, leaving a burning stove unattended, poor hygiene, not wearing suitable clothing for the weather, confusion, inability to attend to housekeeping and dehydration.

Respite Care

Offers short-term, temporary relief to unpaid caregivers, such as family members, who are caring for individuals who might otherwise require permanent placement in a facility outside the home.

Rest Homes

Rest homes offer a supportive living environment for seniors or others who are unable to live independently but do not need nursing home care. They are licensed by the state.

Subsidized Housing

Subsidized housing encompasses all types of housing whereby the government provides some type of subsidy or rent assistance, including public, non-profit and co-operative housing, as well as rent supplements for people living in private market housing. Subsidized housing developments are for people with low- to moderate-incomes, including seniors.

Information was gathered from state and federal government sources and nationwide advocacy agencies. — COMPILED BY SONDRA SHAPIRO