Glossary of Terms

A

Activities of Daily Living – Also called ADLs, these are the usual everyday activities in which an individual participates routinely. ADLs can include bathing, getting dressed, grooming, eating, using the toilet, etc.

Acute Illness – An illness with a sudden onset. An acute illness is the opposite of a chronic condition that last over time.

Advance Directive – A document such as a living will or a power of attorney that details a person’s wishes and instructions about medical care for himself, should he become incapacitated or too ill to communicate those wishes or to participate in making medical decisions.

Advance Care Planning – The process of making decisions and arrangements regarding future health care services for oneself in advance of the need for those services, in the event a person becomes incapacitated and can no longer communicate his wishes.

Alzheimer’s disease – A type of dementia that affects memory, reasoning and behavior. Alzheimer’s is marked by progression from mild issues with cognition and memory to severe dementia.

Anticipatory grief – This grief is the deep, heartfelt sorrow that arises in anticipation of a significant loss, allowing individuals to begin processing their emotions and finding comfort before the loss occurs.

Assisted living facility (ALF) – These living facilities assist people who need different levels of medical and personal care in a home-like setting designed to promote a resident’s independence.

Aspiration – In medical terms, aspiration refers to the accidental inhalation of food, liquid, or other material into the airway or lungs, which can lead to serious health issues.

Atropine – In hospice care, atropine drops are commonly used to reduce excess saliva and respiratory secretions, helping to alleviate discomfort for patients.

B

Bereavement – The process of grieving and mourning, usually the death of a loved one. Because loss is so personal, bereavement can involve a variety of emotions, ranging from sadness to anger to despair. The ways in which bereavement is experienced and expressed vary from person to person.

C

Consumer Assessment of Healthcare Providers and Systems (CAHPS) – A standardized approach to gathering, analyzing and reporting information on consumers’ and patients’ experiences with health care services.

Caregiver – Someone who aids a family member or friend. The term usually refers to the loved one of a patient who spends time with the patient and attends to his needs.

Caregiver burnout – In hospice and palliative care, it's a state of physical, emotional, and mental exhaustion experienced by those providing long-term care for seriously ill patients, often due to the intense and continuous nature of their caregiving duties.

Case management – Case management in hospice care involves coordinating comprehensive and personalized care plans for patients and their families, ensuring they receive the necessary medical, emotional, and logistical support throughout their end-of-life journey.

Coronary Artery Disease (CAD) – This is a condition where the heart's arteries become narrowed or blocked due to the buildup of plaque, reducing blood flow to the heart and increasing the risk of heart attacks.

Chronic Illness – A condition or illness that is ongoing and doesn’t fully respond to treatment.

Chronic Obstructive Pulmonary Disease (COPD) – A chronic respiratory condition that is often characterized by poor airflow in the lungs. This condition frequently results in shortness of breath and a cough.

Centers for Medicare & Medicaid Services (CMS) – The federal agency that administers Medicare and Medicaid, including determinations of benefits.

CNA – the acronym for Certified Nursing Assistant. This person plays a supporting role in providing care for a patient that doesn’t require a registered nurse or physician, such as bathing a patient, helping him with dressing, etc.

Comorbidities – They involve the presence of one or more additional medical conditions or diseases occurring simultaneously with a primary condition in a patient.

Concentrated care – This intensive level of care is provided during periods of acute symptom management or crisis, aimed at ensuring patient comfort and stabilizing their condition.

CPR – Cardiopulmonary resuscitation (CPR) is an emergency procedure that combines chest compressions and artificial ventilation to manually preserve brain function and circulate blood in a person who has stopped breathing or whose heart has stopped beating.

D

Dementia – A more rapid decline in a person’s cognitive functioning than what is typically due to aging.

Diagnosis – A determination made by a physician regarding the name of a disease, its nature and the cause of symptoms experienced by a patient.

Discharge planning – Any interdisciplinary approach to ensuring continuity of care after discharge from a hospital or other acute care facility. Whether the process is formal or informal, discharge planners work to coordinate assessments, recovery goals, planning and implementation between hospitals, health care providers, community organizations and caregivers.

Durable medical equipment (DME) – Equipment that can be used repeatedly such as a wheelchair or walker.

DNR – The acronym for a “DO NOT RESUSCITATE” order, which is a patient’s written order to health care providers that instructs them not to attempt CPR if his heart or breathing ceases. The patient or the patient’s representative requests this document.

Dysphagia – This medical condition is characterized by difficulty or discomfort in swallowing, which can affect the movement of food and liquids from the mouth to the stomach.

Dyspnea – This is the medical term for shortness of breath or difficulty breathing, often described as an intense tightening in the chest or a feeling of suffocation.

E

Edema – This medical condition is characterized by swelling caused by excess fluid trapped in the body's tissues, commonly affecting the legs, feet, and ankles.

Election of Hospice – The choice on the part of the patient or his representative to receive hospice services.

Electronic medical records (EMR) – An electronic version of a patient’s medical history, which is maintained by the provider over time.

End-of-life care – Clinical and comfort care and support for a patient in the last stages of a disease that is life-limiting.

End-stage disease – The last phase in the course of a disease. This term is sometimes used instead of “terminal illness.”

F

Failure to thrive – A diagnosis in an elderly patient that is based on significant weight loss, decreased appetite, inadequate nutrition, and an absence of physical activity.

Feeding tube – A medical device used to provide nutrition to individuals who are unable to eat or swallow safely, delivering food directly to the stomach or small intestine.

Four Levels of Care – According to Medicare, they are routine home care, continuous home care, inpatient respite care, and general inpatient care, each designed to address varying patient needs and symptom management in hospice care.

G

General inpatient care (GIP) – Advanced, skilled care that is provided outside the home in our Hospice House for hospice patients who need short-term management of severe symptoms.

Grief – This is the deep sorrow and emotional pain experienced after the loss of a loved one or something significant in one's life.

H

Healthcare proxy – A legal document that designates a person to make medical decisions on someone else's behalf if they are unable to do so themselves.

Homebound — A patient who is unable to leave home without great difficulty, including patients who need the help of another person, a cane, a walker or a wheelchair. Under Medicare coverage, the patient must be evaluated certified as homebound by a doctor.

Home health aide – Someone who assists or provides the patient with personal care services such as bathing, dressing, feeding and going to the toilet.

Home health care — A term that encompasses a range of professional medical services, including skilled nursing care, as well as other skilled care services, such as physical and occupational therapy, speech-language therapy and medical social services. These services are given by skilled health care professionals in the home.

Home hospice care – A type of end-of-life care provided in the patient's home, focusing on comfort and quality of life through medical, emotional, and spiritual support.

Hospice – A philosophy of medical care that is focused on providing comfort, support, pain management, symptom management and dignity to patients with life-limiting illnesses.

Hospice aide – A trained professional who provides non-medical personal care and support services to hospice patients, such as bathing, dressing, and assisting with daily activities.

Hospice eligibility – It generally requires that a patient be diagnosed with a terminal illness and have a prognosis of six months or less to live if the disease follows its expected course.

Hospice volunteer – An individual who donates their time and compassion to support hospice patients and their families through companionship, emotional support, and assistance with various tasks.

I

Informed consent – The process by which a patient is provided with detailed information about a medical treatment or procedure, including its risks and benefits, and then voluntarily agrees to proceed.

Inpatient care – It refers to short-term, intensive care provided in a hospital or hospice facility to manage acute symptoms or provide respite for caregivers, ensuring patient comfort and stabilization.

Interdisciplinary team – staff members and health care workers who make up a patient’s hospice care team. This team includes members representing several disciplines working together, such as doctors, nurses, social workers, chaplains, nurse’s assistants, home health aides, grief counselors and volunteers.

L
Licensed nurse (LPN/LVN) – Typically, a licensed nurse manages tasks such as: administration of medication; changing wound dressings; administration of tests, such as blood pressure or temperature checks. An LPN/LVN must complete a year of training and pass a licensing exam.

Life-sustaining treatment – Also called life support, this treatment includes procedures and/or medical devices that support or nearly replace functions of the body that are necessary for life. Examples can include CPR, ventilators, breathing tubes, nutrition supplied via tubing or IV lines, kidney dialysis, etc.

Living will – A document that contains an individual’s wishes as they pertain to medical treatment at the end of his life. The living will is enacted if the patient becomes incapacitated and unable to communicate his wishes.

Longterm care – It encompasses a range of services designed to meet the medical, personal, and social needs of individuals who are unable to perform basic activities of daily living over an extended period.

M
Medicaid – State programs that provide health care insurance to individuals who meet specific criteria that deem them medically indigent.

Medicare – the United States federal health insurance program for people who are 65 years of age or older, people younger than 65 with certain disabilities and people with end-stage renal (kidney) disease. It is divided into three sections: Part A, Part B and Part D, each section covering a different scope of medical services, treatments, and equipment.

Medical director – In hospice, a medical director is a physician who works closely with each patient’s physician and care team to create the best plan of care.

Medical Power of Attorney – A document in which an individual designates someone to make decisions about his medical care in the event he is unable to communicate. It is also called a “Durable Power of Attorney for Health Care.” The person designated in the document is referred to as the health care proxy, agent or surrogate.

Mottled skin – A condition where the skin appears patchy and discolored, often with a marbled or web-like pattern, typically due to poor blood circulation.

O
Occupational Therapy – treatment provided by a health care worker who is trained and licensed in working with patients to help them manage Activities of Daily Living (ADLs), such as feeding oneself, dressing, using the toilet, etc., following the patient’s injury, surgery, or illness and sometimes in the midst of the illness.

On-call nurse – A healthcare professional who is available 24/7 to provide immediate medical care, support, and guidance to hospice patients and their families during urgent situations or emergencies.

Outcome and Assessment Information Set (OASIS) – A standardized data collection tool used by home health agencies to assess patient needs, measure outcomes, and improve the quality of care provided.

P
Palliative care – Treatment of patients that is centered around lessening the pain and managing the symptoms experienced by a person with a life-limiting illness. The goal of palliative care is to provide comfort to the patient, rather than a cure for his illness.

Patient’s Bill of Rights – A document that outlines the fundamental rights and protections for patients within the healthcare system, ensuring they receive respectful, informed, and safe care. It covers aspects such as the right to information, the right to choose healthcare providers, the right to privacy, and the right to make decisions about their treatment.

Physical Therapy – Treatment provided by a health care worker who is trained and licensed in helping patients to regain as much mobility, strength and independence as possible following surgery, an illness, or an injury.

Physician orders for life-sustaining treatment (POLST) – A medical order that includes resuscitation and treatment preferences.

Plan of Care (POC) – A detailed, individualized roadmap created by healthcare providers outlining the specific medical, psychological, and social interventions needed to address a patient's unique health issues, goals, and preferences. It serves as a collaborative guide to ensure consistent and comprehensive care delivery.

Post-acute care – A setting in which patients receive care after or in lieu of an acute care stay, such as inpatient rehabilitation hospitals, home health and skilled nursing facilities (SNF).

Power of Attorney – A document used by an individual to designate one person to act on his behalf in legal matters.

Primary care physician (PCP) – Refers to the doctor you see regularly for check-ups. They work closely with home health and hospice teams to create a plan of care specific to each patient’s needs.

Prognosis – A physician’s estimate about how a disease will progress. Diagnoses vary by patient, by illness and by the probability of being cured.

Pulmonary – Relating to the lungs and lung functions.

R
Registered nurse (RN) – Education and licensing requirements vary by state, requiring either an Associate of Science in Nursing degree (ASN) or a Bachelor of Science in Nursing degree (BSN), in addition to passing a licensing exam.

Rehabilitation – It involves a structured program of therapy and exercises designed to restore strength, function, and mobility, helping patients recover and improve their quality of life.

Renal – Relating to the kidneys and kidney functions

Respite care – A term used to describe relief provided to the patient’s primary caregiver by a volunteer who stays with the patient so the caregiver can leave the house to tend to business and family, run an errand, etc.

Respite stay – An arrangement provided at Hospice House—on a case-by-case basis—to provide care for a terminally-ill patient for as many as five days to provide a time of rest for the primary caregiver.

Routine home care – A level of hospice care provided in the patient's home, focusing on managing symptoms and providing comfort through regular visits from the hospice team, including nurses, aides, and other professionals.

S
Skilled care – nursing care usually provided at a skilled nursing facility or at a rehabilitation center, but care than can also be provided at home. It also includes physical, occupational, and speech therapy.

Social worker – in hospice, a professional trained in evaluating the well-being of a patient, and in supporting a patient’s wishes. Hospice social workers help patients in managing and dealing with stress. They are also experts in finding resources available in the community that can help patients and their family members.

Speech-Language Pathologist – a professional specializing in the evaluation and treatment of patients with voice disorders, swallowing difficulties or communication disorders that can occur because of a stroke, neurological disease, or other illness.

Subacute care – A type of comprehensive, intermediate care provided to patients who need more intensive medical services than typical long-term care but do not require the full resources of a hospital, often following a serious illness or surgery.

T
Transfers – Movement of a patient from one place to another. Depending on context, may refer to movement from a bed to a wheelchair, relocation from one ward to another or from one facility to another.

Terminal restlessness – A condition often seen in the final stages of life, characterized by agitation, confusion, and anxiety, making it difficult for patients to remain calm or still.

V

Ventilator withdrawal – The process of discontinuing mechanical ventilation for a patient, often in the context of end-of-life care, allowing natural breathing to cease and providing comfort during the dying process.

Veterans benefits – Government-provided services and financial assistance programs designed to support military veterans and their families, covering areas such as healthcare, education, disability compensation, and housing. These benefits recognize the sacrifices made by veterans and aim to ensure their well-being and successful reintegration into civilian life.