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.

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.

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. 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.

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.

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.

E

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.

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.

H

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.

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.

I
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.

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.

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.

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.

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.

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.

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, 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.

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.

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.