Insider Language about Long Term Care
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Long-term care has its own language, and the terms are constantly evolving. Those who are fluent in this language sometimes forget that newcomers to the field don't understand their acronyms, short-hand, and jargon.
Just to get started, however, here are a few of the terms commonly used in the new world of long-term care that you may encounter. As you move forward, don't hesitate to ask when someone uses a term you don't understand or seems to be using a term in a way that is unfamiliar.
Activities of daily living are ordinary tasks like bathing, eating, getting dressed, and going to the bathroom that most people don't think twice about but that become difficult for a person who is ill or has a disability.
Assistance with ADLs can range from lending a hand, literally or figuratively, to heavy lifting and total responsibility for carrying out the task. The number of ADLs is often used as a benchmark for eligibility for long-term care insurance benefits or nursing home or home-based services.
Acute care: The type of care provided in hospitals to treat an illness or accident that needs immediate attention. Acute care is distinguished from chronic care, which treats illness that last for a long time, and long-term care, which may involve episodes of both acute care and chronic care.
Coordinating care among acute care and chronic and long-term care is often a job that falls to family members or to the person needing the care.
Assisted-living facilities (ALFs): Even though most people have heard of assisted living, there is no standard definition. States vary in what they call these facilities and how they regulate them, if they do at all. Generally, however, assisted-living facilities are group settings for people who need assistance in ADLs or IADLs but do not require nursing home level medical care. (See Chapter 6.)
Instrumental activities of daily living (IADLs): These activities are the common household or management tasks such as paying bills, organizing transportation, shopping, laundry, and the like. They often go hand in hand with ADLs because the person who needs assistance with physical care may not be able to drive or shop alone.
Even using the phone with all the complicated prompts that one encounters today may be difficult for someone with, for example, severe arthritis. But needing assistance with ADLs or IADLs is not necessarily associated with cognitive decline.
Skilled nursing facility (SNF): A nursing home that can provide skilled nursing care that can only be provided by a nurse, such as injections, and rehabilitation services, such as physical therapy, and is certified to meet federal and state standards.
Transfer: Here's a term that has several meanings. In long-term care jargon, it usually means moving a person from bed to chair or the reverse. Someone who is a two-person transfer requires not just one but two aides to do the job. This may be because the person is obese, paralyzed, or has another condition that makes it unsafe for both person and helper to manage alone.
The second meaning of transfer refers to moving a person from one setting to another, such as from an assisted-living facility to an emergency department.
You will find that different people interpret terms differently and that agencies and insurance companies often have their own interpretations of what counts as, for example, medically necessary, which is often the trigger for benefits.
To keep everything straight, write down the information you're given when it relates to eligibility or another aspect of services along, with the name, title, and contact information of the person who gave you the information. And if you don't like the definition you're given by someone, you may be able to get a more favorable interpretation from a supervisor after you've explained the situation.