ACTIVITIES OF DAILY LIVING (ADLs)- personal care necessary for daily living, such as oral hygiene, dressing , toileting, transferring between bed and chair, eating and bathing.

ADULT DAY CARE/SERVICES - a respite care service provided outside the home, designed to meet individual needs and support independence and abilities.

ADVANCED DIRECTIVES - written documents, signed while a person is competent to make decision(s) about instructions stated in the document.

AGE ASSOCIATED MEMORY IMPAIRMENT (AAMI) - a medical condition to describe memory loss that may occur in healthy older persons over 50 years, recognized in 1986 by the National Institute of Mental Health.

AGING IN PLACE - meeting a person's increasing needs in his/her preferred familiar residence.

ANXIETY - feelings of worry, fear, uneasiness, or helplessness possibly caused by many factors.

ART THERAPY - "therapy through art recognizes art processes, forms, content, and abilities, personality, interest, and concerns. Art Therapy can be a means of reconciling emotional conflicts and of fostering self-awareness and personal growth" (American Art Therapy Association, Inc. 1992)

ASSISTED LIVING - residential care settings combining housing, personalized supportive services and health care.

ASSESSMENT - the evaluation, usually of mental, emotional and social status to determine an individual's abilities. Its objectives may be diagnostic, to update a care plan or solve a particular situation.

AUTONOMY - making independent decisions or choices, hopefully retained or involved as one's ability permits.

BEHAVIORAL SYMPTOMS - terms referred to disturbances affecting primarily people with dementia.

BURNOUT - the feeling of becoming overly frustrated and negative experienced by some caregivers.

BURDEN - the impact or consequence of having the responsibility of caring for someone (most frequently with dementia).

CAREGIVER - persons, often relatives who provide assistance (in activities and interaction within the environment) to those who are dependent on others for such assistance.

CARE PLAN - a written action plan which contains the strategies for delivering care to address individual's needs and problems.

CASE/CARE MANAGEMENT - a formal service usually consisting of assessment, arrangement, and coordination of services. Care management and coordination are informal terms. However, case management usually implies a comprehensive assessment, the development of a care plan, evaluating the services, and reassessing the situation. A social worker, nurse, or gerontologist may provide such services.

CARE RECEIVER - a person who may be dependent on another(s) for care in perhaps (?) activities and interaction within the envionment.

CHRONIC ILLNESS - an illness which lasts over an extended period of time and is treated by management rather than with the expectation of a cure.

CO-EXISTING ILLNESS - a medical condition or illness that occurs simultaneously with another and may complicate or obscure diagnosis or treatment of each.

COGNITIVE FUNCTION - describes the way information is processed in the brain with such functions as judgment, memory, perception, etc.

COMPETENCE - usually used in a legal sense, refers to a person's ability to understand information, make an informed choice based on the information and values, and communicate that decision.

CONTINUUM OF CARE - encompasses the different care services and their locations of services considered necessary over the full course of an illness.

CUES - prompts or instructions, verbal, non-verval, landmarks or gestures that assist persons in their daily living.

DEFICITS - physical and/or cognitive abilities (sometimes inappropriate behaviors) lost or presenting difficulty for an individual.

DELIRIUM - a reaction of extreme excitement or confusion to such things as infection, medication, or malnutrition.

DEMENTIA - a significant loss of cognitive functions such as thinking and memory, which interferes with an individual's daily function and everyday life. It may be caused by many different disorders.

DEPRESSION - a prolonged mood disturbance that affects self-worth, outlook, and living. It is capable of cure or improvement and should be diagnosed by a capable professional.

DISORIENTATION - cognitive disability in which time, direction and recognition are confused.

DIFFERENTIAL DIAGNOSIS - the professional clinical evaluation of possible causes of an illness.

ENVIRONMENTAL STIMULI - elements of the physical and interpersonal surroundings that affect an individual. The physical surrounding includes the geographic and climatic effects of the place of residence and the social environment, all of which may impact mood, independence, anxiety, memory, and other reactions highly individualized.

ESTATE PLANNING - thoughtful consideration and planning for an individual's future in the area of finances and property. In some cases planning for health care decisions may begin at this time.

FAMILY EDUCATION - education or training to develop skills or enhance knowledge on a particular topic targeted to families.

FUNCTIONAL STATUS/CAPABILITIES - the measurement (usually through a scale or instrument of assessment) of a person's abilities in activities of daily living or instrumental activities of daily living.

GUARDIAN - a legal term for a person who is lawfully vested with the care of the property and/or person who has been judged legally incompetent.

HOSPICE - a philosophy and approach to care for individuals who are terminally ill. This care is palliative or comfort oriented and assists the family and individuals with their emotional, physical, social, and spiritual needs.

IMAGING TECHNIQUES - methods or tests to view structures and function within the living body to assist with diagnosis of various illnesses.

INCONTINENCE - the loss of bowel and bladder control.

INFORMED CONSENT - a legal term referring to the disclosure and consideration of all relevant facts available on which to base an intelligent decision and consent to a particular medical treatment.

INSTRUMENTAL ACTIVITIES OF DAILY LIVING - secondary level of activities of daily living such as cooking, cleaning, shopping, driving, transportation, etc.

INTERVENTIONS - efforts to modify or decrease the negative impacts of illness.

LIFE EXPECTANCY - the age to which a given person or population is anticipated to live based on survival statistics.

LIFE SPAN - the maximum projected age to which a given person or population is anticipated to live, for example 115 years for humans.

LONG TERM CARE - the extended care (usually outside the home) of an individual who is dependent on others for his/her needs. This usually implies nursing home care, but may include home health or other interventions administered over a prolonged period of time.

MEDICAID - a federal program administered by states to provide health care and services for low-income individuals.

MEDICARE - a federal health insurance program (whose aim is to protect against health care costs, but does not cover all medical expenses nor long term care) for persons over 65 years, particular disabled persons under 65 years and those of any age who have permanent kidney failure.

MEMORY IMPAIRMENT - damage in the brain that interferes with memory processes. This damage may be attributable to numerous conditions, disease or accidents.

MENTAL STATUS - a measure of the cognitive abilities of an individual. An evaluative test instrument, such as the Mini-Mental Status Examination (MMSE) (Folstein, 1975), designed to reveal such difficulties in the measuring instrument. These measures do not address daily function.

MILIEU - refers to the total care atmosphere and its surroundings with the philosophy suggesting that the total environment has the potential for becoming therapeutic or non-therapeutic for the individual experiencing it.

MULTI-DISCIPLINARY TEAM/ INTERDISCIPLINARY TEAM - a group of professionals who share information and consultation related to their skills and training, for a person's care, services, study of gerontological issues of other subjects practiced by multiple disciplines.

MUSIC THERAPY - the use of music therapeutically to address physical, psychological, cognitive and/or social functioning.

NORMALIZATION - making familiar and meaningful activities or behavior for individuals who depend on others for daily activities.

NURSING HOME - an institutional setting that offers 24-hour supervision and care to individuals, usually older persons, who are no longer able to be responsible for themselves in an independent living setting.

OBRA - the Omnibus Budget Reconciliation Act of 1987 which included nursing home reform legislation, focused on resident rights, assessment of a resident's functional status, identification of care needs, outcomes of care and other quality of care issues.

ORGANIC BRAIN SYNDROME - a general term (outdated, as it does not indicate that a differential diagnosis has been performed and/or if treatable conditions have been excluded) referring to conditions for any biologically caused brain disorder.

OMBUDSMAN - and advocate, designated by the State Office on Aging, or Area Agency on Aging to promote quality of care in nursing facilities.

PACING/WANDERING - walking about, either purposefully in a pattern, or andomly in motion.

PERSONAL CARE - assistance with intimate activities (such as grooming, bathing, eating, dressing, etc.) of daily living.

PROFESSIONAL EDUCATION - education on a focused subject for professionals, perhaps with some accreditation process for different disciplines.

PROGRAM ACCESS - equal opportunities/eligibility for individuals to participate in programs or services regardless of diagnosis or disability.

PROGRAMMING - the planned and structured daily routine that includes activities of daily living as well as other activities. It may be broadly defined to include types and frequency of activities, therapeutic programs and staffing patterns, ratios and assignments or the guiding philosophy of programs to meet the needs of residents of particular units, such as special care units (Teresi, 1994).

PSEUDO DEMENTIA - a term used for dementia caused by psychiatric disorders, most commonly depression or other conditions, psychological or physical, whose symptoms mimic dementia, but may be treatable.

PUBLIC AWARENESS - information in a focused area broadly disseminated throughout the community.

REIMBURSEMENT - financial reimbursement for costs incurred by individuals in the care of their loved one.

RESEARCH - study, collection of data, and analysis based on hypotheses regarding a focused topic. It may involve laboratory or clinical study, social and behavioral scrutiny or programmatic evaluation.

RESTRAINT-FREE ENVIRONMENT - surroundings of care where other interventions are used to modify behavior while continuing safety, rather than utilization of restraints (both chemical and physical).

RESTRAINT - control of behavior through physical means (attached or next to the person's body), chemical (as in medications or pharmacological), or environmental (such as locked doors).

RETIREMENT/ LEISURE PLANNING - consideration of and preparation for an individual's use of time and resources after retiring from work.

RETIREMENT COMMUNITY - a group of single or multiple unit residences that are marketed to and utilized by predominately older adults who are retired. Some may be age-restricted. There are often business and retailing amenities and diverse organized interest groups to make the community self sufficient.

RIGHT-TO-DIE - a person's individual medical care choices that impact the end of life. These rights relate to competency, and considerations should include appropriate assessment, advanced directives, quality of life and a supportive environment.

RIGHTS - good and natural expectations that may or may not be assured by law.

SENILE - refers to old age and since originally used to describe older persons who were Dementing, it is often used in place of dementia. Senility encompasses a collection of symptoms that may be caused by a host of different disease processes or conditions.

SHARED RISK - a negotiated agreement between a care provider, a cognitively impaired person and the family in an attempt to balance autonomy and safety without overprotecting the individual.

SHELTERED WORKSHOP - a place of employment structured to maximize the abilities of disabled employees.

SKILLED NURSING FACILITY - provides skilled nursing care and related services for residents who require medical or nursing care, rehabilitation services for injured, disabled, or sick persons, and health-related care and services above the level of board and room and not primarily for the care and treatment of mental diseases.

SPECIAL CARE UNIT - a unit in an institution whose intent is to provide special care to meet the needs of persons with dementia in residential facilities. These differ in name and how each defines and implements the special care.

SUPPORT GROUP - a formal gathering of persons sharing common interests and issues. The participants and facilitators share information, mutual support and often exchange coping skills with one another.

SUPPORTIVE ENVIRONMENT - a specially designed physical and interpersonal environment perhaps with modifications appropriate for a particular disability.

SUPPORTIVE HOUSING - alternative residential care setting (other than skilled nursing facilities) that link housing and services. These may be licensed or unlicensed by state.

SURROGATE - a substitute who makes decisions for someone who is no longer capable of making decisions for him/herself. The surrogate may be appointed as guardian or conservator by a court or identified when the person is competent through a power of attorney process.

THERAPY - a treatment or intervention intended to change an outcome or course of disease.

THERAPEUTIC ACTIVITIES - activities beneficial for a person with dementia. These should be purposeful, dignified, pleasurable, voluntary, simple, and foster self-esteem and independence.

TRANSPORTATION - provision of transportation to and/or from a service often arranged through an agency or organization.

Many of these terms and definitions have been modified from: Alzheimer's Disease and Related Disorders Association, Inc. Patient and Family Services, (1995). Terms and Tips. This can be orderd through The Alzheimer's Association, 919 N. Michigan Avenue, Suite 1010, Chicago, IL 60611-1976; by calling 1-800-272-3900; or E-mail:  info@alz.org

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