Glossary of Terms

MADSA has researched these terms and believes them to be correct. Our goal is to help you with information that is related to ADULT DAY HEALTH and to elder care in general.

Please visit our Useful Links page to link to a number of the agencies and resources listed below.

Activities of Daily Living (ADLs)
Basic self-care tasks that are essential for day-to-day functioning such as the ability to bathe, dress and undress, eat, toilet, transfer in or out of a bed or chair, get around inside one’s own home, and maintain continence. The need for assistance in performing one or more of these self-care activities usually indicates the need for some type of supportive care or supportive housing services.
Adult Day Care
A community-based group program designed to meet the needs of functionally impaired elders and other adults who can benefit from participating in group settings. Most programs include group exercise, adult education classes and recreation, nutritious meals, and social work services. Please see next term.
Adult Day Health (ADH) Care
A community based program more advanced than adult day care — these programs are designed for elders and person with disabilities who need a higher level of care, but still benefit from receiving services in a group setting. Services provided can include: nursing supervision; monitoring of vital signs, blood glucose, blood pressure, medications, and other health issues; assistance with bathroom visits; dietary counseling and supervision; recreation and socialization; physical, occupational and speech therapies; psychological counseling; and an Individualized Plan of Care. Nutritious meals and transportation are included. All services are supervised by trained geriatric specialists. These ADH day-time programs provide family members or other caregivers with respite so they can work/attend to other responsibilities. Starting in Fiscal Year 2012–2013, ADH Programs in Massachusetts will undergo licensure by the Department of Public Health.
Aging Services Access Points (ASAPs)
Massachusetts has 27 ASAPs across state. They are private, non-profit, state-designated agencies under contract with the Mass. Executive Office of Elder Affairs to provide a single-entry point for seniors and caregivers to access a variety of programs and services. ASAPs provide the following direct services: Information and Referral; interdisciplinary case management: intake, assessment, development and implementation of service plans; monitoring of service plans; and reassessment of needs; and Protective Services: investigations of abuse and neglect of elders. They follow Mass Health guidelines and look at family income. They can approve a couple of days of ADH services per week. They service lower-class Medicare seniors who don’t qualify for Medicaid but can’t afford private.
Area Agency on Aging (AAA)
There are 23 of these agencies in MA and they were established under federal law, the Older Americans Act (OAA), to respond to the needs of Americans aged 60 and over in local communities with the goal of keeping seniors living independently in their own homes. Most “Triple A’s” as they are called, are also ASAPs (see above), so they work with the Mass. Executive Office of Elder Affairs to plan and provide social services and nutrition services for elders, and some support for caregivers.
Alzheimer’s Unit or Alzheimer’s Care
A facility with a specialized unit or program designed to meet the needs of people with Alzheimer’s disease or other cognitive impairments. Such programs usually feature more specially designed, secure environments, structured activity programs and more intensive staffing and specialized training than typical Adult Day Health Programs. (The Alzheimer’s Foundation is listed on our Useful Links page)
Assisted Living Facility (ALF) or Assisted Living Residence (ALR)
These are facilities that combine housing and supportive services for elders, including assistance with activities of daily living (ADLs) (see above). These participants do not require the level of 24-hour nursing and medical care provided by nursing institutions.
CARF Accredited
The Commission on the Accreditation of Rehabilitation Facilities (CARF), a private accreditation agency, choses to review some facilities and notes if they are in compliance with CARF quality standards. (CARF is listed on our Useful Links page.)
Center for Medicare & Medicaid Services (CMS)
has oversight of and rules for state agencies such as Mass Health. (See Medicare, Medicaid below)
Community Support Facility
Refers to residential care facilities (rest homes) licensed to provide care to individuals with mental health problems.
Continuing Care Retirement Community (CCRC)
A residential community designed to accommodate the needs of elders who can no longer live alone. CCRCs offer a full continuum of care, ranging from independent living units, to assisted living residences, to a skilled nursing facility care unit, usually all on one campus.
Council on Aging (COA)
COAs are municipally appointed volunteer agencies that provide services to elders, families, and caregivers. There are 348 COAs serving the state’s 351 cities and towns. While each COA is unique to its community, most councils offer information and referral, transportation, outreach, meals (congregate and home delivered), health screening, and fitness and recreation programs. In our state, local COAs belong to the Massachusetts Council on Aging. (MCOA is listed on our Useful Links page). Note: The City of Peabody is the only municipality in MA that has its own ADH program.
A progressive decline of cognitive function, such as memory, concentration, and judgment, due to damage or disease of the brain beyond the natural process of aging. Dementia is sometimes accompanied by emotional disturbance and personality changes. Some ADH facilities are dementia specific, providing specialized care for such participants.
Executive Office of Elder Affairs (EOEA)
EOEA is the lead state-wide agency in Massachusetts on aging and elder care issues. Among services offered are the Home Care Program, the Family Caregiver Support Program, a toll-free telephone help line (1-800-AGE-INFO) and website with elder care information. (EOEA is listed on our Useful Links page.)
Gateway organizations
An agency or organization that provides eldercare information and programs and is a key point of connection for elders and caregivers to access additional elder care resources and service providers. In Massachusetts, key gateway organizations include: the MA Executive Office of Elder Affairs, Aging Access Service Points (ASAPs), Area Agencies on Aging (AAAs) and local Councils on Aging (COAs.).
Group Adult Foster Care (GAFC)
This is a MassHealth program that pays for some assisted living 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. Some of these individuals have their room and board expenses covered by the state’s SSI-G program. (See SSI-G below)
Health Insurance Portability and Accountability Act (HIPAA)
A federal law that ensures privacy provisions for health information and sets rules and limits on who can see an individual’s health information. The law must be followed by health care providers and institutions, and certain government programs that pay for health care, such as Medicare and Medicaid. Information put in medical records, as well as insurance and billing records is protected. (HIPAA is listed on our Useful Links page.)
Hospice Care
A public or private organization or facility that provide end of life care, such as pain relief, symptom management, and supportive services to the terminally ill people and their families in the home, or in a hospice facility. Some health facilities provide this service.
Hospital Skilled Nursing Unit or Transitional Care Unit (TCU)
These units, often located in a hospital, provide short term care to individuals who have been hospitalized but additionally need a period of medical monitoring and/or rehabilitation before returning home.
Independent Living Units
These housing units include some basic services such as meals and housekeeping, usually for a fee. These units may exist in a Continuous Care Retirement Community (CCRC) that also has assisted living units and a skilled nursing facility. (See CCRC above).
In-Home Services
Services provided under the federal Older Americans Act by all Area Agencies on Aging (AAA). They include homemaker and home health aide services, in-person and telephone reassurance, chore maintenance, in-home respite care (including adult day care) and minor home modifications.
Intermediate Care Facility (ICF)
A nursing home which provides health-related services to individuals who do not require the degree of care or treatment given in a hospital or skilled nursing facility, but who -because of their mental or physical condition – do require care and services which are greater than custodial care and can only be provided in an institutional setting.
JCAHO Accredited
A facility, like a hospital, that voluntarily chooses to be reviewed by the Joint Commission on the Accreditation of Health Care Organizations (JCAHO), a private accreditation agency which indicates if the facility is in compliance with JCAHO quality standards. (JCAHO is listed on our Useful Links page.)
Part of the Mass. Executive Office of Health & Human Services, this is a Medicaid program that offers health care coverage for some low-income and moderate-income families, disabled individuals and persons over age 65 who meet eligibility requirements. The program covers most needed services provided by physicians, dentists, hospitals, clinics, medical equipment suppliers and therapists. (MassHealth is listed on our Useful Links page.)
This is both a state and federal health insurance program providing health care coverage for individuals who either have limited incomes or have been impoverished by their medical expenses. This is called MassHealth in Massachusetts. (MassHealth is listed on our Useful Links page.)
This is a federal health insurance program (Title XVIII of the Social Security Act) that provides coverage for elders (65 years of age and older) and permanently disabled individuals. Medicare Part A provides coverage of inpatient hospital services, skilled nursing facility care (up to 100 days only), home health services, and hospice care. Medicare Part B provides limited coverage for out-patient physician services, outpatient hospital services, ambulance use, durable medical equipment, and some home health care services.
Nursing Home
A general term used to cover a wide range of institutions that provide 24/7 personal care and skilled nursing care. They may also be called Skilled Nursing Facility (see entry below), or Intermediate Care Facilities or Custodial Care Facilities. Not all nursing homes are Medicare approved/certified facilities. (For more information, visit Mass. Senior Care Association on our Useful Links page.)
Primary Care Physician (PCP)
The PCP is a doctor who provides continuing care of varied medical conditions. A PCP generally does not specialize in the treatment of specific organ systems, such as cardiology, nor perform surgery. The PCP often provides referrals to specialized care and services, including Adult Day Health.
Program of All-inclusive Care for Elderly (PACE)
This is a model of managed care for very frail elders who are nursing home eligible but receive services in the community, such as Adult Day Health care and interdisciplinary team case management. In Massachusetts, PACE programs are referred to as the Elder Service Plan. (See Mass. Resources on our Useful Links page.)
Rehabilitative Services also referred to as PT (physical therapy), OT (occupational therapy) and SpT (Speech therapy)
may be provided at certain facilities.
Residential Care Facility (or rest homes)
These are facilities licensed by the Massachusetts Department of Public Health to provide 24-hour supervision and supportive services for individuals who do not routinely need nursing or medical care.
Respite Care
Short term care of an older adult or person with a disability in a nursing facility to enable relatives or others caring for them at home to take some time off from their caregiving responsibilities. Sometimes the participant may then need time in an Adult Day Health Program which allows the caregivers to have respite during the day.
Senior Care Options (SCOs)
A coordinated comprehensive health plan for seniors 65 and older that covers acute and long term care services for MassHealth recipients enrolled in one of the four Senior Care Organizations in MA. Participants have both Medicare & Medicaid. For more information, contact MassHealth at 1-888-885-0484 and click MassHealth on our Useful Links page. (Also see Mass. Resources on our Useful Links page.)
SHINE (Serving the Health Information Needs of Elders Program)
A program of the Executive Office of Elder Affairs providing free, confidential and unbiased health insurance counseling through a volunteer network of health benefits counselors. Information is provided to elders about Medicare, Medigap Insurance, Medicaid, HMOs, public benefits, retiree health plans, individual insurance, prescription drug charge coverage, health insurance counseling, and other health insurance options.
Short Term Stay
This refers to a stay of less than 100 days in a nursing and rehabilitation facility, for the purpose of regaining function and wellness after surgery, illness or injury.
Skilled Nursing Facility (SNF)
SNFs are nursing homes that provide health care services for residents, typically frail elders, whose general condition tends to be unstable, and requires close observation and care given by professional staff over a 24-hour period. Some skilled care is financed by Medicare; however, the majority must be covered by private funds or Medicaid. Some SNFs have rehabilitation programs that provide short term, intensive rehabilitative care for those who have been hospitalized and need rehabilitation before returning home. Note: Half of those admitted to such a nursing facility return to their own home.
This is a state-funded program that pays the room and board expenses of individuals who receive federal Supplemental Security Income (SSI) and live in assisted living residences that participate in the state’s Group Adult Foster Care program. (See Group Adult Foster Care above).
Supportive Housing
This type of housing is an “assisted living like” environment in state-funded, public elderly/disabled housing. Services are provided on an as needed basis 24 hours a day. Supportive housing is available through the Supportive Housing Initiative Program run by the Executive Office of Elder Affairs and the Department of Housing and Community Development in Massachusetts. (EOHHS is listed on our Useful Links page.)
Veteran’s Benefits
The Veteran’s Administration provides medical services and other benefits to honorably discharged ex-service members and sometimes to their dependents. For those without service-connected disabilities, income and asset restrictions may apply. Many ADH programs have participants who are veterans and covered by these benefits. (Dept. of Veterans Affairs is listed on our Useful Links page.)
Visiting Nurses and Visiting Nurse Associations (VNA)
Visiting nurses are registered nurses who provide skilled nursing, rehabilitation and hospice services at home. Visiting Nurse Associations are well-known membership associations of home health care providers in a particular region or city, and they are connected by a network of partnerships with regional insurers, hospitals and clinics, and healthcare providers. Some VNAs have Adult Day Health programs. (VNA of America is listed on our Useful Links page)

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