Glossary of Long
Term Care Terms and Definitions
Activities of Daily
Living: Most LTCI policies pay benefits based on the inability to
perform at least two out of six activities necessary for independent living.
The list may include dressing, bathing, feeding, toileting, transferring and
continence.
Adult Day Care:
Usually provided at senior or community centers and may be simply recreational
or include occupational and physical therapy. Some organized programs include
meals and may provide transportation.
Asset Spend Down:
Procedure in which an individual diminishes income and assets to reach the
minimum required levels of one's state in order to be eligible for Medicaid
assistance.
Assisted Living:
An alternate form of 24-hour personal or custodial care provided in a facility,
which is licensed by the state and meets other specified criteria.
Benefit Period:
The length of time for which benefits in a long-term care insurance contract may
be paid. For example: one, two, three, four, five years or lifetime.
Cognitive Impairment:
One of the measurements used to determine eligibility for long term care
benefits in a policy. It is a deterioration or loss of one's intellectual
capacity, confirmed by clinical evidence and standardized tests, in the areas of
short- and long-term memory; orientation as to person, place, and time and
deductive or abstract reasoning.
Custodial Care:
The level of care required by a majority of all nursing home and home care
recipients. This is normally defined as assistance with activities of daily
living, taking medications and other personal needs.
Elimination Period:
Under a Long Term Care Insurance contract, this is the period of time during
which no benefits are payable. It may be thought of as a deductible. Elimination
periods are defined in days, normally 0,30,60,90,180 and 365 days.
Guaranteed Renewable:
The terms under which you can continue the coverage under your Long Term
Care Insurance policy. This type of renewability guarantees that the policy
cannot be cancelled by the insurance company.
Home Care:
Includes a wide range of services provided at home by health aides and
homemakers, part-time skilled nursing care, speech therapy and physical or
occupational therapy.
Intermediate Care:
Occasional nursing and rehabilitative care that can only be performed by, or
under the supervision of, skilled medical personnel. This care must be ordered
by a doctor.
Long Term Care (LTC):
Services delivered over a sustained period to persons who have lost some
degree of physical or cognitive capacity. LTC is provided to people who suffer
from any chronic or disabling condition.
Medicare: The
federal program providing people 65 and older, some disabled persons and those
with end-state renal disease, with hospital and medical insurance. It provides
limited benefits for nursing home and home care services under narrowly defined
circumstances.
Medicare Supplemental
Insurance (Medigap): This is private insurance that supplements gaps in
Medicare coverage and is available in 10 standardized options, designated "A"
through "J."
Nursing Home: A
facility that provides room and board and a planned, continuous medical
treatment program, including 24-hour-per-day skilled nursing care, personal care
and custodial care.
Skilled Nursing Care:
Daily nursing and rehabilitative care that can be performed only by, or
under the supervision of, skilled medial personnel. Examples of skilled care
are physical, occupational or speech therapy.
