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  • Activities of Daily Living (ADLs)

    Daily functions such as getting dressed, eating, taking a shower or bath, going to the bathroom, getting into a bed or chair, or walking from place to place. The amount of help a person needs with ADLs is often used as a measure to determine whether he or she meets the requirements for long-term care services in a nursing home as well as government subsidized home-and community-based services. (Also see Instrumental Activities of Daily Living.)

  • Acute Care

    Medical care for health problems that are new, quickly get worse, or result from a recent accident. Acute care has recovery as its primary goal, typically requires the services of a physician, physician assistant, nurse practitioner, nurse, or other skilled professional, and is usually short-term. It is usually provided in a doctor’s office, a clinic, or a hospital.

  • Adult Day Services

    Community-based programs that provide meals and structured activities for people with cognitive or functional impairments, as well as adults needing social interaction and a place to go when their family caregivers are at work. (See also Respite.)

  • Advance Directive

    Legal documents that allow you to plan and make your own end-of-life wishes about health care and treatment known in the event that you are unable to communicate. Advance directives consist of (1) a living will and (2) a medical (health care) power of attorney, sometimes called “health care surrogate,” depending on the state. (See Living Will and Medical Power of  Attorney).

    You can create a living will and medical power of attorney form without a lawyer. However, it is very important that you use advance directive forms specifically created for your state so that they are legal. Caring Connections ( provides free advance directives and instructions for each state.

  • Advance Practice Nurse (APN)

    These are registered nurses with specialized edu-cation and training beyond the basic registered nurse level. Some are called clinical nurse specialists, and some are called nurse practitioners. (See Nurse Practitioner.)

  • Alzheimer’s Disease

    A progressive, degenerative form of dementia that causes severe intellectual deterioration. The first symptoms are impaired memory, followed by impaired thought and speech, an inability to care for oneself and, eventually, death. Onset can be associated with or preceded by depression.

  • Amyloid beta (Aβ or Abeta)

    Amyloid beta is a normal protein peptide in the human brain, but these particles are chemically “sticky” and gradually build up into plaques, or tough fibril-like structures called amyloid plaques in the brains of people developing Alzheimer’s disease. The small clumps may block cell-to-cell signaling at synapses. They may also activate immune system cells that trigger inflammation in the brain.

    Because amyloid beta starts to accumulate in the brain decades before the onset of dementia, ADRC researchers see a window of opportunity to leverage lifestyle changes or new medications to intervene in this early disease process. Clinical trial efforts are underway, at sites such as the ADRC, to test the efficacy of drugs to remove or prevent amyloid beta buildup, and their potential to reduce or delay the onset of cognitive impairment.

  • Aphasia

    Trouble understanding what people are saying or speaking.

  • APOE

    Apolipoprotein E is a cholesterol transport protein and has been found in the amyloid plaques in Alzheimer’s disease. It comes in several types or “alleles” -2, 3, and 4. Each person has two alleles (one from each parent) which you can have in any combination of the three types. Apolipoprotein E-4 has been shown to increase the risk of Alzheimer’s disease but does not cause Alzheimer’s disease, whereas apolipoprotein E-2 decreases the risk of Alzheimer’s disease. Apolipoprotein E-3, the allele that occurs most commonly, neither increases nor decreases the risk of Alzheimer’s disease. (Finding out one’s apolipoprotein E type is NOT a genetic test for Alzheimer’s disease. Although more people with E-4 eventually get the disease than those with E-3 or 2, some people with E-4 never get Alzheimer’s.)

  • Apraxia

    The loss of the ability to perform tasks that require remembering patterns or sequences of movements (like giving a salute).

  • Area Agencies on Aging (AAAs)

    AAAs coordinate and offer services that help older adults remain in their home, if that is their preference. Services might include Meals-on-Wheels, homemaker assistance, and whatever else it may take to enable the individual to stay in his or her own home. By making a range of options available, AAAs make it possible for older individuals to choose home-and community-based services and a living arrangement that suits them best. (See Eldercare Locator.)

  • Assisted Living/Personal Care Homes/Residential Care Facilities

    A state-regulated residential long-term care option that may have different names depending on the state. Assisted living provides or coordinates oversight and services to meet residents’ individualized, scheduled needs, based on the residents’ assessment and service plans, and their unscheduled needs as they arise. There are more than 26 designations that states use to refer to what is commonly known as “assisted living.” There is no single uniform definition of assisted living, and there are no federal regulations for assisted living. In many states, most assisted living is private pay. Be sure to check with your state about any waiver programs that might be available through Medicaid to pay for the care provided in assisted living.

  • Autonomy

    A person’s ability to make their own choices.


  • Care or Case Manager

    A nurse, social worker, or other healthcare professional who plans and coordinates services for an individual’s care. This person usually works for an agency or care setting. (Also see Geriatric Care Manager.)

  • Care Plan

    A detailed written plan that describes what is needed for an individual’s care and provided by a range of health professionals, including nurses, therapists, social workers, nursing or personal assistants. For those living at home, a good care plan should also list the caregiving activities that family members are able to do, need help learning how to do, and will be doing. “I” Care Plans are written in the first person, as if the person receiving care wrote it her- or himself, and express the desires of the individual for her or his care. Care plans can describe the risks that an individual is prepared to take in exercising his or her autonomous self-determination and choice. Creating the care plan should involve an interdisciplinary team of the care recipient, caregivers, including the nursing assistant, as well as the family as appropriate.

  • Caregiver

    A caregiver is a spouse, family member, partner, friend, or neighbor who helps care for an elder or person with a disability who needs assistance.

  • Case Management

    Assistance for families in assessing the needs of older adults and making arrangements for services to help the older adult remain as independent as possible.

  • Centers for Medicare & Medicaid Services (CMS)

    With a budget of approximately $650 billion and serving approximately 90 million beneficiaries, the Centers for Medicare & Medicaid Services (CMS) plays a key role in the overall direction of the healthcare system. With regard to long-term care, CMS is responsible for regulating and paying nursing homes, home health agencies, and hospices for the care of Medicare and Medicaid (in conjunction with the states) beneficiaries.

  • Certified Nursing Assistant (CNA)

    A person trained and certified to assist individuals with non-clinical tasks such as eating, walking, and personal care. (See definitions for Personal Care and ADLs.) This person may be called a “direct care worker” (DCW). In a hospital or nursing home the person may be called a nursing assistant, a personal care assistant, or an aide.

  • Citizen Advocacy Group (CAG)

    A CAG is a state or regional nonprofit organization dedicated to improving the quality of long-term care. Members of a CAG may include long-term care recipients, their families and friends, citizen advocates, long-term care ombudsmen, and organizations subscribing to the CAG’s purpose.

  • Clinical Trials

    Clinical trials are research studies conducted in people to determine whether treatments are safe and effective. Clinical trials are the best way for researchers to find new ways to detect, slow, treat and hopefully someday prevent Alzheimer’s disease.

  • Cognition

    The process of knowing; of being aware of thoughts. The ability to reason and understand.

  • Cognitive Impairment

    A diminished mental capacity, such as difficulty with short-term memory. Problems that affect how clearly a person thinks, learns new tasks, and remembers events that just happened or happened a long time ago. Problems that affect cognition. (See definition of cognition.)

  • Consistent Assignment

    Residents receive care from the same caregivers (registered nurse, licensed practical nurse, direct care worker/certified nursing assistant) during a typical work week. Consistent assignments give the caregiver and resident the opportunity to build a close relationship, allowing the caregiver to gain a deep understanding of the resident and allowing the resident to develop a true level of comfort and trust with the caregiver.

  • Continuing Care Retirement Community (CCRC)

    A housing option that offers a range of services and levels of care. Residents may move first into an independent living unit, a private apartment or a house on the CCRC campus. The CCRC provides social and housing-related services and might have an assisted living residence and a nursing home, often called the health care center, on the campus. If and when residents can no longer live independently in their apartment or house, they move into assisted living (unless it is provided in their apartment or house) or the nursing home.

  • Cortical Dementia

    Dementia associated with impairment of the part of the brain that affects memory, attention, reasoning and abstract thinking, and arising from disease of the cerebral cortex.

  • Creutzfeldt-Jakob disease

    A rare disorder caused by prions that typically leads to rapid decline in memory and cognition. Most people with this disease die within one year of onset.

  • Cueing

    The process of providing cues, prompts, hints and other meaningful information, direction or instruction—such as adding labels to drawers—to aid a person who is experiencing memory loss.

  • Culture Change

    The common name given to the national movement for the transformation of older adult services, based on person-directed values and practices, where the voices of elders and those working with them always come first. Core person-directed values are choice, dignity, respect, self-determination and purposeful living. Culture change transformation supports the creation of both long- and short-term living environments as well as community-based settings where both older adults and their caregivers are able to express choice and practice self-determination in meaningful ways at every level of daily life. Culture change transformation may require changes in organizational and leadership practices, physical environments, relationships at all levels, and workforce models—leading to better outcomes for all involved. While culture change may focus on elders, it improves the quality of life for all care recipients.


  • Dementia

    Dementia is not a specific disease. It’s an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Alzheimer’s disease is the most common type of dementia.

  • Depression

    Low mood that prevents a person from leading a normal life. It’s more than feeling down or sad. It lasts longer and can affect sleep and appetite. When you’re depressed, you don’t get as much pleasure from things you used to enjoy.

  • Direct Care Staff or Direct Care Worker (DCW)

    An individual working in a nursing home or assisted living community that provides “hands on” help with activities of daily living (ADLs) to residents. (See Certified Nursing Assistant (CNA).

  • Do Not Resuscitate (DNR) Order

    A DNR order, signed by a doctor based on a patient’s wishes, instructs medical personnel to not perform life-saving CPR or other procedures to restart the heart or breathing once they have ceased. Once signed, the DNR directive must be placed in the patient’s chart.

  • Down Syndrome

    A syndrome that causes slowed growth, abnormal facial features and mental retardation. Down syndrome is caused by an extra copy of all or part of chromosome 21. Individuals with Down syndrome develop Alzheimer’s disease in adulthood.

  • Durable power of attorney

    A legal document in which you can authorize another person, usually a trusted family member or friend, to make legal decisions when you are no longer able to do so yourself.

  • Dysphasia

    Not being able to find the right word or understand the meaning of a word.