ADLs (Activities of Daily Living)
An individual's daily routine, including bathing, dressing, grooming, eating, walking, using the telephone, taking medications and other personal care activities.

Admission Agreement
A contract that is drawn up between the facility (community) and the resident specifying the services that will be provided by the facility, the monthly rates, the house rules, the visitor policy and conditions under which a resident may be asked to leave the facility.

Advanced Directive
A written instruction about who can make health care decisions when the elder is unable to do so for him/herself. Advance directives include a Durable Power of Attorney for Health Care and a Declaration pursuant to the Natural Death Act/living will. The advance directive indicates choices for medical treatment and/or designates who should make treatment choices if the elder loses his/her decision-making capacity.

Aging in Place
Providing the opportunity for an elder to remain in their "home" until their care requires a skilled nursing facility or continual medical attention. "Home" maybe their own home or moving into a sheltered community that can provide all levels of care until hospitalization becomes necessary.

Ambulatory
For purposes of residential living an ambulatory individual is one who can exit a building without any mechanical (walker or wheelchair) or personal assistance. A cane is acceptable under the ambulatory definition.

Assisted Care/Residential Care/Board and Care
These terms are synonymous for facilities that are licensed by the State of California. Facilities that provide non medical care and supervision 24 hours a day. The facilities may accept non-ambulatory residents, they will provide assistance with ADLs and they vary in size and price.

Board and Care/Assisted Care/Residential Care
These terms are synonymous for facilities that are licensed by the State of California. Facilities that provide non medical care and supervision 24 hours a day. The facilities may accept non-ambulatory residents, they will provide assistance with ADLs and they vary in size and price.

Care Management/ Case Manager
Coordinates all social and medical needs of the client. A care manager provides support on an on-going basis to insure a stable environment through assessing the client's needs, planning and implementing program delivery and follow-up assessment.

Continuing Care Communities
(see life care communities)
Elder Communities similar to Life Care but usually more flexible in terms of allowable health, service and age at entry. Monthly fees rise as the level of care raises.

Conservator:
A court appointed individual who has the power to make decisions on behalf of a senior. These conservatorships may be granted for financial and/or personal and health decisions.

Custodial Care/24 Hour Care
Terms often used by health professionals that are interchangeable with the terms 24-hour residential care, non-nursing home care or home care. Custodial care is help and supervision with ADLs.

Dementia
A deterioration of intellectual function and other cognitive skills leading to a decline in the ability to perform activities of daily living (Merck Manual of Geriatrics 2nd edition 1996).

Durable Power of Attorney
An individual who has been granted the power to manage financial affairs of another. It can either be "immediate", meaning the agent can act immediately on behalf of the elder or "springing", in which case the agent can act only when the person becomes incapacitated.

Durable Power of Attorney for Health Care
An individual who has been granted the power to make medical decisions for an elder when the elder is unable to speak for himself.

Facility Evaluation
An inspection made of the elder community by the Registry. The Stegner Registry makes an on-site visit to each community in the Registry at least once a year. All health and safety procedures are reviewed, other conditions reviewed are: cleanliness, odors, home-like environment, staff proficiency, food preparation and eating environment (when possible), activities provided, social interaction between staff and other residents, physical and functional level of residents, outdoor surroundings and the overall emotional warmth of the home.

Hospice Care
Specialized health care and emotional support for individuals in the advancing stages of a terminal illness. Hospice care allows terminally ill persons to live their lives as fully as possible and to remain in their "home" until their death occurs. Some assisted living communities have received "hospice waivers" permitting them to retain the elder under hospice care.

Continence/ Incontinence
The ability or lack there of to either inform someone or personally toilet oneself (bladder and bowel).

License Evaluation
A review of each community license is made at the time of admission into the Registry. Any community that has a history of violations of health and safety regulations are not accepted into the Registry. If a community is placed on Probation by the Community Care Licensing Agency, no referrals are made. A Community is removed from the Registry if they lose their license or have repeated health and safety violations.

Licensed Facility
All non-medical facilities that provide hands on care and/or supervision must be licensed by the State of California, Department of Social Services, Community Care Division prior to accepting residents. Licensed facilities are inspected yearly, administrators have met the educational requirements and the facility has successfully met structural requirements and fire codes. Records are open for review at the Department of Social Services.

Life Care Communities
Elder communities that require an extensive entry fee and a monthly fee. Entry fees and monthly fees are dependent on the size of the apartment the elder chooses. Monthly fees stay the same no matter what level of care the resident may subsequently require. Life Care Communities offer progressive levels of assistance to meet the changing needs of the elder. Residents are required to enter at the Independent Living Level, must be in relatively good health and usually under the age of 87. Care is guaranteed for life. These communities offer Independent Living, Assisted Living and Skilled Nursing.

Living Will/ California Declaration
A living will allows one to specify in advance ones wishes about withdrawing or withholding medical cares in the event of a terminal illness or the inability to make medical decisions.

Medi-Cal/Medicaid
Medi-Cal is a federal financial health care program that helps the state in providing financial assistance for low income and needy persons with limited assets. Medi-Cal can provide financial assistance for patients in Medi-Cal certified nursing care centers who meet specific financial requirements. This does not provide any financial assistance to Assisted Care Facilities.

Ombudsman
A free service funded with government monies to assist in resolving complaints regarding long term care facilities. See Additional Resources.

Respite Care
A temporary stay, the length of which is specified at the time of admission. For example, the senior's primary caretaker is unavailable or the senior is recovering from surgery.

Retirement Communities
Elder communities that offer at least two levels of care on the same campus, Independent Living and Assisted Living is usually offered and sometimes Skilled Nursing. Fees are billed monthly. There is usually a entry fees or deposit. Care for life is not guaranteed. Some communities have extensive Independent Living units with only a minimal number of Assisted Living units so that more extensive care may not be available at the time the resident needs it. Most Retirement Communities have all of their units covered under Licensing so that Assisted Living services can be brought to the resident when needed.

Retirement Condominiums
Units that vary in size from studios to multiple room apartments that are purchased by the senior and require a monthly "condo" fee. The monthly fee generally includes one or more meals, social activities and other amenities as well as a Long-term Care Insurance Policy. Retirement Condos do not usually provide personal care as part of their initial package and are not required to obtain a Residential Care License.

Retirement Hotels
Residential Hotels that provide services to elders only. Hotel services usually include meals, housekeeping and other typical hotel amenities in the monthly fee. They do not provide personal care or supervision. They are not required to obtain a Residential Care License.

Skilled Nursing Facility (SNF)
Facilities that provide 24 hour supervised skilled nursing care and includes meals, housekeeping, assistance with ADLs and therapeutic/rehabilitative nursing services. In California these facilities are licensed and regulated by the California Department of Health Services.

SSI
Supplemental Security Income is a monthly benefit including eligibility for Medical. It is administered by the Social Security Administration. Eligibility is based on disability and financial need.