Senior Care Glossary: Every Term Families Actually Encounter

Family guide · Updated July 20, 2026

Senior care has a vocabulary problem: everyone in the industry speaks it, and no one hands families a dictionary. Here’s ours - every term in plain English, with a link to the full guide when there’s more to know. Bookmark it; you’ll hit these words on every tour, contract, and phone call. Start with the abbreviations, then read the fuller definitions below.

Abbreviations, A to Z

The acronyms you’ll see on brochures, contracts, and inspection records, with what each stands for. The fuller definitions are in the sections that follow.

Care and daily living

• ADLs (Activities of Daily Living) - the basics of self-care: bathing, dressing, eating, toileting, transferring (getting in/out of bed or a chair), and continence. Care levels and costs are largely set by how many ADLs a person needs help with.
• IADLs (Instrumental ADLs) - the life-management tasks: cooking, cleaning, driving, managing money and medications. Trouble with IADLs usually shows up years before trouble with ADLs.
• Care level / level of care - a community’s internal tier (Level 1, 2, 3 or a points system) assigned after assessing your parent; it sets the real monthly price above base rent. See assisted living.
• Care assessment - the evaluation a community performs before move-in (and periodically after) to set the care level. Ask for the resulting cost in writing.
• Aging in place - staying in one home or community as needs grow, rather than moving at each stage.
• Memory care - secured, dementia-specific care with trained staff. Full guide.
• Sundowning - increased confusion or agitation in late afternoon/evening, common with dementia; a reason memory care staffing patterns matter.
• Elopement - the industry term for a resident with dementia leaving a building unsupervised; secured units exist to prevent it.
• Two-person transfer - needing two staff members to move safely (bed to wheelchair, etc.). Many assisted living communities can’t accommodate it - a common discharge trigger to ask about.
• Respite care - a short-term stay for caregiver relief, recovery, or a trial run. Full guide.
• Hospice / palliative care - comfort-focused care; palliative alongside treatment, hospice near end of life (a Medicare-covered service, not a place). Full guide.

Housing types

• Independent living (IL) - housing plus meals, activities, and housekeeping; no hands-on care. Full guide.
• Assisted living (AL / ALF) - daily personal-care help in a residential setting; not a medical facility. Full guide.
• Skilled nursing facility (SNF / “nursing home”) - 24/7 licensed nursing care; also where Medicare-covered short-term rehab happens. Full guide.
• CCRC / Life Plan Community - one campus with every care level and a contract (types A/B/C) that governs lifetime costs; usually an entrance fee. Full guide.
• Adult family home / adult foster home / RCFE / board and care - state names for small residential care homes (roughly 5-10 residents) run in houses; often owner-operated with high attention. Full guide.
• Home care vs. home health - home care is non-medical help (aides, companionship), paid privately or by Medicaid; home health is physician-ordered skilled care (nursing, therapy) that Medicare covers short-term. Full guide.
• 55+ / active adult community - age-restricted housing with no services; real estate, not care.

Money and contracts

• Base rent vs. care charges - the advertised price vs. the assessed care fees added on top; the real bill is both. How the bill is built.
• Community fee / move-in fee - a one-time charge at move-in, often $1,500 - $5,000+, usually negotiable. Hidden fees guide.
• Second-person fee - the added charge when a couple shares an apartment. Couples guide.
• Entrance fee - the large upfront payment at most CCRCs ($100k - $1M+), with varying refundability.
• Long-term care (LTC) insurance - private insurance that reimburses care costs; claiming it takes paperwork and persistence. Paying for care.
• VA Aid & Attendance - a Veterans Affairs pension add-on that helps qualifying veterans and surviving spouses pay for care.
• Medicare vs. Medicaid - Medicare covers short-term skilled care only; Medicaid covers long-term nursing home care (and some assisted living via waivers) for people with limited assets. The full comparison.
• HCBS waiver - a state Medicaid program (every state names its own) that pays for care outside nursing homes - assisted living, small homes, or in-home care. Often waitlisted.
• PACE (Program of All-Inclusive Care for the Elderly) - a Medicare/Medicaid program that coordinates all of a frail person’s care so they can keep living at home; available only in areas with a PACE organization.
• Spend-down - using up assets on care until Medicaid’s financial limits are reached.
• Look-back period - Medicaid’s review of the past 5 years of financial transfers; gifts in that window can delay eligibility.
• Spousal impoverishment protections - Medicaid rules letting the at-home spouse keep a portion of income and assets.
• MERP (Medicaid Estate Recovery Program) - the state’s claim against the estate after a Medicaid recipient 55+ dies. What families need to know.
• Private pay - paying from savings/income; many communities require 1-2 years of it before accepting Medicaid.

Quality and oversight

• CMS / Care Compare / five-star rating - the federal rating for nursing homes, built from health inspections, staffing data, and quality measures (not consumer reviews). The components use different data sources, so read them separately. What the stars mean.
• CCN - a nursing home’s CMS Certification Number; the key to its federal record.
• Survey / citation / deficiency - an inspection, and the findings when a rule isn’t met; comes with a required plan of correction (POC). How to read records fairly.
• F-tag - the code number for a specific federal nursing-home requirement in an inspection report (for example, F689 for accident hazards); the tag tells you which rule the finding is about.
• Scope and severity - the grid (letters A to L) surveyors use to rate how serious and widespread a deficiency is; higher letters are worse.
• Immediate Jeopardy (IJ) - the most serious finding: a situation that has caused or is likely to cause serious harm. Rare, and a strong signal.
• Special Focus Facility (SFF) - a nursing home CMS has flagged for a persistent pattern of serious problems and put under extra inspection; there is also an SFF “candidate” list. Worth knowing if a facility appears on either.
• Substantiated complaint - an allegation the state investigated and confirmed. One is not disqualifying; patterns are.
• MDS (Minimum Data Set) - the standardized resident assessment nursing homes submit; much of the quality-measure score is built from it.
• PBJ (Payroll-Based Journal) - the payroll-based staffing data facilities report to CMS, used for the staffing rating.
• Long-Term Care Ombudsman - a public advocate for residents in every region; free to call, knows every building’s reputation.
• Area Agency on Aging (AAA) - your county’s public aging-services hub; free options counseling. Find yours via the Eldercare Locator (1-800-677-1116).
• SHIP (State Health Insurance Assistance Program) - free, unbiased Medicare counseling in every state; the place to take coverage and billing questions.
• Adult Protective Services (APS) - the state agency that investigates suspected abuse, neglect, or financial exploitation of vulnerable adults.
• Staffing ratio - residents per caregiver on a shift; rarely published, always worth asking. What to ask.

People you’ll meet

• Placement specialist / senior living advisor - helps families find communities, paid a referral fee by the community chosen (like a realtor’s commission). How that works.
• Geriatric care manager (aging life care professional) - a nurse or social worker you pay hourly to assess, plan, and advocate; no placement commissions.
• Discharge planner - the hospital staffer arranging where a patient goes next, often on a 24-48 hour clock.
• Med tech / medication aide - trained (non-nurse) staff who administer routine medications in assisted living, where state rules allow.
• CNA (Certified Nursing Assistant) - the certified caregivers who provide most hands-on care in nursing facilities.
• RN (Registered Nurse) - the highest routine nursing license; assesses residents, manages care plans, and handles clinical decisions. Ask whether an RN is in the building overnight or only on call.
• LPN / LVN (Licensed Practical / Vocational Nurse) - a licensed nurse who gives medications and treatments under an RN’s direction.
• Director of Nursing (DON) - the nurse who runs clinical care for the whole community; their tenure is worth asking about, since turnover here often shows up in care.
• Executive Director (ED) / administrator - the person who runs the community day to day. Leadership churn tends to drive staff churn. Why tenure matters.

Legal and medical directives

These come up in admission paperwork and care planning. Definitions vary by state, and none of this is legal or medical advice - confirm the specifics with an elder law attorney and your parent’s doctor.

• Advance directive - the umbrella term for written instructions about future care, including a living will and a health-care power of attorney.
• Power of Attorney (POA) / Durable POA (DPOA) - a document letting someone act for your parent on financial or health matters; “durable” means it stays in effect if your parent loses capacity. Communities often ask who holds it.
• DNR (Do Not Resuscitate) - a medical order not to perform CPR if the heart or breathing stops; it does not mean “do not treat.”
• POLST / MOLST - portable medical orders (Physician/Medical Orders for Life-Sustaining Treatment) that travel with your parent across settings; the name and form differ by state.
• Guardianship / conservatorship - a court-appointed authority to make decisions for someone who can no longer make their own; a last resort, since it removes rights. Talk to an attorney before pursuing it.

Missing a term you ran into? Email us - if one family hit it, others will: hello@senior.living.community.