Glossary Terms

Alzheimer’s Disease is a type of Dementia. It is a progressive disease that causes degeneration of the brain cells that effects brains proteins consisting of plaques & tangles which leads to impaired cognitive, behavioral & social skills. While the exact cause is not yet known, most researchers believe Alzheimer’s is caused by several factors, including; genetics, lifestyle & environment.

Common symptoms seen in Alzheimer’s Disease that affect memory are forgetting recent events, misplacing items, getting lost, trouble finding words, repeating stories & questions. 

Thinking and reasoning is often affected causing difficulty concentrating & multitasking making it hard to pay bills or manage money.  People with Alzheimer’s often lack judgment and may leave the stove on, or not dress appropriately for the weather.

Behavioral & personality changes are also common.  A person with Alzheimer’s may present with signs of aggression, combativeness, agitation, withdrawal, depression, paranoia or delusions.

Alzheimer’s diagnosis is typically diagnosed by the doctor noting changes in many areas of cognitive and behavioral areas over a period of time and then labeling the changes as possible, probable or definite Alzheimer’s.  Conclusive diagnosis requires a brain biopsy which are only performed after a person has passed. There continues to be a lot of research and development in the area of Alzheimer’s. 

There currently is no cure for Alzheimer’s Disease, but evidence suggests changes to lifestyle through diet and exercise can help reduce the risk of developing Alzheimer’s disease.  read more at Alzheimer’s Care      

Typically, Assisted Living Facilities are large, elegant, hotel-like buildings which house anywhere from 50 -150 residents.  Assisted Livings are often referred to as Retirement communities.  Residents who reside in these facilities are seniors who are largely independent & don’t need a lot of assistance with personal care or activities of daily living.  

Most Assisted Living Facilities have studio or small one-bedroom apartments and include meals in the main dining room, cleaning & laundry services in the base price. Other services may include a variety of in-house activities and a facility bus for residents to go out and do shopping or other tasks.  Assistance with personal care & activities of daily living are offered for an additional fee and are determined based on a points scale or tiered system and depend on the functional level of the individual.    

Most Assisted Living Facilities have 2-3 caregivers available to assist anywhere from 50 to 150 residents. Typically, Assisted Livings also have 1-2 medication technicians assigned to manage and administer medications for 50- 150 residents. These staffing ratios may be lower during overnight hours. Types of services and activities may have some variation between facilities, but typically the structure and amounts and types of care and service are pretty standard. Before choosing an assisted living setting it is recommended to inquire about staffing availability and types of services offered in that particular facility to ensure the needs of your loved one can be met now and in the future as care needs increase.

Rules & regulations vary from state to state.  In Nevada, Assisted Living facilities & Residential Care Homes operate according to Nevada State Laws and Regulations and are overseen by BHCQC (Bureau of Health Care Quality & Compliance).   All facilities under RFFG’s receive annual surveys with a letter grade and unannounced visits from the state Ombudsman to ensure basic minimum standard of care are followed.  Click here for more info on Nevada’s Rules and Regulations.

Residential Care Homes (RCH) are also referred to as group homes or board and care homes.  Residential Care Homes are single-family homes where seniors and the disabled can reside and receive 24-hour assistance with personal care and activities of daily living.

The number of residents allowed to reside in homes vary statewide and ranges from 2- 10 residents.  Many Residential Care Homes offer private and shared rooms. Residential Care Homes provide a personal, family-like environment where residents can receive more personal & individualized care allowing personal relationships to develop between caregivers, residents and their families

Residents who reside in Residential Care Homes receive 24hr supervision and assistance with personal care like bathing, dressing, grooming, toileting and other Activities of Daily Living.  Medication Management, Meal Preparation, frequent snacks, Housekeeping & Laundry services are also provided.

Residential Care Homes are required to offer a variety of actives that cater to each residents’ interest; puzzles, bingo, crafts, checkers, playing cards etc.  Due to the smaller size of RCH’s caregivers are often available to provide more direct time with residents to interact and participate with them in activities.  

In addition, Residential Care Homes usually schedule doctor appointments & and have a caregiver who knows the resident, their medications and knows their daily status, accompany residents to doctor appointments. This helps the resident to rely pertinent information back to the family and the home.

Caregivers in Residential Care Homes receive at least, the state minimum required caregiver and medication management training and additional Dementia, Chronic Illness or other special training if the home has a specialized endorsement.  See residential care homes for additional info on staffing and training

Costs of Residential Care Home vary anywhere between $3,000- $6000 for shared or private rooms.  The monthly rate typically is inclusive and covers all personal care, medication management, meals, laundry, housekeeping and activities.  This makes it a cost-effective choice.

Typically, Adult Day Care facilities are designed to provide a form of respite to family caregivers. Either adult children who are caring for a parent and still working or a spouse who is advanced in age and may need a break form being the sole caregiver. 

In general, they provide day care services, usually during regular working hours 9a-5p with some facilities having extended evening & weekend hours.  Most Adult Day Cares are geared toward providing socialization and are mostly a “sitting” service. There are some Adult Day Care facilities that provide medical care the majority do not.  Adult Day Health Care Centers are different than Social Adult Day Care Center, as Adult Day Health Care (ADHC) usually require a physician’s assessment before someone is being allowed to attend the program. They are staffed with an RN and can also provide physical, occupational, speech therapy when indicated.  There are also some Adult Day Care centers that focus on a particular group of individuals., like those with Dementia or Alzheimer’s.

The types of services and activities offered in each Day Care Facility may vary.  Many Adult Day cares provide a variety activity, including arts & crafts, games. gardening, music appreciation, exercise program, movies to name a few.  The degree of benefit to each individual is largely dependent on the individual’s function & ability to interact. In general, these facilities do not provide much assistance with personal care, like bathing, dressing & grooming.   

The National Adult Day Services Association (NADSA) offers some overall guidelines in its Standards and Guidelines for Adult Day Care, but state laws and regulations may be more or less restrictive and vary from state to state.  

“The term “hospice” originated as a place of shelter and rest for weary or ill travelers on a long journey.  The name was first applied to specialized care for dying patients by Dr. Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice—in London called St. Christopher’s Hospice. 

Saunders concept of specialized care for the dying was brought to the United States in 1963 at Yale university and focused on the concept of holistic hospice care and the dramatic improvements received in symptoms management & relief when this concept was applied to terminally ill patients. 

Today, Hospice Care is typically provided in one’s home, Residential Care Homes, or Assisted Living Facilities.  Some Hospice Programs have an in-patient units where patients can go for short periods of time for heavy care needs that the hospice team cannot provide in the home environment the length of stay is typically 1 week.  

Services provide by a hospice program include; Social Worker (SW), Spiritual Advisor, registered nurse (RN), Certified Nurse Aide (CNA), Medical Doctor (MD) and sometimes community volunteers.  The nurse makes weekly visits but can visit more frequently if needed and coordinates the care of other disciplines; i.e. CNA’s to provide assistance with personal care, like bathing and dressing a few times a week. Families still provide assistance with personal care or activities of Daily living when hospice is not on site.  Social workers and spiritual advisors are available for added support and assistance to help address other needs that may arise during the transition. 

The Hospice Insurance Benefit replaces all preexisting medical insurance, such as Medicare or Advantage Medicare. Typically visits from your own private physicians, hospital stays, Physical therapy and medical testing such as x- rays, are not covered under the hospice benefit.

Memory Care Units are a type of long-term care specifically designed to care for those with cognitive impairment or memory problems usually associated with Dementia and Alzheimer’s Disease. 

Memory care units are typically locked units in a separate building or wing of an Assisted living facility.  The locked unit helps prevent those who wander from leaving the facility unaccompanied.  In general, Memory Care Units have shared & private rooms.

Assistance with personal care, like bathing, dressing, incontinence care and other activities of daily living, like feeding & medication management is provided. Activity programs in Memory Care Units vary from facility to facility but are typically designed to engage residents and stimulate interactions.  Whether it’s through arts & crafts, music therapy, gardening, pet therapy, behavioral therapy or exercise therapies, it’s important to find a memory care unit that has activities that best suit your loved ones needs, abilities and interests. Of course, the benefit of the activities not only depends on the ability and function of the resident but the availability and participation of caregiving staff to help the resident participate and get the most out of the activity. 

Most states have specific rules & regulations for Assisted Living and specifically Memory Care. Many states require caregivers in Memory Care Units to have additional training specific to Dementia and may have required staff to resident ratios, in addition to other rules & regulations.  Requirements vary state to state so it is important to check for the particular rules specific to your state. 

Costs for Memory Care or Alzheimer’s Care can be quite expensive.  Costs typically range between $5,000 to $8,000 per month depending on the location and level of care required. Memory Care is the most expensive type of long-term care. Many of the larger memory care facilities utilize tiered or point based billing system based on specific care needs, which can significantly increase costs.  It is recommended to ask if costs are expected to rise and how costs are calculated before choosing a memory care unit.   

This glossary is NOT INTENDED to be medical advice or to be relied on for any clinical decisions.

This is an expanded glossary.  The goal is to stimulate each readers thoughts on new views on these common terms.  Our intent is for you to discuss these with MANY OTHER PROFESSIONALS.  These ideas are viewed differently depending on which professional you talk to.