Insurance terminology can be confusing, but the definitions below can help with some of the most commonly referenced terms you'll encounter as you're researching long-term care options.
Long-term care-related terminology
Activities of daily living (ADLs)
These six basic tasks are required to function in everyday life. If someone is unable to perform two or more of these functions, he or she may require assistance.
- Bathing
- Continence (controlling one’s bladder and bowel)
- Dressing
- Eating
- Toileting (ability to go to the bathroom, use the toilet and clean oneself afterward)
- Transferring (ability to get up and move from a bed or chair)
Adult day care
A structured program for individuals who need long-term care, adult day care provides a helpful and supportive option for people who continue to live at home and need company, activities and assistance during the day while caregivers work. An adult day care center can meet participants’ health, nutritional, social and spiritual needs. While the setting is nonresidential, the staff of professionals is equipped and trained to respond to the needs of older adults.
Caregiver
Someone who helps another person accomplish basic everyday activities due to an illness, injury or cognitive impairment. A caregiver may be a friend, family member or paid professional.
Claimant
In insurance terms, the claimant is the insured person who is receiving long-term care services and filing a claim for benefits.
Cognitive impairment
A gradual or sudden decrease in a person’s ability to think and reason. Generally, one or more of the following areas are affected: short- and long-term memory; awareness of people, place and time; reasoning and judgment. Examples of cognitive impairment include dementia and Alzheimer’s disease.
Daily benefit
A long-term care insurance plan will pay a maximum amount, called a daily benefit, in a single day.
Elimination period (also called the waiting period)
The elimination period on a long-term care policy is like a deductible. Before benefits are paid out, the insured (claimant) will pay their long-term care costs for a set number of days. The elimination period may go by calendar days or service dates; one’s long-term care policy will outline the details.
Home health aide
A trained, certified professional who can be hired to visit individuals in their own home to provide help with the activities of daily living.
Home health care
Medical and non-medical professional or personal care services provided at home. Home health care can include several types of therapy, such as occupational, physical, respiratory and speech therapy, as well as custodial and/or nursing care.
Homemaker services
Non-medical, nominal support services provided by a professional or volunteer that can help an older adult remain at home. Homemaker services may include meal prep, laundry, cleaning and supervising self-administration of medicine.
Hospice care
At or near the end of life, hospice care is provided by professional medical staff to help make the individual physically, emotionally and spiritually comfortable.
Long-term care (LTC)
Personal care and medical services are provided for an extended time to an individual who needs help with the activities of daily living* or who needs supervision due to a severe cognitive impairment. Long-term care services can be provided at home or in a nursing home, assisted living facility or adult day care center.
Monthly benefit
The maximum amount a long-term care insurance policy will pay in a single month.
Plan of care
A formal plan tailored to meet an individual’s needs with qualified long-term care services, prescribed by a licensed health care practitioner.
Policy
A legal contract written by the insurance company and issued to a policyholder or group sponsor to define the claims the company is required to pay.
Policyholder
The individual who has a legal, signed contract with the insurance provider.
Power of attorney (POA)
A legal document that grants authority for a person to make decisions on another person’s behalf. Such decisions may include matters related to medical treatment and living arrangements.
Supportive equipment
Equipment used to modify/update a house to make it safer and more functional for the resident. In the case of an older adult, home modifications may include installing a wheelchair ramp, walk-in tub and grab bars.
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Other resources
Information about community services and programs
Resources for risk reduction, early detection and maximizing quality care and support surrounding Alzheimer’s disease and all other dementia
National Association of Area Agencies on Aging
Resources for older adults and people living with disabilities
American Speech-Language-Hearing Association Helpline
Referrals to audiologists and speech pathologists
Alliance of Claims Assistance Professionals
Services to help navigate insurance claim paperwork, denials and payments
An AARP program offering free legal and social services
Information, resources and assistance for locating hospice and end-of-life care
Home
*Activities of Daily Living (ADLs), include bathing, maintaining continence, dressing yourself, eating/feeding yourself, toileting (including getting on and off a toilet), transferring (like from a bed to a chair) and cognitive impairment (such as Alzheimer’s disease).
Provided content is for overview and informational purposes only and is not intended as tax, legal, fiduciary, or investment advice.