Glossary of Terms

C

Caregiver: Anyone who provides care to a person with Alzheimer’s disease or related dementias. Caregivers can be family members, friends, or paid professional caregivers. Caregivers may provide full- or part-time help to the individual with dementia.

Chronic disease: According to the U.S. National Center for Health Statistics, a chronic disease is one persisting for a long time (usually three months or more) and generally cannot be prevented by vaccines or cured by medications, nor do the symptoms disappear on their own. Health-damaging behaviors—particularly tobacco use, lack of physical activity, and poor eating habits—are major contributors to chronic disease.

D

Dementia: Dementia is not a specific disease. Instead, dementia describes a group of symptoms associated with a decline in memory, thinking, and social abilities severe enough to reduce an individual’s ability to perform everyday activities. Alzheimer’s disease is the most common type of progressive dementia in older adults, yet there are a number of types of dementia.

Do Not Resuscitate (DNR) Order: A DNR order, signed by a health care provider based on a patient’s wishes, instructs medical personnel not to 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. This sometimes take the form of a Physician Order for Life Sustaining Treatment (POLST). The POLST form is often more detailed than a DNR order and also includes an individual’s wishes regarding how aggressive to be with care (ICU or not, for example) and use of feeding tubes.

G

Geriatric Assessment Clinic: A clinic dedicated solely to the evaluation and management of medical conditions in older adults, including dementia. These clinics usually help develop a comprehensive plan of care that addresses the individual’s medical, cognitive, and functional needs.

Geriatricians: Physicians concerned with the diagnosis, treatment, and prevention of disease in older adults. They specialize in managing conditions specific to aging, including dementia.

Guardian: Guardianship is established by a court order. The court grants the guardian authority and responsibility to act on behalf of another person. The relationship is fiduciary, which means that the guardian is obliged to act in the best interest of the individual for whom he/she is a guardian.

H

Hospice: A hospice program offers support for dying individuals to live as fully and comfortably as possible. Hospice care is generally provided to individuals with a life expectancy of six months or less. Rather than seeking a cure, hospice care aims to make an individual’s remaining time as comfortable and as meaningful as possible. Hospice is a Medicare benefit.

L

Long-term care facility: A long-term care facility is a nursing home or assisted living center designed to provide a variety of services, including both medical and personal care, to individuals who are unable to manage independently in the community. Many residents in long-term care facilities have dementia.

M

Medicaid: Medicaid is a joint federal and state program that helps with medical costs for qualified individuals with limited income and resources. Medicaid can also provide benefits not normally covered by Medicare, including long-term nursing home care and personal care services.

Medicaid waiver: States can use the waiver process to test new or existing ways to deliver and pay for health care services in Medicaid and the Children’s Health Insurance Program (CHIP). There are four primary types of waivers and demonstration projects, one of which is the Section 1915(c) Home and Community- based Services Waiver. Montana participates in this program to provide Medicaid-funded long-term care services in home and community settings rather than institutional settings. However, only a limited number of people can participate in this program based on the level of matching funds provided by the State.

Medicare: Medicare is a federally-funded government health insurance program for people aged 65 and older and for certain younger individuals with disabilities.

P

PACE: The Program of All-Inclusive Care for the Elderly (PACE) provides comprehensive medical and social services to certain frail, community- dwelling elderly individuals, most of whom are eligible for both Medicare and Medicaid benefits. An interdisciplinary team of health professionals provides PACE participants with coordinated care. For most participants, the comprehensive service package enables them to remain in the community rather than receive care in a nursing home.

Palliative care: Palliative care includes medical and/or surgical methods to ease the pain of a serious or incurable illness.

Person-centered care: This term refers to health care and social services designed to reflect the individual’s unique preferences, values and needs, identified and agreed upon in partnership with the medical providers, the patient, and other family members when appropriate. The goal is for people to be treated as individuals and to receive appropriate and timely care that meets their needs.

Power-of-attorney form: A power of attorney form is a legal document designating someone to act on someone’s behalf when making major decisions such as medical and financial decisions when the individual is unable to make those decisions him/herself.

Montana has a statutory power-of-attorney form.

R

Respite care: Respite care provides a caregiver temporary relief from the responsibility and stress of caring for individuals with chronic physical or mental disabilities. Examples of respite care include in-home assistance, a short or long-term care facility stay, or day care programs for adults.

Rural and frontier communities: For the purposes of this plan, rural communities in Montana were those with a total population of less than 25,000.

U

Urban communities: For the purposes of this plan, urban communities in Montana were those with a total population of more than 25,000. For this report, those counties include Cascade, Flathead, Gallatin, Lake, Lewis and Clark, Missoula, Ravalli, Silver Bow, and Yellowstone counties.