Today, let’s talk about Acronyms typically used in the world of geriatric care. It has been our experience in helping many families and clients through the aging process, that being in the medical or care setting can be very isolating and sometimes scary when there are lots of words or acronyms being thrown out and you don’t know what they mean! There’s nothing worse than lying in a hospital bed and having all the people around you talking about you in a language you can’t understand. We hope this email helps to demystify some of the common phrases, acronyms or abbreviations you might encounter in your aging journey.

I like to explain, from a high level, who pays for what – which is always a question we get. I think about it like there are two worlds: the medical world, and the community world.

Medical World:

Most things in the medical world are covered by insurance (though of course every plan is different and it depends on your specific coverage). The medical world consists of: hospital, skilled nursing or rehab facilities, outpatient rehab, home health, medical doctors, and palliative or hospice care. In this world, a physician needs to order whatever service you are using for insurance to pay for it.

Community World:

Most things in the community world are private pay (out of pocket) unless you have Long Term Care Insurance (mostly referred to as LTC Ins), which usually covers a portion of the community world needs. The community world consists of: assisted living communities, memory care communities, home care (caregiving in the home), care managers, and private pay nursing or physical therapy. In this world, you or your responsible party are deciding what is needed and you are also paying for it.

Here is a breakdown of some of the most commonly used terms or acronyms you might hear on your journey:

SNF (pronounced “sniff”) – stands for Skilled Nursing Facility. These are part of the medical system, meaning in most cases the stay is covered by Medicare or other insurance as long as a physician orders it and it’s short term. Generally, SNF stays are short term (usually 1-2 weeks) and follow a hospital stay where you would go to the SNF to rehab, get stronger, do an IV treatment, etc before going back home. Medicare pays for 100 days in a SNF per year and if you don’t use them, you lose them (they don’t carry over). If you go over the 100 days in a year or have a medical condition that requires you to reside in a SNF long-term, you will likely have to pay (at least a portion of it) out of pocket and it can be very costly per day.

AL (Assisted Living)– The term assisted living is thrown out in many different scenarios which can be confusing. The state of California uses the term Assisted Living to refer to any setting where someone resides and receives care, regardless of its size or specialization. In the industry, we actually break it down by size and type of resident specialty, labeling the big apartment style buildings with lots of amenities as “Assisted Living”. The other options within the state’s definition of assisted living are below!
- MC (Memory Care)- This is a residential community that specializes in helping those with dementia or dementia-like symptoms or behaviors. Most of the time, if someone refers to a “memory care community”, they mean an entire building that is secured with alarms and fencing and the entire population has memory impairment. Generally, anywhere from 30-100 residents reside here, though there can be bigger or smaller communities. According to state licensing, a resident must have a dementia or dementia-like diagnosis to reside there. This is not to be confused with a memory care unit within a big assisted living building. This is typically where one floor or area of the building is secured and individuals with memory impairment live in that section of the building while the assisted living residents reside in the other areas of the building.
- B&C Home (Board and Care Home or residential care home) – These are smaller homes, rather than apartment style buildings, where each bedroom is rented out to either one (private room) or two (shared room) residents. Caregivers live on site and provide care, manage medications, cook meals, etc. These tend to have 6-10 residents, as compared to 150 residents in assisted living buildings.
- Home Health – Home Health is often confused with Home Care, and there is also usually confusion around who pays for what! Home Health is part of the medical continuum, meaning as long as a physician has ordered home health, it is typically paid for by most insurance plans. Home Health tends to be short term in nature, usually 4-6 weeks, and is meant to continue the progress a person made recovering from a hospital stay, SNF stay, or after a recent fall or decline in mobility at home. Generally, a nurse, social worker, physical therapist, speech therapist, and occupational therapist (or just whomever is appropriate) will come to the person’s home and provide their specialty of service in the privacy of their home, usually for an hour or less each visit, maybe 1-2 visits a week. Generally, the doctor needs to confirm that outpatient services (where you go to a physicial therapy office rather than them coming to your home) are not appropriate for the person, and the need for home health to come to them is warranted.
- Home Care (non-medical caregiving, aids, caregivers) – Home care is generally used to refer to hiring an agency to oversee caregivers coming into the home on a regular, long-term basis, though sometimes the need can be short term. Caregivers help with things like bathing, dressing, cooking, laundry, medication reminders, exercise, transportation, etc. Most home care agencies now have a 20 hour per week minimum – meaning you have to have a caregiver for at least 20 hours per week in your home to use their service. Home care is part of the community world, and is thus private pay, though many LTC Ins policies will cover home care.

ADLs (Activities of Daily Living) – You may hear this term a lot in any community care setting (assisted living, memory care, b&c homes, etc) or in the caregiving arena. ADL refers to an Activity of Daily Living and includes things like: bathing, getting dressed, personal hygiene (brushing teeth, etc), grooming (putting on makeup, doing your hair, etc), cooking meals, light housekeeping (laundry, doing dishes, etc), transportation, groceries and other supply ordering or shopping, errand help, medication reminders, etc. Many community care settings and home care agencies will assess the ADL needs to determine the right fit and skill level needed to provide appropriate care.
DME (durable medical equipment) – Durable Medical Equipment is usually shortened to DME (just say the three letters). This refers to shower chairs or benches, walkers/canes/wheelchairs, hospital beds, alarm pads, etc. Basically any equipment in your home that will make activities of daily living easier. It used to be a lot easier to order DME through insurance carriers, and most are covered if your doctor orders the specific equipment you need, but it’s getting harder and harder to do that. In most cases, it’s easier to order online and have it delivered to your home. Big ticket items, like hospital beds, should be ordered or rented through a company and usually insurance covers most of the cost. Be sure to check with your insurance company and either home health company or doctor for your specific needs.

Resources/Tips

If you are ever in a situation where you don’t understand what someone is referencing, just ask! People in the industry have pressure and a lot of patients to see, it can be easy to assume everyone understands the terms they are using. If you don’t know what something means, we encourage you to just ask!