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Activities of Daily Living (ADL) — The self-care tasks which are used to measure the Functional Impairment Level of an applicant or a client for home care services include the ability to bathe, dress and undress, eat, toilet, transfer in and out of a bed or chair, get around inside one's own home, and maintain continence. Also see Instrumental Activities of Daily Living, (IADL).

Administration on Aging (AoA) — The principal federal agency responsible for administering the provisions of the Older Americans Act, except Title V. It advocates at the national level for the needs, concerns and interests of elder persons throughout the nation, and is housed within the Office of Human Development Services (OHDS) of the Department of Health and Human Services (DHHS).

Adult Day Care — A community-based group program designed to meet the needs of functionally impaired elders and other adults who can benefit from participating in group settings. Most programs include an individualized plan of care, group exercise, adult education classes and recreation, nutritious meals, and social work services. In addition, these programs make respite for caregivers possible, and provide support groups for participants and caregivers.

Adult Day Health Care — A community-based program similar to adult day care but designed for elders and persons with disabilities who need a higher level of care, but can still benefit from receiving services in a group setting. In addition to the services of an Adult Day Care program, other services provided include physical, occupational and speech therapies; nursing supervision; monitoring of vital signs, blood glucose, blood pressure, and medications; assistance with bathroom visits; dietary counseling and supervision; psychological counseling; and an Individualized Plan of Care. All services are supervised by trained geriatric specialists.

Adult Foster Care — see Group Adult Foster Care (GAFC)

Advance Directive — A document, such as a health care proxy or living will which allows an individual to convey his or her wishes about end-of-life care ahead of time. In Massachusetts, only the Health Care Proxy is legally binding on medical providers.

Aging Service Access Point (ASAP) — A private, non-profit, state-designated agency under contract with the Massachusetts Executive Office of Elder Affairs to provide a single-entry point for seniors and caregivers to access a variety of programs and services. Formerly known as "Home Care Corporation".

Area Agency on Aging (AAA) — Agencies established under federal law, the Older Americans Act (OAA), to respond to the needs of Americans aged 60 and over in every local community with the goal of keeping seniors living independently in their own homes. Like the ASAPs (see above), AAAs work with the MA Executive Office of Elder Affairs to plan and provide social services and nutrition services for elders, and support for caregivers.

Assignment — A system under Medicare in which out of pocket costs depend on whether your doctor or supplier of health care equipment and supplies (such as wheelchairs, oxygen, braces and ostomy supplies) agrees to accept the Medicare approved payment amount. When doctors and suppliers agree to accept the Medicare approved amount, they accept assignment.

Assisted Living Facility (ALF) or Assisted Living Residence (ALR) — A facility that combines housing and supportive services for elders. Services include assistance with personal care, such as medication management, bathing, dressing and ambulating, and may include laundry, housekeeping, transportation, and social activities.

Assistive Technology – Products, devices or equipment used by individuals with disabilities to maintain, increase or improve their functional capabilities. Assistive technology can include mobility devices such as walkers and wheelchairs, as well as hardware, software, and peripherals that assist people with disabilities in accessing computers or other information technologies.

Care Plan – see Geriatric Care Manager

CARF Accredited — A rehabilitation facility that has been chosen to be reviewed by the Commission on the Accreditation of Rehabilitation Facilities (CARF), a private accreditation agency, and has been found to be in compliance with CARF quality standards.

Case Management – see Geriatric Care Manager

Certified Home Health Agency (CHHA) — A home health agency that meets Medicaid and Medicare requirements and standards for the provision of nursing care, rehabilitation therapies and the service of home health aides. Certification is by the MA Department of Public Health for reimbursement under Medicare, Medicaid and other insurance policies.

CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) — Auxiliary medical services for active military/veterans and their dependents.

Chore Services — A type of home care service to assist frail elders to remain in their home, including vacuuming, washing floors and walls, defrosting freezers, cleaning ovens, cleaning attics and basements, and removing fire and health hazards.

COBRA (Consolidated Omnibus Budget Reconciliation Act) — A federal law requiring employers to offer time-limited cash-premium health insurance to employees who will lose their insurance due to termination. If you were an active participant in your employer's health plan prior to your departure date, you can continue the health insurance that you and your family received for up to 18 months.

Companions — People provided by home care agencies who regularly visit frail elders providing socialization, medical escort, errand service, light meal preparation, as well as respite or temporary relief to family caregivers.

Congregate Housing - A shared living arrangement that allows elders to maintain their privacy and independence in a home-like setting with supportive services. In Massachusetts, the program is sponsored by the Department of Housing and Community Development (DHCD) and the Executive Office of Elder Affairs.

Congregate Living Facility — A non-institutional, independent group living environment that integrates shelter and service needs of functionally impaired and/or socially isolated elders who do not need institutional supervision and/or intensive health care.

Congregate Meals — A program, funded under Title 111-C of the Older Americans Act, providing one meal a day (usually lunch) at senior centers, churches and other community sites.

Conservatorship — Legal process in which a probate court appoints one or more persons to handle the financial affairs of a person the court determines to be incompetent or otherwise unable to handle her/his own finances.

Continuing Care Retirement Communities (CCRCs) — An alternative housing option designed to accommodate the needs of elders who can no longer live alone. CCRCs offer a full continuum of care, ranging from fully independent units, to assistance with personal care in assisted living apartments, to long-term care in a skilled nursing facility.

Council on Aging (COA) — A municipally appointed volunteer agency that provides services to elders, families and caregivers. While each COA is unique to its community, most councils offer information and referral, transportation, outreach, meals (congregate and home delivered), health screening, and fitness and recreation programs.

Custodial Care – A type of home care service that provides non-professional care to assist elders' activities of daily living such as walking, getting in and out of bed, bathing, dressing, eating, toileting, and taking medicine.

Dementia — A progressive decline of cognitive function, such as memory, concentration, and judgment, due to damage or disease of the brain beyond the natural process of aging. It is sometimes accompanied by emotional disturbance and personality changes.

DNR/DNI Order (Do Not Resuscitate/Intubate Order, also known as a "Comfort Care Order") — Instructions in the medical record of an individual who has decided that they not wish cardiopulmonary resuscitation. A DNR informs medical personnel, including EMTs and paramedics, to provide care and transport in the community without artificial means to maintain heart function and breathing.

Durable Power of Attorney — A document that grants a person(s) the legal powers to perform on behalf of the Grantor certain specified acts and functions, related to real estate, banking and financial transactions, personal and family maintenance, and government benefits, among others. This power is effective immediately and continues to be effective even if the Grantor becomes disabled or incompetent.

Elder Abuse Prevention Programs — Programs designed to alleviate situations of abuse, neglect or self-neglect; includes programs such as adult protection and guardianship/conservatorship.

Elder at Risk (EAR) Program — Program providing casework services to elders that allow them to safely remain in their own community when they can no longer meet their own needs for food, clothing, shelter, personal care, or medical care due to physical and/or mental impairments, substance abuse, or other serious problems.

Elder CHOICE – A financing subsidy program of the Massachusetts Housing Authority in which at least 20% of the units are reserved for low-income elderly residents.

Emergency Response Systems — see Personal Emergency Response Systems.

Enrollment Period – A certain period of time when you can join a Medicare health plan, if it is open and accepting new Medicare members. If a health plan chooses to be open, it must allow all eligible people with Medicare to join. There are four periods during which you can enroll in Medicare Part A: Initial Enrollment Period (IEP) which starts three months before you are 65 and seven month afterwards, General Enrollment Period (GEP) which is the first three months of each year, Special Enrollment Period (SEP) for people who did not sign up when they were 65, and Transfer Enrollment Period (TEP) for those who only have Part B and enrolled in a Medicare managed care plan.

Escort Services (Escorted Transportation) – A service that provides either group transportation or individual escorts to take seniors to medical appointments, shopping, errands, banks, government offices, hospitals to visit friends and family, and on recreational or cultural outings.

Executive Office of Elder Affairs (Elder Affairs) - The lead state-wide agency in Massachusetts on aging and elder care issues. Among services offered are the Home Care Program, the Family Caregiver Support Program, a toll-free telephone help line (1-800-AGE-INFO) and website with elder care information. (See Section 1 for more information.)

Executor — A person appointed in a will to handle the probate of a deceased person's estate.

Family Caregiver Support Program, Massachusetts – A program run by the Executive Office of Elder Affairs in conjunction with the Aging Service Access Points (ASAP) and Area Agencies on Aging (AAA). It provides information and referrals, training, counseling, support groups, respite care options, and other services to family caregivers.

Family Medical Leave Act (FMLA) – A federal law that provides caregivers up to 12 weeks of job-protected leave to care for a seriously ill parent, child or spouse (also covers leave for one's own serious illness, a birth, or an adoption). Workers are eligible who work for firms with 50 or more employees, have at least one year of continuous employment, and worked at least 1250 hours in the 12 months prior to leave. There is no wage replacement available with this leave.

Friendly Visitor — A volunteer who visits isolated elders in their homes up to one or two hours per week, usually arranged by a home care agency.

Gateway organizations — An agency or organization that provides eldercare information and programs and is a key point of connection for elders and caregivers to access additional elder care resources and service providers. As used in this Handbook, key gateway organizations include: the MA Executive Office of Elder Affairs, Aging Access Service Points (ASAPs), US Agencies on Aging (AAAs) and local Councils on Aging (COAs.).

Geriatric Care Manager — A professional case manager, usually a licensed social worker, who assesses an elder's ability to live independently in a home environment, develops an appropriate care plan for services and equipment, and organizes needed home care services. This person may monitor and augment services on an on-going basis, or trouble shoot as particular problems arise.

Geriatric Medicine – A subspecialty of internal medicine or family medicine focused on the clinical care of elders.

Gerontologist — A health care professional who specializes in elder care, with a degree in nursing, psychology, sociology, or other social-related professions. An applied gerontologist works directly with elders, evaluating and assisting individuals, families and groups. A research gerontologist is a scientist who conducts research on the biological, psychological, and sociological phenomena associated with old age and aging.

Group Adult Foster Care (GAFC) — A MassHealth program that pays for personal care services for eligible seniors and adults with disabilities who live in GAFC-approved housing. Housing may be an assisted living residence or specially designated public or subsidized housing.

Guardianship — A legal process by which a probate court appoints one or more individuals to handle the personal and financial affairs of a minor or person of any age the court determines to be mentally incompetent. The state Executive Office of Elder Affairs contracts with seven agencies to provide Guardianship services to elders who have been abused and/or who a court has determined to be at risk or harm, and to lack decision-making capacity.

Health Care Proxy — A document legally recognized in Massachusetts that is authorized by a competent person designating another person to act as his/her health care agent with the authority to make all health care decisions (unless specifically limited) for the grantor should he/she become unable to make or communicate those decisions.

Health Maintenance Organization (HMO) – is a group health insurance plan that entitles members to services of participating physicians, hospitals, and clinics. Coverage for services must be cleared by the HMO, and a primary care physician (PCP) within the HMO handles referrals. Members of the HMO pay a fee for coverage as well as small additional "co-payments" for out-patient visits and prescription drugs.

HIPAA (Health Insurance Portability and Accountability Act) — A federal law that ensures privacy provisions for health information and sets rules and limits on who can see an individual's health information. The law must be followed by health care providers and institutions, and certain government programs that pay for health care, such as Medicare and Medicaid. Information put in medical records, as well as insurance and billing records, is protected.

Home Care Program, Massachusetts — The state program that provides home-based services to elders so they can maintain their independence and live at home. It is administered through contracts with 27 private non-profit corporations called Aging Service Access Points (ASAPs).

Home Health Agency (HHA) — A public or private agency that specializes in providing skilled nursing services, home health aides, and other therapeutic services, such as physical therapy, in the home.

Home Health Care — Health care services provided in the home on a part-time basis for the treatment of an illness or injury, and covered by Medicare only if skilled care is needed and required on an intermittent or part-time basis.

Home Monitoring System — An electronic system designed to alert a caregiver when an elder, wearing a transmitting device, enters the zone near a monitored door or goes beyond a designated footage outside the home. These systems can be rented or purchased and are useful for conditions, such as Alzheimer's disease, causing disorientation or restlessness.

Homemaker Services — Assistance in home management, including light housekeeping, laundry, grocery shopping and meal preparation provided by trained personnel working under home care agency supervision.

Hospice — A public or private organization that provides pain relief, symptom management, and supportive services to terminally ill people and their families in the home or in a separate hospice facility.

Hospitalist — Physicians trained and board certified in internal medicine who specialize in the care of hospitalized patients. They serve as the physicians-of-record for patients. The hospitalist returns the patient to the care of their primary care physician at the time of hospital discharge.

Independent Living Units — Housing units that include some basic services such as meals and housekeeping, usually for a fee. These units may exist in a Continuous Care Retirement Community (CCRC) that also has assisted living units and a skilled nursing facility.

In-Home Services — Services provided under the federal Older Americans Act by all Area Agencies on Aging (AAA). They include homemaker and home health aide services, in-person and telephone reassurance, chore maintenance, in-home respite care (including adult day care) and minor home modifications.

Initial Enrollment Period – see Enrollment Periods.

Instrumental Activities of Daily Living (IADL) — The six daily tasks (light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money) that enable the patient to live independently in the community. (Also see Activities of Daily Living, ADL.)

Intermediate Care Facility (ICF) — A nursing home which provides health-related services to individuals who do not require the degree of care or treatment given in a hospital or skilled nursing facility, but who (because of their mental or physical condition) require care and services which are greater than custodial care and can only be provided in an institutional setting.

JCAHO Accreditation — indicates that a facility, like a hospital, has voluntarily chosen to be reviewed by the Joint Commission on the Accreditation of Health Care Organizations (JCAHO), a private accreditation agency, and been found to be in compliance with JCAHO quality standards.

Legal Services Programs for the Elderly — Programs providing free legal assistance, counseling and representation in civil matters by an attorney, or other person under the supervision of an attorney, to people sixty years of age and older, prioritizing those elders in the greatest economic and social need.

Levels of Care in Nursing Facilities — While the federal government has eliminated all references to and makes no distinction regarding levels of care, the state still utilizes level of care classifications for the sole purpose of licensing long-term care facilities. Multilevel facilities may maintain graduated levels of care up to or including skilled nursing services.

Level I and Level II, financed by Medicaid or private payment, provide twenty-four hour skilled nursing services as well as restorative and other therapeutic services. Many specialize in areas such as rehabilitation.

Levels III and IV includes nursing homes and retirement homes. Services range from routine nursing care to assistance with activities of daily living or supervised care for persons who do not require nursing or medical services. Most retirement homes (Level IV) provide residential rather than nursing care.

Limited Medication Administration – An optional service in assisted living residences that allows a family member or licensed practitioner to administer medication to a resident.

Living Will – A set of instructions documenting a person's wishes about medical care intended to sustain life. It is used if a patient becomes terminally ill, incapacitated, or unable to communicate or make decisions. Massachusetts law does not recognize a Living Will as binding on medical personnel. However, documents used to prepare a Living Will provide information that can convey the individual's intent, and facilitate instructions to the designated agent in a health care proxy which Massachusetts does recognize as binding.

Local match — The funds that a program must raise in order to qualify for and receive funding from various federal or state programs.

Long-Term Care Insurance (LTCI) — An insurance policy designed to alleviate some of the costs associated with nursing home and home health care for persons who become unable to care for themselves independently. Most policies provide coverage for a specified number of years or may offer lifetime coverage. The cost of policies varies in relation to the age of the individuals at purchase, the conditions and services covered, and, the amount and length of coverage.

Long-Term Care Ombudsman Program (LTCOP) — A program designed to investigate actions or decisions by nursing homes and other agencies which may adversely affect the health, safety, welfare, or rights of elders living in long term care facilities. The program is operated through 24 local agencies to facilitate access to all nursing and rest home residents, and works closely with the Department of Public Health's Division of Health Care Quality in resolving issues and concerns. It also provides information on selecting a nursing home.

Massachusetts Family Caregiver Support Program — see Family Caregiver Support Program.

MassHealth — The Massachusetts Medicaid program that offers health care coverage for some low-income and moderate-income families, disabled individuals and persons over age 65 who meet eligibility requirements. The program covers most needed services provided by physicians, dentists, hospitals, clinics, medical equipment suppliers and therapists.

Mass Home Care — see Home Care Program.

Meals on Wheels (MOW) – A service that provides home-delivered meals to elderly and disabled citizens without regard to income. It is funded through a combination of federal funds through Title IIIC of the Older Americans Act and state funds.

Medicaid — The health insurance program for low income and elderly Americans. It is financed by the federal and state governments and is the primary means of payment for nursing home services in the United States. (see MassHealth)

Medicare — Title XVIII of the Social Security Act is a two-part (A and B) federal health insurance program for Americans aged 65 and older and certain disabled people who have benefits under the social security system or who have ESRD (End Stage Renal Disease).

Medicare Part A — Hospital insurance for those 65 and older, primarily provides coverage for in-patient hospital care, skilled nursing home, home health, and hospice care.

Medicare Part B — Medical insurance for those 65 and older, provides limited coverage for out-patient physician services, ambulance use, durable medical equipment, and home health care services.

Medicare HMO — A Health Maintenance Organization for individuals 65 years and older covered by Medicare. (see HMO).

Medigap — A type of health insurance elders can purchase to supplement their health benefits under Medicare and bridge the gap between what Medicare pays and what clinical care and prescription drugs actually cost.

NORC (Naturally Occurring Retirement Communities) — A initiative for connecting elders to community-based eldercare services while remaining in their own homes and staying connected to neighbors and community institutions. A NORC connects elders to supportive services and to each other, often using computer technology as a key tool.

Nursing Home — A term used to cover a wide range of institutions providing 24/7 personal care and skilled nursing care, also called Skilled Nursing Facilities, Intermediate Care Facilities and Custodial Care Facilities. Not all nursing homes are Medicare approved/certified facilities.

Nursing Home Report Cards — A resource of the MA Department of Public Health's Division of Health Care Quality to help consumers make educated and informed decisions about the availability and quality of nursing home residency. The Nursing Home Report Cards use 44 federal minimal standards to help measure the care provided at nearly 600 certified nursing care facilities in Massachusetts.

Nursing Home Screening — A procedure to ensure that those people entering a Skilled Nursing Facility or participating in an Adult Day Health Program meet Medicaid guidelines. Screenings are conducted by the nursing department of an Aging Service Access Point (ASAP) through a contract agreement with Medicaid.

Occupational therapy – A form of therapy that helps people improve basic motor functions and reasoning, and their ability to perform tasks in their daily living and working environments.

Ombudsman (ombudsperson) — A person (sometimes a state official) who advocates on behalf of residents in an assisted living facility or health care institution. This person receives, investigates and resolves complaints against the residential facility or health care institution involving the safety, health, welfare and rights of the elderly residents and patients.

PACE (Program of All-inclusive Care for the Elderly) — A program that provides low-income frail elders with all of their health, medical, rehabilitation, social, and support services and health insurance for one monthly fee. It enables them to remain independent in their community and in their own homes.

Palliative Care — Any form of medical care or treatment that concentrates on reducing pain and /or the severity of the symptoms of a disease, or slowing the disease's progress, rather than providing a cure.

Paratransit – A type of transportation for people whose physical condition restricts their use of regular public transit systems. Services are provided by lift-equipped vans and shuttles that can be scheduled as needed for pick-ups and drop-offs. This is also known as "demand responsive transportation."

PDF (Portable Document Format) — A file format used to create copies of documents that can be read, copied or printed by any computer with the Adobe Reader software installed (available free on the internet.) PDFs allow users to share exact copies of pages containing any kind of text, graphics and photos, but the images cannot be modified using the free software.

Primary Care Physician (PCP) — A doctor who provides continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. A PCP generally does not specialize in the treatment of specific organ systems, such as cardiology, nor perform surgery. The term is often used by Health Maintenance Organizations (HMOs) to describe the physician who manages treatment for HMO members and provides referrals to specialized care and services.

Personal Care Attendant (PCA) — A person trained to provide assistance with the personal care activities of daily living, such as bathing, shampooing, personal hygiene, and medication reminders, usually arranged by a home care agency.

Personal Care Services — Services that provide assistance with one or more activities of daily living either through physical support or supervision. These services are not routinely paid for by either Medicare or Medicaid.

Personal Emergency Response Systems (PERS) – A medical communications alerting system that allows an elder experiencing a medical emergency at home to access medical service via an electronic transmitter to a central monitoring station.

Physical Therapy – A form of therapy that help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease.

Prescription Advantage — A Massachusetts state program that provides insurance to cover prescription costs. Enrollment is currently (2006) closed but the intended population is the elderly and the disabled. Premiums, deductibles and co-payments are required and vary by income and marital status.

Probate — A legal proceeding defined by State law in which the court determines the validity of a decedent's will and the correctness with which the provisions of the will are carried out.

Qualified Medicare Beneficiary Program (QMBs) — A federally required medical assistance program administered by Medicaid which pays the Medicare premiums, deductibles, and co-payments for certain Medicare recipients whose assets are limited and whose income falls at or below the federal poverty level.

Rehabilitation — Services and therapies needed by people who have sustained severe injury, often due to trauma, a stroke, an infection, a tumor, surgery, or a progressive disease.

Respite Care — Temporary care service to relieve an in-home caregiver of responsibility for an individual with long-term care needs. Relief care can be provided in the home, in day programs, nursing facilities, rest homes or an Adult Foster Care program.

Rest Home — A facility providing custodial care. Services provided in these facilities are more residential than medically oriented. They include protective supervision for the residents, as well as room, board, social activities and limited social services.

Reverse Mortgage — A special type of home loan that allows homeowners to convert a portion of their home equity into cash. The US Dept of Housing and Urban Development (HUD) offers a federally-insured reverse mortgage loan plan that enhances financial security and allows elders to stay in their own homes and pay for needed home modifications and/or home care services.

Section 8 Housing – An affordable housing assistance program offered by the federal government, either as rental vouchers which can sometimes be used for assisted living housing or as a "project-based Section 8" which pertains to a specific building.

Self Administered Medication Management – A program in certified assisted living residences that enables frail elders to take their own medications by using trained practitioners to: remind patients to take medication; check the medication package; verify the resident's name on the package; observe the resident while they take the medication; and document their observations.

Senior Care Options – A managed care program offered to eligible MassHealth (Medicaid) members age 65 and older that provides comprehensive multi-specialty care from physician visits, lab tests, and hospital treatment to dental care, prescription drugs and eyeglasses.

Senior Companions — Elder Service Corps enrollees and Senior Aides who are assigned to provide company and supervision to handicapped or socially isolated elder people, and to provide relief to family members with dependent elderly relatives.

SHINE (Serving the Health Information Needs of Elders Program) — A program of the Executive Office of Elder Affairs providing free, confidential and unbiased health insurance counseling through a volunteer network of health benefits counselors. Information is provided to elders about Medicare, Medigap Insurance, Medicaid, HMOs, public benefits, retiree health plans, individual insurance, prescription drug charge coverage, health insurance counseling, and other health insurance options.

Skilled Nursing Facility (SNF) — A nursing home providing services for residents whose general condition tends to be unstable, and requires close observation and care given by professional staff over a 24-hour period. Some skilled care is financed by Medicare; however, the majority must be covered by private funds or Medicaid. Some SNFs have rehabilitation programs that help people maintain their ability to function or to readjust to limitations.

Sliding Fee — A fee that fluctuates according to the income of the person who is receiving the service. This term is applied to certain home care services and may be applied to other elder care services.

Social Day Care (SDC) — see Adult Day Care

Social Security Disability Income (SSDI or SSI, Supplemental Security Income) — A monetary benefit paid through Social Security to persons under age 65 with disabilities. SSI-G provides funds for eligible residents to pay for certified assisted living. It can be combined with GAFC (Group Adult Foster Care) subsidy for those financially and clinically eligible.

Special Care — A unit on a special floor or wing of a long-term care facility designed for those with Alzheimer's disease, dementia, and other related brain disorders.

Speech Therapy — A therapy that treats speech impairment from stroke, dementia, Parkinson's disease or Multiple Sclerosis; cognitive and memory problems with speaking and listening, voice disorders, speech disorders, and swallowing disorders (dysphasia.)

Spousal Impoverishment Law — A federal law providing that if one member of a married couple becomes a nursing home resident, the property and assets of the married couple will be combined, regardless of who owns the asset, and divided in half, according to Health Care Financing Administration (HCFA) standards. This process protects the spouse who still lives in the community from becoming impoverished. The spouse who still lives in the community can appeal the division of marital assets under certain conditions.

SSI — see Social Security Disability Income

Supplemental Security Income – see Social Security Disability Income

Supportive Housing — An "assisted living like" environment in state-funded, public elderly/disabled housing. Services are provided on an as needed basis 24 hours a day. This type of housing is available through the Supportive Housing Initiative Program run by the Executive Office of Elder Affairs and the Department of Housing and Community Development in Massachusetts.

Telephone Reassurance — Regular, pre-scheduled calls to homebound older adults to reduce isolation and provide a routine safety check.

Third Party Liability — A party other than a beneficiary who is responsible for payment of part or all of a specific Medicare claim. Medicare supplemental insurance (Medigap) coverage is one example.

TTY (Text Telephone) or TTD (Telecommunication Device for the Deaf) — Special telephones and telephone numbers for the deaf, and those who are hard of hearing or speech impaired that allows people to communicate by typing messages back and forth rather than talking and listening.

Veteran's Benefits — Medical services and other benefits provided by the Veteran's Administration to honorably discharged ex-service members and sometimes to their dependents. For those without service-connected disabilities, income and asset restrictions may apply.

Visiting Nurses (Visiting Nurse Association/VNA) – Registered nurses who provide skilled nursing, rehabilitation and hospice services at home. The VNA is a well-known membership association of home health care providers in the region, connected by a network of partnerships with regional insurers, hospitals and clinics, and healthcare providers.

Wander Locator — tracking equipment used for wander prevention and location for those who are wander-prone (Alzheimer's.)

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