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Comprehensive Guide to Caregiving, Legal, and Estate Planning Terminology
This document provides definitions and explanations of key terms related to caregiving, legal matters, and estate planning, essential for navigating the complexities of aging and long-term care. Items are always being added, check back soon if or email sgoodman@goldenagreements.com if you want an item added.
Table of Contents
Caregiving Terminology
Companion
Home Attendant/Personal Care Aide (PCA)
Home Health Aide (HHA)
Licensed Vocational Nurse (LVN)/Licensed Practical Nurse (LPN)
Geriatric Care Manager
Legal Terminology
Medical Power of Attorney (MPOA)/Durable Power of Attorney for Healthcare (DPOA-HC)
Advance Care Directive (ACD)
Living Will
Do Not Resuscitate (DNR)
Do Not Intubate (DNI) Order
Do Not Hospitalize (DNH) Order
Out-of-Hospital DNR Order
Physician Orders for Life-Sustaining Treatment (POLST)/Medical Orders for Life-Sustaining Treatment (MOLST)
Dementia Directive
Capacity
Wills and Trusts Terminology
Will Terminology
Testator/Testatrix
Beneficiary
Executor/Executrix
Probate
Intestate
Heir
Codicil
Bequest
Trust Terminology
Grantor/Settlor/TrustorTrustee
Revocable Trust
Irrevocable Trust
Living Trust
Corpus/Principal
Successor Trustee
Caregiving Terminology
Companion:
Definition: A non-medical caregiver who provides assistance with activities of daily living (ADLs) such as light housework, shopping, meal preparation, and transportation to appointments.
Scope: Companions focus on providing support for individuals who are generally independent but require assistance with tasks that may be physically or logistically challenging. They do not typically provide hands-on personal care.
Additional Information: Companion care is ideal for those seeking assistance with maintaining independence and social engagement.
Resources: Local senior centers, home care agencies, and online caregiver directories.
Home Attendant/Personal Care Aide (PCA):
Definition: A caregiver who provides the services of a companion, along with assistance with personal care tasks such as bathing, dressing, grooming, and toileting.
Scope: PCAs assist individuals who have some physical limitations that hinder their ability to perform personal care tasks independently.
Additional Information: These caregivers provide more intimate care than companions and may require specific training.
Resources: Home care agencies, state health departments, and caregiver training organizations.
Home Health Aide (HHA):
Definition: A trained healthcare worker who provides personal care and basic medical assistance under the supervision of a registered nurse (RN) or other licensed medical professional.
Scope: HHAs assist with ADLs, mobility assistance (including transfers), vital sign monitoring, medication reminders, and basic medical tasks like wound care and oxygen administration (depending on state regulations).
Additional Information: HHAs often work in conjunction with home health nurses and therapists to provide comprehensive care. State regulations regarding HHA scope of practice vary.
Resources: Home health agencies, state nursing boards, and the National Association for Home Care & Hospice (NAHC).
Licensed Vocational Nurse (LVN)/Licensed Practical Nurse (LPN):
Definition: A healthcare professional who provides basic medical care under the supervision of an RN or physician. LVN is the term used in Texas and California, while LPN is used in most other states.
Scope: LVNs/LPNs administer medications, monitor vital signs, provide wound care, assist with patient hygiene, and maintain medical records.
Additional Information: Credentialing requires completion of a state-approved nursing program (typically 1-2 years) and passing the National Council Licensure Examination for Practical Nurses (NCLEX-PN).
Resources: State nursing boards, the National Council of State Boards of Nursing (NCSBN), and vocational nursing schools.
Geriatric Care Manager:
Definition: These professionals, sometimes called aging life care managers, are usually licensed nurses or social workers trained in caring for older adults.
Scope: They act as private advocates and guides for family members who want to ensure their loved one is in the best hands, and they generally serve clients and families whose incomes are too high to qualify for publicly financed services
Legal Terminology
Medical Power of Attorney (MPOA)/Durable Power of Attorney for Healthcare (DPOA-HC):
Definition: A legal document that designates an agent to make healthcare decisions on an individual's behalf if they become incapacitated.
Scope: MPOAs/DPOA-HCs grant authority to make decisions regarding medical treatment, including end-of-life care.
Additional Information: It is essential that the appointed agent understands the individual's healthcare wishes. Requires proper execution, including witness signatures, and may vary by state.
Resources: State bar associations, legal aid organizations, and online legal document providers.
Advance Care Directive:
Definition: A legal document that outlines an individual's preferences for medical treatment in the event of incapacity.
Scope: Advance care directives may include instructions regarding life-sustaining treatments, such as resuscitation, ventilation, and artificial nutrition.
Additional Information: It is crucial to discuss advance care directives with healthcare providers and ensure that copies are readily available to medical personnel.
Resources: Healthcare providers, state health departments, and the National Hospice and Palliative Care Organization (NHPCO).
Living Will (instructions for while living):
Definition: A type of advance care directive that specifies an individual's wishes regarding end-of-life care.
Scope: Living wills typically address decisions about life-sustaining treatments, pain management, and organ donation.
Additional Information: While a living will expresses wishes, a healthcare proxy is still needed to interpret and apply these wishes in unforeseen situations.
Resources: State bar associations, healthcare providers, and the American Bar Association (ABA).
Do Not Resuscitate (DNR) Order:
Definition: A medical order that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if an individual's heart 1 or breathing stops.
Scope: DNR orders apply in hospital and nursing facility settings.
Additional Information: Out-of-hospital DNR orders are also available for emergency medical services (EMS).
Resources: Healthcare providers and state health departments.
Do Not Intubate (DNI) Order:
Definition: A medical order that instructs healthcare providers not to place a breathing tube (endotracheal intubation).
Scope: DNI orders apply in hospital and nursing facility settings.
Additional Information: Often used in conjunction with DNR orders.
Resources: Healthcare providers.
Do Not Hospitalize (DNH) Order:
Definition: A medical order that instructs long-term care providers not to transfer an individual to a hospital for treatment.
Scope: DNH orders apply in nursing homes and other long-term care facilities.
Resources: Long-term care facilities and healthcare providers.
Out-of-Hospital DNR Order:
Definition: A medical order that instructs EMS personnel not to perform CPR or other life-sustaining measures.
Scope: Applies to situations outside of hospital or nursing facility settings.
Resources: State EMS agencies and healthcare providers.
Physician Orders for Life-Sustaining Treatment (POLST)/Medical Orders for Life-Sustaining Treatment (MOLST):
Definition: Medical orders that translate an individual's healthcare wishes into actionable instructions for healthcare providers.
Scope: POLST/MOLST forms provide specific guidance regarding life-sustaining treatments.
Additional Information: These forms are typically used for individuals with serious illnesses or advanced frailty.
Resources: Healthcare providers and state health departments.
Dementia Directive:
Definition: A supplemental advance care planning tool that addresses specific care preferences for individuals with dementia.
Scope: Dementia directives clarify wishes regarding future care, including levels of intervention and end-of-life care, during various stages of dementia.
Additional Information: Works in conjunction with standard Advance Health Care directives. Legal council is highly recommended.
Resources: Elder law attorneys, Alzheimer's Association.
Capacity:
Definition: The legal ability to make informed decisions.
Scope: Capacity can be affected by cognitive impairment, such as dementia.
Additional Information: Advance planning is crucial to ensure wishes are respected when capacity diminishes.
Resources: Elder law attorneys, gerontologists, and neuropsychologists.
Trust and Will Terminology
Will Terminology (instructions for after passing):
Testator/Testatrix: The person who creates the will.
Beneficiary: The person or entity usually designated by the Testator that receives assets from the will.
Executor/Executrix: The person designated to carry out the instructions in the will.
Probate: The legal process of validating a will and distributing the estate.
Intestate: Dying without a valid will.
Heir: A person legally entitled to inherit property.
Codicil: An amendment or addition to an existing will.
Bequest: A gift of personal property by will.
Trust Terminology:
Grantor/Settlor/Trustor: The person who establishes the trust.
Trustee: The person or entity responsible for managing the trust assets.
Beneficiary: The person or entity that benefits from the trust.
Revocable Trust: A trust that can be changed or terminated by the grantor.
Irrevocable Trust: A trust that cannot be easily changed or terminated.
Living Trust: A trust that is created during the grantor's lifetime.
Corpus/Principal: The assets held within the trust.
Successor Trustee: The person who takes over management of the trust if the original trustee is unable to continue.
Important considerations:
Estate planning laws are state specific.
Legal counsel is crucial.
These documents secure your wishes regarding assets and healthcare.
Resources: Elder law attorneys, estate planning professionals, and state bar associations.
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