Glossary

A

active ageing 
The process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age.

acute care / acute health care 
Care that is generally provided for a short period of time to treat a new illness or a flare-up of an existing condition.  This type of care may include treatment at home, short-term hospital stays, professional care, surgery, X-rays and scans, as well as emergency medical services.

adult care home / residential facility
A residence which offers housing and personal care services to a number of residents.  Services (such as meals, supervision and transportation) are usually provided by the owner or manager.  Usually 24-hour professional health care is not provided on site.

advance care planning 
Planning in advance for decisions that may have to be made prior to incapability or at the end of life.  People may choose to do this planning formally, by means of advance directives, or informally, through discussions with family members, friends and health care and social service providers, or a combination of both methods.

aged 
The state of being old.  A person may be defined as aged on a number of criteria including chronological age, functional assessment, legislation or cultural considerations.

aged care 
Services provided to people deemed to be aged or elderly.

ageing / aging  
The lifelong process of growing older at cellular, organ or whole-body level throughout the life span.

ageing / aging in place  
Meeting the desire and ability of people, through the provision of appropriate services and assistance, to remain living relatively independently in the community in his or her current home or an appropriate level of housing.  Ageing in place is designed to prevent or delay more traumatic moves to a dependent facility, such as a nursing home.

assisted living facility / assisted care living facility  
Establishment which provides accommodation and care for older or disabled persons who cannot live independently but do not need nursing care.  Residents are also provided with domestic assistance (meals, laundry, personal care).

autonomy 
The perceived ability to control, cope with and make personal decisions about how one lives on a daily basis, according to one’s own rules and preferences.

B

basic health service 
A network of health units providing essential health care to a population.  Basic health services include communicable disease control, environmental sanitation, maintenance of records for statistical purposes, health education of the public, public health nursing and medical care.

bereavement
A process of loss, grief and recovery, usually associated with death.

burden of disease  
The total significance of disease for society beyond the immediate cost of treatment.  It measures years of life lost to ill-health as the difference between total life expectancy and disability-adjusted life expectancy.

C

care
The application of knowledge to the benefit of a community or individual.  There are various levels of care:
intermediate care:  A short period of intensive rehabilitation and treatment to enable people to return home following hospitalization or to prevent admission to hospital or residential care.

primary care:  Basic or general health care focused on the point at which a patient ideally first seeks assistance from the medical care system.  It is the basis for referrals to secondary and tertiary level care.

secondary care:  Specialist care provided on an ambulatory or inpatient basis, usually following a referral from primary care.

tertiary care:  The provision of highly specialized services in ambulatory and hospital settings.

care-dependent  
Persons with chronic illnesses and/or impairments which lead to long-lasting disabilities in functioning and reliance on care (personal care, domestic life, mobility, self direction).

care home 
A residential facility that provides accommodation and offers a range of care and support services.  Care homes may provide a limited number of services to support low dependency or may provide a wide range of services to cater for the continuum from low to high dependency care.

caregiver
A person who provides support and assistance, formal or informal, with various activities to persons with disabilities or long-term conditions, or persons who are elderly.  This person may provide emotional or financial support, as well as hands-on help with different tasks.  Caregiving may also be done from long distance.

caregiver burden  
The emotional, physical and financial demands and responsibilities of an individual’s illness that are placed on family members, friends or other individuals involved with the individual outside the health care system.

chronic care
The ongoing provision of medical, functional, psychological, social, environmental and spiritual care services that enable people with serious and persistent health and/or mental conditions to optimize their functional independence and well-being, from the time of condition onset until problem resolution or death.  Chronic care conditions are multidimensional, interdependent, complex and ongoing.

community-based care / community-based services / programmes
The blend of health and social services provided to an individual or family in his/her place of residence for the purpose of promoting, maintaining or restoring health or minimizing the effects of illness and disability.  These services are usually designed to help older people remain independent and in their own homes.  They can include senior centres, transportation, delivered meals or congregate meals sites, visiting nurses or home health aides, adult day care and homemaker services.

community care  
Services and support to help people with care needs to live as independently as possible in their communities.

community health
The combination of sciences, skills and beliefs directed towards the maintenance and improvement of the health of all the people through collective or social actions.  The programmes, services and institutions involved emphasize the prevention of disease and the health needs of the population as a whole.  Community health activities change with changing technology and social values, but the goals remain the same.

community health care
Includes health services and integrates social care.  It promotes self care, independence and family support networks.

community health centre

An ambulatory health care programme, usually serving a catchment area which has scarce or non-existent health services or a population with special health needs.  These centres attempt to coordinate federal, state and local resources in a single organization capable of delivering both health and related social services to a defined population.

community health worker
A trained health worker who works with other health and development workers as a team.  The community health worker provides the first contact between the individual and the health system.  The types of community health worker vary between countries and communities according to their needs and the resources available to meet them.  In many societies, these workers come from and are chosen by the community in which they work.  In some countries they work as volunteers; normally those who work part-time or full-time are rewarded, in cash or in kind, by the community and the formal health services.

community involvement
The active involvement of people living together in some form of social organization and cohesion in the planning, operation and control of primary health care, using local, national and other resources.  In community involvement, individuals and families assume responsibility for their and their communities’ health and welfare, and develop the capacity to contribute to their own and their communities’ development.

continuing care 
The provision of one or more elements of care (nursing, medical, health-related services, protection or supervision, or assistance with personal daily living activities) to an older person for the rest of his or her life.

continuing care facility  
A facility which provides continuing care.

continuing care retirement community
A community which provides several levels of housing and services for older people, ranging from independent living units to nursing homes, on one site but generally in separate buildings.

D

day care centre 
A facility, operated by a local authority, voluntary organization, geriatric centre or acute hospital, providing activities for older people.  These activities, usually during the day for a determined period, are intended to promote independence and enhance living skills, and can include the provision of personal care and preparation of meals.

day hospital 
A facility, which may be attached to an acute hospital, geriatric centre or nursing home, providing non-residential care, such as medical care, nursing care, physiotherapy, occupational therapy, podiatry, speech therapy and counselling services, usually during the day.

day surgical centre / clinic  
A free-standing ambulatory surgery centre, independent of a hospital.

domiciliary care  
Care provided in an individual’s own home.

E

expectation of life  
The average number of years an individual of a given age is expected to live if current mortality rates continue to apply.
    See “life expectancy”.

extra care sheltered housing
Housing where there is additional support (such as the provision of meals and extra communal facilities) to that usually found in sheltered housing.  Sometimes called ‘very sheltered housing’.

F

foster care  
A form of assisted housing, usually provided in private homes owned and occupied by individuals or families, offering a place of residence, meals, housekeeping services, minimum supervision, and personal care for a fee to non-family members who do not require supervision by skilled medical personnel.

frail older person
An older person in need of a substantial level of care and support.

functionally disabled
A person with a physical or mental impairment that limits the individual’s capacity for independent living.

G

geriatric care  
Care of older persons that encompasses a wide range of treatments from intensive care to palliative care.

geriatric centre  
A facility specializing in services for older persons which include acute care, geriatric assessment, rehabilitation, medical and nursing services, therapy services and residential care.

geriatric medicine
The branch of medicine specializing in the health and illnesses of old age and the appropriate care and services.

gerontology 
The multidisciplinary study of all aspects of ageing, including health, biological, sociological, psychological, economic, behavioural and environmental factors.

H

health  
The state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.  Health has many dimensions (anatomical, physiological and mental) and is largely culturally defined.

health expectancy
A population-based measure of the proportion of the expected life span estimated to be healthful and fulfilling, or free of illness, disease and disability.

healthy ageing
An approach which recognizes that growing older is a part of living; recognizes the interdependence of generations; recognizes that everyone has a responsibility to be fair in their demands on other generations; fosters a positive attitude throughout life to growing older; eliminates age as a reason to exclude any person from participating fully in community life; promotes a commitment to activities which enhance well-being and health, choice and independence, and quality of life for all ages; encourages communities to value and listen to older people and to cater for the diverse preferences, motivations, characteristics and circumstances of older persons in a variety of ways.

home-from-hospital / hospital after-care schemes
Schemes providing nursing care, personal care or practical help for older people who have returned home after a stay in hospital.

home health aide
A person who, under the supervision of a home health or social service agency, assists an older, ill or disabled person with household chores, bathing, personal care and other daily living needs.

home help 
A person or a service providing practical help in the home, such as household chores, to support an older person with disabilities to remain living in his/her own home.

I

independence  
The ability to perform an activity with no or little help from others, including having control over any assistance required rather than the physical capacity to do everything oneself.

independent living
Living at home without the need for continuous help and with a degree of self determination or control over one’s activities.

informal assistance 
Help or supervision (usually unpaid) that is provided to persons with one or more disabilities by family, friends or neighbours (may or may not be living with them in a household).

institutional (care) health services
Health services delivered on an inpatient basis in hospitals, nursing homes or other inpatient institutions.  The term may also refer to services delivered on an outpatient basis by departments or other organizational units of such institutions, or sponsored by them.

integrated care
The methods and strategies for linking and coordinating the various aspects of care delivered by different care systems, such as the work of general practitioners, primary and specialty care, preventive and curative services, and acute and long-term care, as well as physical and mental health services and social care, to meet the multiple needs/problems of an individual client or category of persons with similar needs/problems.

intensive care
Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring.  It is usually administered in a specially equipped unit of a health care facility.  It can also be administered at home under certain circumstances (dialysis, respirators, etc.).

interim nursing home care 
Care provided in geriatric centres and acute hospitals to older persons who are in need of limited medical care and who are awaiting nursing home placement.

L

life cycle  
The entire course of a person’s life – from infancy to old age.  2 The genetically prescribed course followed by all living organisms, including humans.

life expectancy 
The average number of years of life remaining to a person at a particular age based on a given set of age-specific death rates, generally the mortality conditions existing in the period mentioned.

life span
The longest period over which the life of any plant or animal organism or species may extend, according to the available biological knowledge concerning it.

long-term care (LTC) / long-term aged care  
A range of health care, personal care and social services provided to individuals who, due to frailty or level of physical or intellectual disability, are no longer able to live independently.  Services may be for varying periods of time and may be provided in a person’s home, in the community or in residential facilities (e.g. nursing homes or assisted living facilities).  These people have relatively stable medical conditions and are unlikely to greatly improve their level of functioning through medical intervention.

longevity 
The duration of life.

M

mobility aid
Equipment item to help an individual to get around more easily, including wheelchairs, walking sticks and walking frames.

N

naturally occurring retirement communities
Geographic areas or multi-unit buildings that are not restricted to persons over a specified age, but which have evolved over time to include a significant number (typically, over 50%) of residents who are aged 60 and over.

neglect  
The refusal or failure on the part of a person (or persons) in a caring role to fulfil a care-giving obligation, either consciously or unintentionally, which results in physical or emotional distress for an older person.

nursing facility  
Licensed facility that provides skilled nursing care and rehabilitation services to functionally disabled, injured or sick individuals.

nursing home 
See “high dependency care facility”.

O

old people (old old) 
Persons aged 75 to 84 years in a categorization of “young old” (60-74) and “oldest old” as 85 years and over.

older person
A person who has reached a certain age that varies among countries but is often associated with the age of normal retirement.

oldest old person  
Persons aged 85 years and over in a categorization of “young old” (60-74) and “old old” (75-84).

P

palliative care 
The active total care offered to a person and that person’s family when it is recognized that the illness is no longer curable, in order to concentrate on the person’s quality of life and the alleviation of distressing symptoms.  The focus of palliative care is neither to hasten nor postpone death.  It provides relief from pain and other distressing symptoms and integrates the psychological and spiritual aspects of care.  It offers a support system to help relatives and friends cope during an individual’s illness and with their bereavement.

population ageing  
The increase over time in the proportion of the population of a specified older age.

preventive care  
Care that has the aim of preventing disease or its consequences.  It includes health care programmes aimed at warding off illnesses, early detection of disease, and inhibiting further deterioration of the body.

preventive medicine
The branch of medicine dealing with the prevention of disease and the maintenance of good health practices.

psychogeriatric facility  
Institutions which provide a domestic setting for confused, older people who require 24-hour care, but whose behaviour makes them unsuitable for accommodation in a general purpose facility.

Q

quality of life  
The product of the interplay between social, health, economic and environmental conditions which affect human and social development.  It is a broad-ranging concept, incorporating a person’s physical health, psychological state, level of independence, social relationships, personal beliefs and relationship to salient features in the environment.  As people age, their quality of life is largely determined by their ability to access needed resources and maintain autonomy and independence.

R

rehabilitation 
A proactive and goal-oriented activity to restore function and/or to maximize remaining function to bring about the highest possible level of independence, physically, psychologically, socially and economically.  It involves combined and coordinated use of medical, nursing and allied health skills, along with social, educational and vocational services, to provide individual assessment, treatment, regular review, discharge planning and follow-up.  Rehabilitation is concerned, not only with physical recovery, but also with psychological and social recovery and reintegration (or integration) of the person into the community.

reminiscence therapy 
Treatment which aims to stimulate older people’s memories by means of old films, pictures, objects, music etc.  It allows an older person to remember his or her life’s achievements and contribution and can enhance self-esteem.

residential care 
Provides accommodation and other care, such as domestic services (laundry, cleaning), help with performing daily tasks (moving around, dressing, personal hygiene, eating) and medical care (various levels of nursing care and therapy services).  Residential care is for older people with physical, medical, psychological or social care needs which cannot be met in the community.

residential care services
Accommodation and support for people who can no longer live at home.

restorative care
Services provided to older people on a short-term basis to restore their physical condition to a level which would allow them to return home with appropriate support.

retirement 
Period or life stage following termination of, and withdrawal from, regular employment.

retirement village / retirement community
A community which provides several levels/types of housing and services for older people, ranging from independent living units to nursing homes, on one site but generally in separate buildings.

S

self care
Health activities, including promotion, maintenance, treatment, care and health related decision-making, carried out by individuals and families.

senility  
The generalized characterization of progressive decline in mental or physical functioning as a condition of the ageing process.  Within geriatric medicine, this term has limited meaning and has generally been replaced by more specific terminology.

sheltered housing  
Purpose-built or adapted accommodation for older people with a warden and an emergency alarm system.  Different kinds of sheltered housing provide different levels of care.

short-term aged care 
Involves care designed to improve the physical wellbeing and restore the health of older people to an optimum level following a serious illness.

sitting service  
A service which involves a worker or volunteer going into an older person’s home to provide care whilst the carer takes a break for up to six hours.

social capital  
Kin and other sources of support available to an individual.

social care service 
Assistance with the activities of daily life (personal care, domestic maintenance, self-direction) delivered by a personal care helper, home helper or social worker and aimed at supporting older people who experience disabilities in functioning.

social control 
A process within society which both formally, through law, and informally, through customs, norms and mores, attempts to influence and order the actions of social groups and their members and thus maintain public order.

social exclusion  
A situation in which individuals are prevented from fully participating in society by factors such as age, poverty, disability or ethnicity.

social group
Any set of persons within society with particular demographic, economic or social characteristics.

social integration  
The extent to which individuals are engaged with their families, friends, neighbours and communities.

social isolation
A condition in which an individual has extremely limited social networks and supports.

social network  
An individual’s web of kinship, friendship and community ties.

social support
Emotional, instrumental and financial assistance obtained from an individual’s social network.  Social support provided by family, friends and neighbours is referred to as ‘informal support’, whereas social support provided by formal service agencies is called ‘formal support’.

T

terminal care  
Medical and nursing care of persons in the terminal stage of an illness.

W

welfare service  

A type of social care service supported through public funding.  Eligibility criteria vary from universal coverage to specialized requirements.

well-being
A dynamic state of physical, mental and social wellness; a way of life which equips the individual to realize the full potential of his/her capabilities and to overcome and compensate for weaknesses; a lifestyle which recognizes the importance of nutrition, physical fitness, stress reduction, and self responsibility.  Well-being has been viewed as the result of four key factors over which an individual has varying degrees of control: human biology, social and physical environment, health care organization (system), and lifestyle.