Reference

Home Care Glossary: Common Terms Families Need to Know

Updated August 2026

Reviewed by Valerie VanBooven, RN, BSN

ADLs (Activities of Daily Living)

The basic self-care tasks a person needs to manage independently: bathing, dressing, eating, toileting, transferring (moving in and out of a bed or chair), and continence. Difficulty with ADLs is a common trigger for home care and for Medicaid long-term care eligibility.

IADLs (Instrumental Activities of Daily Living)

More complex daily tasks beyond basic self-care: managing money, taking medications correctly, preparing meals, using the phone, shopping, doing laundry, and driving or arranging transportation. IADL difficulty often shows up before ADL difficulty does.

Home Care (Non-Medical / Personal Care)

Non-medical assistance with ADLs, IADLs, companionship, and supervision, provided in a person's home by a caregiver or home health aide. Home care is generally private-pay or Medicaid-funded and does not require a physician's order.

Home Health Care

Medical care delivered at home by licensed clinicians, such as skilled nursing, physical therapy, or wound care, ordered by a physician and typically covered by Medicare or Medicaid when specific eligibility criteria are met. Home health is short-term and skilled; home care is typically ongoing and non-medical.

HCBS (Home and Community-Based Services)

Medicaid-funded services delivered at home or in the community, rather than in a nursing facility, usually through a state HCBS waiver. HCBS can include personal care, respite, home modifications, adult day services, and case management.

Medicaid Waiver

A state program that 'waives' certain Medicaid rules to let eligible people receive long-term care services at home or in the community instead of in an institution. Waivers vary significantly by state in name, eligibility, and covered services.

Consumer Direction / Self-Direction

A Medicaid or state-program option that lets the care recipient (or a representative) hire, train, schedule, and sometimes dismiss their own caregiver, potentially including certain family members, instead of using an agency-assigned worker.

Level of Care

A clinical determination of how much assistance a person needs, often expressed as 'nursing facility level of care.' Many Medicaid waivers require this determination as a condition of eligibility, even though the person will receive care at home rather than in a facility.

Respite Care

Short-term care that gives a family caregiver a planned break, ranging from a few hours to several days. Respite may be delivered at home, at an adult day center, or in a facility, and is often available through state caregiver-support programs even when Medicaid or Medicare is not involved.

PACE (Program of All-Inclusive Care for the Elderly)

A Medicare/Medicaid program that provides comprehensive medical care and long-term services and supports through a single organization, for people 55 or older who need a nursing-facility level of care but can live safely in the community. Availability is limited to specific service areas.

Aid and Attendance

A VA pension add-on for wartime veterans or surviving spouses who need help with daily activities, are housebound, or meet certain other criteria. It adds monthly income that can be used toward home care but is not itself health insurance.

Veteran-Directed Care

A VA program that gives an eligible veteran a budget to hire caregivers directly, potentially including family or friends, rather than receiving VA-arranged home care services.

Area Agency on Aging (AAA)

A local or regional agency, funded partly through the federal Older Americans Act, that provides or connects older adults to services such as meals, transportation, caregiver support, and information and referral. Most counties or regions have one.

ADRC (Aging and Disability Resource Center)

A federally supported 'no wrong door' access point that helps people find long-term services and supports, regardless of income or diagnosis, often serving as a single phone number for benefits screening and referrals.

Estate Recovery

A federally required process that lets a state seek repayment, after a Medicaid recipient's death, for certain long-term care costs the state paid, generally from the value of the recipient's estate. This is a key reason families should get legal advice before major Medicaid planning decisions.

Look-Back Period

The window (typically five years) before a Medicaid long-term care application during which the state reviews financial records for asset transfers made for less than fair value. Transfers found during this period can create a penalty period of Medicaid ineligibility.

Spend-Down

The process of reducing countable income or assets to meet Medicaid's financial eligibility limits, often by paying for medical or care expenses. Rules vary by state and are easy to get wrong without guidance.

Care Plan

A written document describing a person's needs, goals, and the specific services or tasks a caregiver is authorized or expected to provide. A good care plan is reviewed and updated as needs change.

Care Manager / Geriatric Care Manager

A professional, often a nurse or social worker, who assesses needs, coordinates services, and helps families navigate the health and long-term care systems, usually for a private fee.

Custodial Care

Help with ADLs and daily supervision that does not require the skills of a licensed medical professional. Original Medicare generally does not cover ongoing custodial care when it's the only service needed.